Petterson T, Lee P, Hollis S, Young B, Newton P, Dornan T
Department of Geriatric Medicine, Hope Hospital, Salford, Manchester, U.K.
Diabetes Care. 1998 Jun;21(6):930-5. doi: 10.2337/diacare.21.6.930.
To measure well-being and treatment satisfaction and their correlates in older people with diabetes.
A postal survey was conducted of 1,000 diabetic patients aged > or = 60 years, representing 56% of the resident older diabetic population in an inner-city health district with a largely indigenous population of 230,000 people and a widely varied socioeconomic mix. Well-being and treatment satisfaction were measured with diabetes-specific instruments and correlated with patient data held in a central register.
There was an 81% response. The general well-being scores (median [interquartile range]) for patients on diet alone, tablets, and insulin were 54 (44-60), 53 (42-61), and 48 (35-56) (P < 0.001 comparing insulin with diet and tablets) compared with a scale maximum of 66. Treatment satisfaction scores were 35 (31-36), 35 (32-36), and 34 (30-36) (P < 0.001 comparing insulin with diet and tablets), scale maximum 36. Mean HbA1c concentrations were 5.0 +/- 1.4% (for patients on diet alone), 5.8 +/- 1.6% (tablets), and 6.6 +/- 1.7% (insulin) (P < 0.001 for each difference). Neither well-being nor treatment satisfaction correlated with HbA1c. Insulin-treated patients were younger and had been diabetic longer than non-insulin-treated patients; their well-being remained slightly, but significantly, lower when adjusted for age, sex, BMI, and diabetes duration, but treatment satisfaction was no longer significantly different. Women had lower well-being than men.
It has proved possible to measure well-being and treatment satisfaction in a large community-based samples of older people with diabetes. At the level of glycemic control in this population, neither parameter correlated with HbA1c. The lower well-being in insulin-treated patients remained significant in multivariate analysis.
测量老年糖尿病患者的幸福感和治疗满意度及其相关因素。
对1000名年龄≥60岁的糖尿病患者进行了邮寄调查，这些患者占一个市中心健康区老年糖尿病居民人口的56%，该健康区主要为原住民，人口23万，社会经济构成多样。使用糖尿病专用工具测量幸福感和治疗满意度，并与中央登记处保存的患者数据相关联。
回复率为81%。仅接受饮食治疗、服用药物和使用胰岛素的患者的总体幸福感得分（中位数[四分位间距]）分别为54（44 - 60）、53（42 - 61）和48（35 - 56）（胰岛素治疗组与饮食和药物治疗组相比，P < 0.001），量表最高分为66。治疗满意度得分分别为35（31 - 36）、35（32 - 36）和34（30 - 36）（胰岛素治疗组与饮食和药物治疗组相比，P < 0.001），量表最高分为36。平均糖化血红蛋白（HbA1c）浓度分别为5.0±1.4%（仅接受饮食治疗的患者）、5.8±1.6%（服用药物患者）和6.6±1.7%（使用胰岛素患者）（各差异P < 0.001）。幸福感和治疗满意度均与HbA1c无关。胰岛素治疗的患者比非胰岛素治疗的患者更年轻，患糖尿病的时间更长；在调整年龄、性别、体重指数和糖尿病病程后，他们的幸福感仍略低但显著降低，但治疗满意度不再有显著差异。女性的幸福感低于男性。
已证明在大量基于社区的老年糖尿病患者样本中测量幸福感和治疗满意度是可行的。在该人群的血糖控制水平上，这两个参数均与HbA1c无关。在多变量分析中，胰岛素治疗患者较低的幸福感仍然显著。
