Abstract
BackgroundDiabetes mellitus (DM) is a chronic disease, leading to many complications and substantial decrease in patients’ Health Related Quality of Life (HRQoL). HRQoL among diabetic patients could affect by concurrent various factors. Therefore, analysis of these concomitant factors using generalized structural equation model (GSEM) that takes account the complex network of relationship could be a more utilitarian approach to better understand factor affecting HRQoL. The present study aimed to assesses the level of HRQoL and its associated factors among adults with and without diabetes.MethodsA comparative cross-sectional study was conducted from March 13 to April 4, 2019 in Adama Hospital and Medical College and Adama city Kebele 2, 4 and 5, East Shewa Ethiopia. Data related to socio-demographics, behavioral, clinical factors and HRQoL were collected from 359 adults with diabetes & 415 adults without diabetes through face to face interviews. Data was entered to Epi-data 3.1 then it was exported to STATA 14 for further analysis. GSEM was employed to verify relationships and association among exogenous, mediating and endogenous variable concurrently.ResultsDiabetic groups had a significant lower mean score in all domains of HRQoL than non- diabetic group (p-value< 0.0001). Depression had a direct negative effect on all domains of HRQoL in both groups. Fasting blood sugar also had a direct negative effect on all domains of HRQoL except social relation. Diabetes mellitus complication had a direct negative effect on both physical and psychological health. Low Medication adherence and poor diabetic self-care activity had a negative direct, indirect and total effect on physical and environmental health through fasting blood sugar.ConclusionDiabetic patients had lower HRQoL in all the domains of quality of life. Socio-demographic factor (Age, residence and marital status), clinical factor (Depression & Diabetes mellitus complication) and behavioral factor (diabetic self-care activity and medication adherence) mediated by fasting blood sugar were factor associated HRQoL among the diabetic group. Thus, we recommend that integration of screening for depression and give counseling on medication adherences and diabetic self-care activity along with the already existing DM treatment.
Highlights
Diabetes mellitus (DM) is a chronic disease, leading to many complications and substantial decrease in patients’ Health Related Quality of Life (HRQoL)
We recommend that integration of screening for depression and give counseling on medication adherences and diabetic self-care activity along with the already existing DM treatment
Among domains of HRQoL, the physical health was the most affected domain in diabetic group and this is in agreement with other reports [14, 16, 31]
Summary
Diabetes mellitus (DM) is a chronic disease, leading to many complications and substantial decrease in patients’ Health Related Quality of Life (HRQoL). Diabetes mellitus (DM) is a group of metabolic disease characterized by hyperglycemia resulting from defects in insulin secretion, action or both [1]. It is one of the most common chronic diseases in most counties and continues to increase in number and significance, as the changing life style leads to physical inactivity and increase obesity [2]. The IDF expects that until 2045 the number of adult patients suffering from diabetic in Africa will increase from 1.6 million to 4.6 million by 2045 [3]. Diabetes mellitus is a chronic disease, leading to many complication includes micro-vascular (nephropathy, retinopathy and neuropathy) and macro-vascular (stroke, coronary artery disease and diabetes foot ulcer) with comorbidities lead to substantial decrease in patient’s quality of life (QoL) as well as socio-economical implication [5]
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