scholarly journals Self-management behavior and fasting plasma glucose control in patients with type 2 diabetes mellitus over 60 years old: multiple effects of social support on quality of life

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xinye Qi ◽  
Jiao Xu ◽  
Guiying Chen ◽  
Huan Liu ◽  
Jingjing Liu ◽  
...  

Abstract Objective Elderly patients with type 2 diabetes mellitus are highly vulnerable due to severe complications. However, there is a contradiction in the relationship between social support and quality of life, which warrants further exploration of the internal mechanism. This study assessed the quality of life and its interfering factors in this patient population. Methods In total, 571 patients with type 2 diabetes mellitus over 60 years old were recruited from two community clinics in Heilongjiang Province, China. We collected data on health status, quality of life, self-management behavior, fasting plasma glucose (FPG) level, and social support. Structural equation modeling and the bootstrap method were used to analyze the data. Results The average quality of life score was − 29.25 ± 24.41. Poorly scored domains of quality of life were “Psychological feeling” (− 8.67), “Activity” (− 6.36), and “Emotion” (− 6.12). Of the 571 patients, 65.32% had normal FPG, 9.8% had high-risk FPG, 15.94% had good self-management behavior, and 22.07% had poor social support. Significant correlations among social support, self-management behavior, FPG level, and quality of life were noted. A multiple mediator model revealed that social support influenced quality of life in three ways: (1) directly (c′ = 0.6831); (2) indirectly through self-management behavior (a1*b1 = 0.1773); and (3) indirectly through FPG control (a2*b2 = 0.1929). Self-management behavior influenced the quality of life directly and indirectly through FPG control. Conclusion Improving self-management behavior and monitoring hypoglycemia should become priority targets for future intervention. Scheduled social support to self-management projects should be put into the standardized management procedure. Physicians should provide substantial and individualized support to the elderly patients with type 2 diabetes mellitus regarding medication, blood glucose monitoring, and physical exercise.

2020 ◽  
Author(s):  
Xinye Qi ◽  
Jiao Xu ◽  
Guiying Chen ◽  
Huan Liu ◽  
Jingjing Liu ◽  
...  

Abstract Objective: Elderly patients with type 2 diabetes mellitus are highly vulnerable due to serious complications. Thus far, there is little research on the relationship between social support and quality of life, which warrants further exploration of the internal mechanism. This study assessed quality of life and its interfering factors in this patient population.Methods: In total, 571 patients with type 2 diabetes mellitus over 60 years old were recruited from two community clinics in Heilongjiang province, China. We collected data on health status, quality of life, self-management behavior, fasting plasma glucose (FPG) level, and social support. Structural equation modeling and the bootstrap method were used to analyze the data. Results: The average quality of life score was -29.25 ± 24.41. Poorly scored domains of quality of life were “Psychological feeling” (-8.67), “Activity” (-6.36), and “Emotion” (-6.12). Of the 571 patients, 65.32% had normal FPG, 9.8% had high-risk FPG, 15.94% had good self-management behavior, and 22.07% had poor social support. Significant correlations among social support, self-management behavior, FPG level, and quality of life were noted. A multiple mediator model revealed that social support influenced quality of life in three ways: (i) directly (c´ = 0.6549); (ii) indirectly through self-management behavior (a1*b1 = 0.2596); and (iii) indirectly through FPG control (a2*b2 = 0.2825). Self-management behavior influenced quality of life directly and indirectly through FPG control. Conclusion: Improving self-management behavior and monitoring hypoglycemia should become priority targets for future intervention. Scheduled social support to self-management projects should be put into the standardized management procedure. Physicians should provide substantial and individualized support to elderly patients with type 2 diabetes mellitus regarding medication, blood glucose monitoring, and physical exercise.


2020 ◽  
Author(s):  
Jorge Caro-Bautista ◽  
Carmen Rodriguez-Blazquez ◽  
David Perez-Manchon ◽  
Eva Timonet ◽  
Gloria Carvajal ◽  
...  

Abstract Background: Worldwide, type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic diseases and one of those producing greatest impact on patients’ day-to-day quality of life. Our study aim is to validate the “Living with Chronic Illness Scale” for a Spanish-speaking T2DM population.Methods: In this observational, international, cross-sectional study, 582 persons with T2DM were recruited in primary care and outpatient hospital consultations, in Spain and Colombia, during the period from May 2018 to June 2019. The properties analysed were feasibility/acceptability, internal consistency, reliability, precision and (structural) content-construct validity including confirmatory factor analysis (CFA). The COSMIN checklist was used to assess the methodological/psychometric quality of the instrument.Results: The scale had an adequate internal consistency and test retest reliability (Cronbach’s alpha = 0.90; intraclass correlation coefficient = 0.96, respectively). In addition, the instrument is precise (standard error of measurement = 3.34, with values <½SD = 8.52) and correlates positively with social support (DUFSS) (rs = 0.56), quality of life (WHOQOL) (rs = 0.51-0.30) and satisfaction (SLS-6) (rs = 0.50-0.38). The original 26-items version of the scale did not support totally the CFA. The COSMIN checklist is favourable for all the properties analysed, although weaknesses are detected for structural validity.Conclusions: The LW-CI-T2DM is a valid, reliable and accurate instrument for use in clinical practice to determine how a person’s life is affected by the presence of diabetes. This instrument correlates well with the associated constructs of social support, quality of life and satisfaction. Additional research is needed to determine how well the questionnaire structure performs when robust factor analysis methods are applied.


2020 ◽  
Author(s):  
Jorge Caro-Bautista ◽  
Carmen Rodriguez-Blazquez ◽  
David Perez-Manchon ◽  
Eva Timonet ◽  
Gloria Carvajal ◽  
...  

Abstract Background: Worldwide, type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic diseases and one of those producing greatest impact on patients’ day-to-day quality of life. Our study aim is to validate the “Living with Chronic Illness Scale” for a Spanish-speaking T2DM population.Methods: In this observational, international, cross-sectional study, 582 persons with T2DM were recruited in primary care and outpatient hospital consultations, in Spain and Colombia, during the period from May 2018 to June 2019. The properties analysed were feasibility/acceptability, internal consistency, reliability, precision and (structural) content-construct validity including confirmatory factor analysis (CFA). The COSMIN checklist was used to assess the methodological/psychometric quality of the instrument.Results: The scale had an adequate internal consistency and test retest reliability (Cronbach’s alpha = 0.90; intraclass correlation coefficient = 0.96, respectively). In addition, the instrument is precise (standard error of measurement = 3.34, with values <½SD = 8.52) and correlates positively with social support (DUFSS) (rs = 0.56), quality of life (WHOQOL) (rs = 0.51-0.30) and satisfaction (SLS-6) (rs = 0.50-0.38). The CFA supported the 5-domains structure, but a 23-item version showed better fit: CMIN/df= 3.11; goodness of fit index= 0.91; comparative fit index= 0.91 and root mean square error of approximation = 0.06 (90% confidence interval, 0.06-0.07). The COSMIN checklist is favourable for all the properties analysed, although weaknesses are detected for content validity.Conclusions: “Living with T2DM” (LW-T2DM) is a valid, reliable and accurate instrument for use in clinical practice to determine how a person’s life is affected by the presence of diabetes. This instrument correlates well with the associated constructs of social support, quality of life and satisfaction. Additional research is needed to determine how well the questionnaire structure performs when robust factor analysis methods are applied.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jorge Caro-Bautista ◽  
Carmen Rodríguez-Blázquez ◽  
David Perez-Manchon ◽  
Eva Timonet-Andreu ◽  
Gloria Carvajal-Carrascal ◽  
...  

Abstract Background Worldwide, type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic diseases and one of those producing greatest impact on patients’ day-to-day quality of life. Our study aim is to validate the “Living with Chronic Illness Scale” for a Spanish-speaking T2DM population. Methods In this observational, international, cross-sectional study, 582 persons with T2DM were recruited in primary care and outpatient hospital consultations, in Spain and Colombia, during the period from May 2018 to June 2019. The properties analysed were feasibility/acceptability, internal consistency, reliability, precision and (structural) content-construct validity including confirmatory factor analysis. The COSMIN checklist was used to assess the methodological/psychometric quality of the instrument. Results The scale had an adequate internal consistency and test retest reliability (Cronbach’s alpha = 0.90; intraclass correlation coefficient = 0.96, respectively). In addition, the instrument is precise (standard error of measurement = 3.34, with values < ½SD = 8.52) and correlates positively with social support (DUFSS) (rs = 0.56), quality of life (WHOQOL-BREF) (rs = 0.51–0.30) and ssatisfaction with life (SLS-6) (rs = 0.50–0.38). The original 26-items version of the scale did not support totally the confirmatory factor analysis. The COSMIN checklist is favourable for all the properties analysed, although weaknesses are detected for structural validity. Conclusions The LW-CI-T2DM is a valid, reliable and accurate instrument for use in clinical practice to determine how a person’s life is affected by the presence of diabetes. This instrument correlates well with the associated constructs of social support, quality of life and satisfaction. Additional research is needed to determine how well the questionnaire structure performs when robust factor analysis methods are applied.


2020 ◽  
Author(s):  
Jorge Caro-Bautista ◽  
Carmen Rodriguez-Blázquez ◽  
David Perez-Manchon ◽  
Eva Timonet ◽  
Gloria Carvajal ◽  
...  

Abstract Background: Worldwide, type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic diseases and one of those producing greatest impact on patients’ day-to-day quality of life. Our study aim is to validate the “Living with Chronic Illness Scale” for a Spanish-speaking T2DM population.Methods: In this observational, international, cross-sectional study, 582 persons with T2DM were recruited in primary health care and outpatient hospital consultations, in Spain and Colombia, during the period from May 2018 to June 2019. The properties analysed were feasibility/acceptability, internal consistency, reliability, precision and (structural) content-construct validity. The COSMIN checklist was used to assess the methodological/psychometric quality of the instrument.Results: The instrument has adequate internal consistency and test retest reliability (Cronbach’s alpha = 0.90; intraclass correlation coefficient = 0.96, respectively). In addition, the instrument is accurate (standard error of measurement = 3.34, with values <½SD = 8.52 considered acceptable) and correlates positively with social support (DUFSS) (rs = 0.56), quality of life (WHOQOL) (rs = 0.51-0.30) and satisfaction (SLS-6) (rs = 0.50-0.38). The questionnaire discriminates by the level of severity of the illness (Patient Based Global Impression of Severity Scale), associating lower values with greater severity, and also by male gender. The COSMIN checklist is favourable for all the properties analysed, although some weaknesses are detected for content validity.Conclusions: “Living with T2DM” (LW-T2DM) is a valid, reliable and accurate instrument for use in clinical practice to determine how a person’s life is affected by the presence of diabetes. This instrument correlates well with the associated constructs of social support, quality of life and satisfaction. Additional research is needed to determine how well the questionnaire structure performs when robust factor analysis methods are applied.


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