Type 2 Diabetes Self-Management Variables and Predictors

2021 ◽  
pp. 105477382110673
Author(s):  
Karin A. Emery ◽  
Jo Robins ◽  
Jeanne Salyer ◽  
Linda Thurby-Hay ◽  
Gemechis Djira

Guided by the Self and Family-Management framework, relationships between diabetes distress, self-efficacy, resilience and outcomes of A1c, quality of life and health status were explored. A cross sectional descriptive design was used. 78 individuals were enrolled from US clinics. Data were analyzed to test for associations, main effects and interactions and predictors of self-management. Results indicated low diabetes distress ( M = 20.53), high self-efficacy ( M = 7.32), moderate resilience ( M = 80.27), and mean A1c 7.35%/56.88 mmol/mol. 76% scored above the mental health norm, 46% scored above the physical health norm. Average weighted quality of life = −1.74. Diabetes distress was negatively associated with self-efficacy, resilience, physical health, mental health, and quality of life. Self-efficacy was positively associated with resilience, physical health and quality of life. Resilience was positively associated with physical health, mental health and quality of life. Positive associations were found between quality of life, physical and mental health. No associations were found between A1c and variables in the study. Multiple significant interactions were found with A1c, mental health and quality of life outcomes. Terms in the model included treatment regimen, years since diagnosis, provider collaboration and history of diabetes self-management education. Distress was a significant predictor of health status and quality of life. The results confirm self-management facilitators self-efficacy and resilience and barrier diabetes distress and their relationships with outcomes in the framework. This study contributes to the understanding of the emotional aspect of diabetes. Continuing this work will allow researchers to better understand self-management, support self-management efforts and better outcomes.

Author(s):  
Robert Brackbill ◽  
Howard Alper ◽  
Patricia Frazier ◽  
Lisa Gargano ◽  
Melanie Jacobson ◽  
...  

Fifteen years after the disaster, the World Trade Center Health Registry (Registry) conducted The Health and Quality of Life Survey (HQoL) assessing physical and mental health status among those who reported sustaining an injury on 11 September 2001 compared with non-injured persons. Summary scores derived from the Short Form-12 served as study outcomes. United States (US) population estimates on the Physical Component Score (PCS-12) and Mental Component Score (MCS-12) were compared with scores from the HQoL and were stratified by Post-traumatic Stress Disorder (PTSD) and injury status. Linear regression models were used to estimate the association between both injury severity and PTSD and PCS-12 and MCS-12 scores. Level of injury severity and PTSD history significantly predicted poorer physical health (mean PCS-12). There was no significant difference between injury severity level and mental health (mean MCS-12). Controlling for other factors, having PTSD symptoms after 9/11 predicted a nearly 10-point difference in mean MCS-12 compared with never having PTSD. Injury severity and PTSD showed additive effects on physical and mental health status. Injury on 9/11 and a PTSD history were each associated with long-term decrements in physical health status. Injury did not predict long-term decrements in one’s mental health status. Although it is unknown whether physical wounds of the injury healed, our results suggest that traumatic injuries appear to have a lasting negative effect on perceived physical functioning.


2015 ◽  
Vol 20 (4) ◽  
pp. 242-255 ◽  
Author(s):  
Andy Turner ◽  
Alba X. Realpe ◽  
Louise M. Wallace ◽  
Joanna Kosmala-Anderson

Purpose – There is growing interest in self-management support for people living with mental health problems. The purpose of this paper is to describe the evaluation of a co-designed and co-delivered self-management programme (SMP) for people living with depression delivered as part of large scale National Health Service quality improvement programme, which was grounded in the principles of co-production. The authors investigated whether participants became more activated, were less psychologically distressed enjoyed better health status, and quality of life, and improved their self-management skills after attending the seven-week SMP. Design/methodology/approach – The authors conducted a longitudinal study of 114 people living with depression who attended the SMP. Participants completed self-reported measures before attending the SMP and at six months follow up. Findings – Patient activation significantly improved six months after the SMP (baseline M=49.6, SD=12.3, follow up M=57.2, SD=15.0, t(113)=4.83, p < 0.001; d=0.61). Participants’ experience of depression symptoms as measured by the Patient Health Questionnaire-9 significantly reduced (baseline M=15.5, SD=6.8, follow up M=10.6, SD=6.9, t(106)=7.22, p < 0.001, d=−0.72). Participants’ anxiety and depression as measured by the Hospital Anxiety Depression Scale also decreased significantly (baseline anxiety: M=13.1, SD=4.2, follow up M=10.2, SD=4.4, t(79)=6.29, p < 0.001, d=−0.69); (baseline depression: M=10.3, SD=4.6, follow up M=7.7, SD=4.5, t(79)=5.32, p < 0.001, d=−0.56). The authors also observed significant improvement in participants’ health status (baseline M=0.5, SD=0.3, follow up M=0.6, SD=0.3, t(97)=−3.86, p < 0.001, d=0.33), and health-related quality of life (baseline M=45.4, SD=20.5, follow up M=60.8, SD=22.8, t(91)=−2.71, p=0.008, d=0.75). About 35 per cent of participant showed substantial improvements of self-management skills. Originality/value – The co-produced depression SMP is innovative in a UK mental health setting. Improvements in activation, depression, anxiety, quality of life and self-management skills suggest that the SMP could make a useful contribution to the recovery services in mental health.


2020 ◽  
Vol 13 (2) ◽  
pp. 119-128
Author(s):  
Kirill Kosilov ◽  
Hiroki Amedzawa ◽  
Irina Kuzina ◽  
Vladimir Kuznetsov ◽  
Liliya Kosilova

Aim: The study of the impact of socio-economic, demographic factors and polymorbidity on the quality of life associated with health (HRQoL) in elderly people from Japan and Russia. Background: Factors affecting the quality of life of the elderly in both countries are poorly understood. Objective: Make a comparative analysis of factors affecting the quality of life of the elderly of both sexes in Japan and Russia. Methods: The age range in this study is 65-95 years old. For the study of HRQoL, a questionnaire Health Status Survey-Short Form 36v2 was used, including two main domains: physical and mental health. The level of polymorbidity was studied using CIRS-G. The linear regression model of the influence of variables upon HRQoL was calculated for SES, demographic characteristics, and morbidity. Results: Strong associations with HRQoL in the combined sample had a living together with relatives (r=6.94 (5.17-8.72) p<0,05), the incidence rate (r=8.50 (5.51-11.49), p<0.01) and the older age (r=5.39 (2.63-8.16), p<0,01.). The elderly inhabitants of Japan had a higher self-assessment for physical health in the age ranges 65-74 and over 85 years old (p<0.05), and a higher selfassessment of mental health at the age of 75-84 years old. Sixty-eight elderly Japanese and 48% Russians estimated their physical health as normal. Conclusion: The effect of living together, morbidity and age upon HRQoL is manifested equally strongly both among the inhabitants of Japan and among the Russians. The elderly Japanese estimate the state of physical and mental health as a whole higher than their Russian peers.


Medicina ◽  
2007 ◽  
Vol 43 (9) ◽  
pp. 736 ◽  
Author(s):  
Daina Krančiukaitė ◽  
Daiva Rastenytė ◽  
Kristina Jurėnienė ◽  
Diana Šopagienė

The aim of the study was to compare the quality of life among stroke survivors and healthy controls and to evaluate the influence of age, sex, and social and demographic factors on the quality of life. Contingent and methods. The case group consisted of 508 inhabitants of Kaunas city who were 25–84 years of age and had experienced their first stroke. The control group consisted of age- and sex-stratified randomly selected 508 stroke-free inhabitants of Kaunas city. The quality of life was evaluated using the SF- 12 questionnaire. The study compared the quality of life between stroke survivors and controls in eight domains of quality of life and compared the evaluation of quality of life considering social and demographic features. Results. In the domain of physical and mental health, stroke survivors presented poorer evaluation of their quality of life compared to controls except for the evaluations of mental health in the age groups of 25–34 and 35–44 years. As compared to healthy controls, stroke survivors presented poorer evaluation of their quality of life in all domains except for pain. Only in the control group, females presented poorer evaluation of physical health, whereas no differences in the evaluation of mental health between sexes were found. The evaluation of physical health in both groups worsened with age. Both stroke survivors and controls presented better evaluation of their physical health if they were living not alone, were better educated, and were employed compared to those who were living alone, had poorer education level, and were unemployed. In addition, controls who were currently or previously engaged in mental work evaluated their physical health better. Conclusions. Stroke survivors presented poorer evaluations of their quality of life in both physical and mental health domains compared to controls. Only in the control group, females evaluated their physical health worse than males did. In both groups studied, poorer evaluation of physical health was associated with older age and lower social and demographic status. Relationship between mental health and subjects’ social and demographic status was not statistically significant in either of the studied groups.


2020 ◽  
Vol 7 (3) ◽  
pp. 991-997
Author(s):  
Maria Kilikova

Introduction: The quality of a women's life is very closely related to their health. Oncogynecological disease brings substantial changes into their life that women need to adapt to them. As determination of quality of life is in nurse competence, the quality of life in women with diagnosed oncogynecological illness and surgical treatment has been described in the paper. Aim: The aim of the paper was to examine cancer's influence on the quality of life based on physical health, survival, social relationships, and the environmental domains. Methods: The sample consisted of 84 female respondents with surgical treatment of oncogynecological disease and the patients fulfilled the standardized WHOQOL-BREF questionnaire. Results: The results have shown that patients experienced significant reductions in the quality of life in regard to physical and mental health. Social and environmental domain were significantly less affected. Conclusions: The oncogynecoogical diseases significantly affect quality of life in all four investigated domains, but to a different extent. These findings emphasize an individual approach that takes into account not only the nursing aspect but also the ability to respond to a variety of other related factors that affect the quality of women with oncogynecological disease.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 740-740
Author(s):  
Andrea Huseth-Zosel ◽  
Heather Fuller

Abstract The COVID-19 pandemic is a public health crisis the world has not seen in a century, with older adults faced with unique impacts due to their increased vulnerability and need to social distance. This research examines changes in physical and mental health and quality of life among older adults in the upper Midwest during the COVID-19 pandemic. Seventy older adults aged 70-97 participated in three phone interviews (April [Time 1], June [Time 2], and October [Time 3] 2020) focusing on experiences coping with the pandemic and understanding overall changes in well-being. Participants rated their quality of life, physical health, and mental health on a scale from 1 to 5 with 1 being “Poor” and 5 being “Excellent.” Self-reported quality of life, mental health, and physical health initially declined between retrospective pre-COVID and Time 1 scores, with gradual increases seen across all three variables for Time 2 and Time 3 scores. Thematic analysis of qualitative responses for each interview wave identified salient themes of: 1) reduced quality of life, 2) distraction and routine, 3) loss and uncertainty, and 4) resilience and adaptation. The significance and meaning of these themes shifted across each time point. For example, the reduced quality of life theme initially encompassed loss of activities, later shifted to concerns about struggles to maintain relationships, and finally focused on hope for the future. Findings will be discussed in light of the significance of change over time as well as policy and practice implications for older adults.


2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S415-S415 ◽  
Author(s):  
Evan Tzanis ◽  
Surya Chitra ◽  
Marla Curran ◽  
Paul McGovern ◽  
Jordan Hinahara ◽  
...  

Abstract Background The appearance of multidrug-resistant Gram-positive bacteria is a major challenge in clinical care. Omadacycline is the first aminomethylcycline antibiotic (semisynthetic compounds related to tetracyclines) in late-stage clinical development for acute bacterial skin and skin structure infections (ABSSSI), and demonstrates potent in vitro activity against many pathogens. Methods Seven hundred thirty-five patients were enrolled in the OASIS-2 randomized controlled trial comparing omadacycline and linezolid for the treatment of adult subjects with ABSSSI known or suspected to be due to a Gram-positive pathogen, with 368 and 367 enrolled in each group, respectively. Subjects completed the 36-Item Short Form Health Survey Version 2 (SF-36v2), a validated questionnaire on physical and mental health, at both screening and post-treatment evaluation. Results of the SF-36v2 were analyzed in accordance with established norm-based standards for the survey (Ware 2000) for the intention-to-treat population. Results Subjects who received omadacycline experienced a 3.25 point mean improvement in overall physical health (P &lt; 0.001, Figure 1) and reported significant improvements across all but one component parameter of overall physical and mental health, including physical functioning, bodily pain, role physical, vitality, role emotional, mental health, and social functioning (Figure 2). In contrast, while overall physical health improved for subjects who received linezolid, the improvement in vitality, role emotional, mental health, and general health was not significant (Figure 2). Although omadacycline achieved greater increase from baseline than linezolid across all domains analyzed, the difference in scores was not statistically significant at the P &lt; 0.05 level (Figure 1). Conclusion Omadacycline provides significant improvement in the physical component of quality of life over baseline for adult subjects with ABSSSI known or suspected to be due to a Gram-positive pathogen. Although the OASIS-2 trial was neither designed nor powered to measure differences in quality of life following treatment, trends identified in this analysis merit further investigation. References 1. Ware JE. SF-36 Health Survey Update. SPINE 2000; 25(24); 3130–3139. Disclosures E. Tzanis, Paratek Pharmaceuticals: Employee, Salary. M. Curran, Paratek Pharmaceuticals: Employee, Salary. P. McGovern, Paratek Pharmaceuticals: Employee, Salary. J. Hinahara, Paratek Pharmaceuticals: Consultant, Consulting fee. T. Goss, Paratek Pharmaceuticals: Consultant, Consulting fee.


2009 ◽  
Vol 124 (5) ◽  
pp. 692-701 ◽  
Author(s):  
Haomiao Jia ◽  
Erica I. Lubetkin

Objectives. Although numerous studies have examined health-related quality of life (HRQOL) longitudinally, little is known about the impact of seasonality on HRQOL. We examined trend and seasonal variations of population HRQOL. Methods. We used data from the monthly Behavioral Risk Factor Surveillance System (BRFSS). We examined monthly observed mean physically and mentally unhealthy days from January 1993 to December 2006, using the structural time-series model to estimate the trend and seasonality of HRQOL. Results. We found overall worsening physical and mental health during the time period and a significant and regular seasonal pattern in both physical and mental health. The worst physical health was during the winter and the best physical health was during the summer. The mean number of physically unhealthy days in January was 0.63 days higher than in July. The worst mental health occurred during the spring and fall, but the magnitude of the seasonal effect was much smaller. The difference between the best and worst months of mentally unhealthy days was approximately 0.23 days. We found significant differences in unadjusted and season-adjusted unhealthy days in many counties. Conclusions. Our findings can be used to examine time-varying causal factors and the impact of interventions, such as policies designed to improve population health. Our findings also demonstrated the need for calculating season-adjusted HRQOL scores when examining cross-sectional factors on the population HRQOL measures for continuous surveys or longitudinal data.


Author(s):  
Dominik Joskowiak ◽  
Daniela Meusel ◽  
Christine Kamla ◽  
Christian Hagl ◽  
Gerd Juchem

Abstract Background With increasing importance, health-related quality of life (HRQoL) has become a crucial outcome measure of cardiac surgery. The aim of this study was to assess the dynamics of HRQoL change within 12 months after surgery and to identify predictors of deterioration in physical and mental health. Methods The cohort of this prospective study included 164 consecutive patients who underwent elective surgery. HRQoL was assessed on the basis of the Short-Form 36 questionnaire at three different times: upon admission and at 3 and 12 months after surgery. The minimal clinically important difference (MCID) was used to determine whether the surgery resulted in deterioration of HRQoL. Results In general, physical and mental health status improved within the first year after cardiac surgery. However, after 12 months, 7.9 and 21.2% of patients had clinically significant poorer physical (PCS) and mental component summary (MCS) scores, based on the MCID approach. The results of multivariate analysis identified preoperative health status, age < 70 years, coronary artery bypass grafting, and a previous neurological event as predictors of deterioration in postoperative HRQoL. The greatest risks for deterioration were higher preoperative PCS and MCS scores. Conclusion Although we were able to demonstrate a general improvement in the HRQoL following cardiac surgery, in one-fifth of patients, there was no recovery of mental health status even after 1 year. As this effect is mainly determined by preoperative functional status, HRQoL should be an integral part of medical consultation, especially in younger patients with a positive perception of quality of life.


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