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马拉维利隆圭卡穆祖中央医院2型糖尿病患者的生活质量:一项混合方法研究。

Quality of life among type 2 diabetes mellitus patients at Kamuzu Central Hospital in Lilongwe, Malawi: A mixed-methods study.

作者信息

Chisalunda Alinafe, Ng'ambi Wingston Felix, Tarimo Nesto Salia, Banda Ndaziona Peter Kwanjo, Muula Adamson Sinjani, Kumwenda Johnstone, Nyondo-Mipando Alinane Linda

机构信息

Department of Physiotherapy, Mangochi District Hospital, Mangochi, Malawi.

Department of Health Systems and Policy, School of Global and Public Health, Kamuzu University of Health Sciences, Lilongwe, Malawi.

出版信息

PLOS Glob Public Health. 2023 Oct 9;3(10):e0002367. doi: 10.1371/journal.pgph.0002367. eCollection 2023.

Abstract

Type II diabetes mellitus (T2DM) significantly impacts quality of life (QoL) yet data among these patients in Malawi are lacking. This study was conducted to assess QoL among patients with T2DM. A mixed-method cross-section study was conducted at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. Data collection was done using a modified diabetes quality of life (MDQoL)-17 questionnaire for quantitative data while in-depth interviews and diary methods were used for qualitative data. Demographic data were summarized using descriptive statistics and inferential statistics using t-tests and ANOVA. Thematic analysis was utilized for qualitative data. A sample of 339 participants (mean age 50.3±15.5) was recruited. Overall, the mean QoL score was moderate (mean QoL 63.91±19.54). Those on health insurance had better QoL (QoL 76.71, C.I. 69.22-84.19, p-value 0.005) compared to those without health insurance. Furthermore, the absence of comorbidities was associated with having better QoL (QoL 71.18, C.I. 66.69-75.67, p-value < 0.0001). Qualitatively, T2DM was associated with patients' health status, increased stress levels, and loss of independence. There were QoL-promoting factors among T2DM patients such as diabetes health talks, having a supportive family, and following hospital advice. Inhibiting factors include drug shortages, societal perceptions, a sedentary lifestyle, stress, and despising hospital advice. Overall QoL in patients with T2DM receiving treatment at KCH is moderate. QoL of patients with T2DM is influenced by interrelated factors which require multidisciplinary team care to optimize the QoL among these patients. Health workers need to adopt a holistic approach when treating patients with T2DM, such as managing comorbidities and including assessment of QoL, behavioral change measures like physical exercises, and a healthy diet.

摘要

2型糖尿病(T2DM)对生活质量(QoL)有显著影响,但马拉维这些患者的数据却很缺乏。本研究旨在评估T2DM患者的生活质量。在马拉维利隆圭的卡穆祖中央医院(KCH)进行了一项混合方法横断面研究。定量数据收集使用改良的糖尿病生活质量(MDQoL)-17问卷,而定性数据则采用深入访谈和日记法收集。人口统计学数据采用描述性统计进行总结,推论统计采用t检验和方差分析。定性数据采用主题分析。招募了339名参与者(平均年龄50.3±15.5)。总体而言,生活质量平均得分中等(平均QoL 63.91±19.54)。与没有医疗保险的患者相比,有医疗保险的患者生活质量更好(QoL 76.71,置信区间69.22 - 84.19,p值0.005)。此外,没有合并症与生活质量更好相关(QoL 71.18,置信区间66.69 - 75.67,p值<0.0001)。定性方面,T2DM与患者的健康状况、压力水平增加和独立性丧失有关。T2DM患者中存在一些促进生活质量的因素,如糖尿病健康讲座、有支持性的家庭以及遵循医院建议。抑制因素包括药品短缺、社会认知、久坐的生活方式、压力以及轻视医院建议。在KCH接受治疗的T2DM患者的总体生活质量中等。T2DM患者的生活质量受到相互关联的因素影响,这需要多学科团队护理来优化这些患者的生活质量。医护人员在治疗T2DM患者时需要采取整体方法,如管理合并症、包括评估生活质量、采取体育锻炼等行为改变措施以及健康饮食。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3197/10561856/0029dd4c5d57/pgph.0002367.g001.jpg

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