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2型糖尿病患者健康相关生活质量及其决定因素的评估:一项横断面研究。

Assessment of Health-Related Quality of Life and Its Determinants in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study.

作者信息

Mishra Amit Kumar, Choudhary Manoj Kumar, Kumar Chandan, Kishor Anand, Kumari Anjali

机构信息

Department of General Medicine, Indira Gandhi Institute of Medical Sciences, Patna, IND.

出版信息

Cureus. 2024 Aug 3;16(8):e66055. doi: 10.7759/cureus.66055. eCollection 2024 Aug.

Abstract

Background Type 2 diabetes mellitus is a complex metabolic disorder associated with several complications that determine the quality of life of the patients. Health-related quality of life (HRQoL) is a measurable outcome of the self-perception of a patient's health which is affected due to age, lifestyle changes, medication, and treatment modalities. This study was undertaken to understand the impact of individual parameters of age, medication type and duration, diabetes-associated complications, and levels of glycated hemoglobin (HbA1c) on the quality of life (QoL) of the patient.  Methodology This single-center prospective, cross-sectional study was conducted at the Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India. Participants were recruited from the Outpatient Department of General Medicine, IGIMS. HRQoL was measured using a validated and reliable EuroQol 5-dimensions 5-levels (EQ-5D-5L) questionnaire developed by the EuroQol Research Foundation, along with the EuroQol-Visual Analogue Scale (EQ-VAS). The eligibility criteria included adult diabetic patients above 18 years of age with complete medical records, who had been treated at the outpatient department for a minimum of three months and could be interviewed. Results The results from this study show that 46% of the patients belonged to the age group of 45-65 years. The quality of health index scores and EQ-VAS scores significantly correlated with age (p-values: 1.11 e and 3.09 e; <0.05). Of the subjects, 66.4%, 6.7%, and 26.8% were under oral hypoglycaemic agents (OHA), insulin, and both insulin with OHA medications respectively. HbA1C levels were statistically significantly correlated with mobility, self-care, usual activities, pain or discomfort, and anxiety or depression (p-value 0.032; <0.05), along with self-perception of the patient's health (p-value 0.00026; <0.05). Also, the perception of having slight problems in mobility, self-care, usual activities, pain or discomfort, and anxiety or depression was similar irrespective of gender (EQ-5D-5L score for males: 9.47 and females: 9.3). Despite suffering from diabetes-associated chronic complications, 60.5% of the subjects perceived their overall health to be good as indicated by the scores. Conclusion The self-perception of HRQoL concerning mobility, self-care, usual activities, pain or discomfort, and anxiety or depression was correlated with age, duration of anti-diabetic medication, and HbA1C level. Good mobility, self-care, and performing usual activities reduce anxiety or depression as opposed to age, pain, and discomfort. However, the subjects in this study cohort perceived overall good health in themselves in terms of EQ-VAS and 5D-5L scores, indicating effective diabetic care and management options available to them.

摘要

背景 2 型糖尿病是一种复杂的代谢紊乱疾病,伴有多种并发症,这些并发症决定了患者的生活质量。健康相关生活质量(HRQoL)是患者对自身健康自我认知的可衡量结果,它会受到年龄、生活方式改变、药物治疗和治疗方式的影响。本研究旨在了解年龄、药物类型和用药时长、糖尿病相关并发症以及糖化血红蛋白(HbA1c)水平等个体参数对患者生活质量(QoL)的影响。

方法 这项单中心前瞻性横断面研究在印度比哈尔邦巴特那的英迪拉·甘地医学科学研究所(IGIMS)进行。研究对象从 IGIMS 的普通内科门诊招募。使用欧洲生活质量研究基金会开发的经过验证且可靠的欧洲五维度五水平量表(EQ - 5D - 5L)问卷以及欧洲生活质量视觉模拟量表(EQ - VAS)来测量 HRQoL。纳入标准包括年龄在 18 岁以上、有完整病历、在门诊接受治疗至少三个月且能够接受访谈的成年糖尿病患者。

结果 本研究结果显示,46%的患者年龄在 45 - 65 岁之间。健康指数得分和 EQ - VAS 得分与年龄显著相关(p 值分别为 1.11 e 和 3.09 e;<0.05)。在研究对象中,分别有 66.4%、6.7%和 26.8%的患者接受口服降糖药(OHA)、胰岛素以及胰岛素联合 OHA 治疗。HbA1C 水平与行动能力、自我护理、日常活动、疼痛或不适以及焦虑或抑郁在统计学上显著相关(p 值为 0.032;<0.05),同时也与患者对自身健康的自我认知相关(p 值为 0.00026;<0.05)。此外,无论性别如何,在行动能力、自我护理、日常活动、疼痛或不适以及焦虑或抑郁方面存在轻微问题的认知相似(男性 EQ - 5D - 5L 得分为 9.47,女性为 9.3)。尽管患有糖尿病相关的慢性并发症,但 60.5%的研究对象根据得分表明他们对自身整体健康状况的认知良好。

结论 关于行动能力、自我护理、日常活动、疼痛或不适以及焦虑或抑郁方面的 HRQoL 自我认知与年龄、抗糖尿病药物使用时长和 HbA1C 水平相关。良好的行动能力、自我护理和进行日常活动可减少焦虑或抑郁,而年龄、疼痛和不适则相反。然而,本研究队列中的研究对象根据 EQ - VAS 和 5D - 5L 得分认为自己整体健康状况良好,这表明他们可以获得有效的糖尿病护理和管理方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d75/11367283/d813af1124f4/cureus-0016-00000066055-i01.jpg

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