Abstract
BackgroundAlthough numerous health-related quality of life (HRQoL) instruments are available for patients with diabetes, the length of these measures may limit their feasibility to routine practice. Also, these measures do not distinguish items for generic and diabetes-specific HRQoL. This study was aimed to develop a diabetes-specific quality of life questionnaire module (DMQoL) to be in conjunction with the World Health Organization Quality of Life scale brief version (WHOQOL-BREF).MethodsOne hundred seventeen patients with diabetes were enrolled from a medical center in Taiwan. The item content of DMQoL was constructed based on an extensive review of existing HRQoL instruments for diabetes, expert discussions and patient interviews. A series of psychometric tests were conducted to ensure the reliability and validity of DMQoL. The WHOQOL-BREF served as an existing HRQoL measure for construct validity testing. The response scale of DMQoL was adopted from the 5-point Likert scale of WHOQOL-BREF.ResultsA total of 10 items without ceiling or floor effects were selected from 20 items. Exploratory factor analysis (EFA) with parallel analysis and Rasch analysis concluded that the 10 items were embedded in the same underlying concept. The corrected item-total correlations and factor loadings from EFA were all above 0.4. The internal consistency of the 10 items was satisfactory (Cronbach’s α = 0.84). The DMQoL total score was moderately correlated with that of WHOQOL-BREF (r = 0.48, p < 0.001). The known-group validity showed that patients with HbA1c ≤ 7% had significantly higher mean scores of DMQoL than did those with HbA1c > 8% (3.66 ± 0.47 vs. 3.41 ± 0.53; p = 0.037).ConclusionsThe DMQoL with only 10 items is developed and it is sensitive to the change of diabetes progression in early phases (e.g., glycemic changes). The combination of WHOQOL-BREF and DMQoL provides a comprehensive picture of overall HRQoL in patients with diabetes and enhance the instrument’s ability to detect clinically meaningful changes in diabetes.
Highlights
Numerous health-related quality of life (HRQoL) instruments are available for patients with diabetes, the length of these measures may limit their feasibility to routine practice
The present study aims to develop a diabetes-specific HRQoL instrument that is stand-alone, allows quick and identification of the effects of diabetes on the HRQoL of patients in daily practice, and can be supplementary to World Health Organization Quality of Life Questionnaire (WHOQOL)-BREF for assessing overall HRQoL in such individuals
Less than one fifth of them were aged 50 years or below (n = 21), and most of the patients controlled their diabetes quite well according to their HbA1c (32 were >8%), laboratory data, and data on the clinical diagnosis of diabetes-related complications (Table 1)
Summary
Numerous health-related quality of life (HRQoL) instruments are available for patients with diabetes, the length of these measures may limit their feasibility to routine practice. These measures do not distinguish items for generic and diabetes-specific HRQoL. Acute episodes of hyperglycemia (e.g., diabetic ketoacidosis) and hypoglycemia, fear of hypoglycemia, change in lifestyle, and fear of long-term microvascular complications (e.g., retinopathy, nephropathy) and macrovascular complications (e.g., cardiovascular diseases; CVD) may diminish health-related quality of life (HRQoL) in such individuals [2]. For chronic illnesses such as diabetes, assessing how the disease influences patients’ lives and the burden of the demands of the disease on patients is essential for planning care and establishing therapies
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