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生活质量与1型糖尿病:一项评估患者认知及自我管理需求的研究

Quality of life and type 1 diabetes: a study assessing patients' perceptions and self-management needs.

作者信息

Alvarado-Martel Dácil, Velasco Rebeca, Sánchez-Hernández Rosa M, Carrillo Armando, Nóvoa Francisco Javier, Wägner Ana María

机构信息

Servicio de Endocrinología y Nutrición, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria ; Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.

Servicio de Endocrinología y Nutrición, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria.

出版信息

Patient Prefer Adherence. 2015 Sep 14;9:1315-23. doi: 10.2147/PPA.S87310. eCollection 2015.

Abstract

PURPOSE

The main objective of this study was to assess quality of life (QoL) and treatment satisfaction in a group of patients with type 1 diabetes (T1D) and explore their needs regarding and their perception of QoL living with diabetes.

MATERIALS AND METHODS

Patients with type 1 diabetes attending the outpatient endocrinology clinics of a reference hospital were invited to participate in a cross-sectional study. Clinical and sociodemographic data were obtained (interview and clinical records), and diabetes-related QoL was assessed using a standardized questionnaire. In 67 participants, satisfaction with treatment was also assessed, and an open interview was performed, assessing the impact of diabetes, long-term worries, flexibility, restrictions, and self-perception of QoL. Descriptive statistical analysis, bivariate analysis, and multivariate analysis were performed in order to find factors associated with QoL. Interviews were analyzed and summarized questionwise.

RESULTS

Mean patient age was 31.4±11.6 years, diabetes duration 14.2±9.3 years, and glycated hemoglobin (HbA1c) 8.5%±1.9% (69±20.8 mmol/mol International Federation of Clinical Chemistry [IFCC]). The questionnaires showed good average QoL scores (94.6+22.9) and treatment satisfaction scores (25.7±6.7). QoL worsened with increasing HbA1c, female sex, severity of complications, and lower education (r (2)=0.283, P<0.005). In the open interview, 68.5% of the patients reported that diabetes had changed their lives, 83.5% identified complications as their most important long-term concern, and 59.7% said that they needed more training to manage the disease.

CONCLUSION

Poor glycemic control, lower education, complications, and female sex are associated with worse QoL. Semi-structured interviews identified aspects not included in the standardized questionnaires.

摘要

目的

本研究的主要目的是评估一组1型糖尿病(T1D)患者的生活质量(QoL)和治疗满意度,并探讨他们对糖尿病生活质量的需求和认知。

材料与方法

邀请在一家参考医院门诊内分泌科就诊的1型糖尿病患者参与一项横断面研究。获取临床和社会人口统计学数据(访谈和临床记录),并使用标准化问卷评估与糖尿病相关的生活质量。对67名参与者还评估了治疗满意度,并进行了开放式访谈,评估糖尿病的影响、长期担忧、灵活性、限制以及生活质量的自我认知。进行描述性统计分析、双变量分析和多变量分析以找出与生活质量相关的因素。对访谈进行逐题分析和总结。

结果

患者平均年龄为31.4±11.6岁,糖尿病病程为14.2±9.3年,糖化血红蛋白(HbA1c)为8.5%±1.9%(国际临床化学联合会[IFCC]为69±20.8 mmol/mol)。问卷显示平均生活质量得分良好(94.6+22.9),治疗满意度得分(25.7±6.7)。生活质量随着HbA1c升高、女性、并发症严重程度增加和教育程度降低而恶化(r(2)=0.283,P<0.005)。在开放式访谈中,68.5%的患者报告糖尿病改变了他们的生活,83.5%的患者认为并发症是他们最重要的长期担忧,59.7%的患者表示他们需要更多疾病管理培训。

结论

血糖控制不佳、教育程度较低、并发症和女性与较差的生活质量相关。半结构化访谈确定了标准化问卷未涵盖的方面。

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