Self-care behaviour, treatment satisfaction and quality of life in people on intensive insulin treatment

Elena Gurkova,Katarina Ziakova

doi:10.5507/bp.2013.010

Abstract

The aim of this cross-sectional study was to identify self-care behaviours and their relationships with treatment satisfaction and quality of life in people attending a structured educational programme for patients on intensive insulin therapy. A sample of 104 people with diabetes (62 with type-1; 42 with type 2) was recruited from the National Institute of Endocrinology and Diabetology in Ľubochňa over six months. The majority of respondents were women (62.5%); had multiple daily injections of insulin (73%); diabetic late complications (68%) and had not previously participated in the structured educational programmes in the specialized diabetes centre (64.4%). Self-management behaviour data were collected by means of structured interviews with patients as well as during clinic visits. For measuring quality of life, the Audit Diabetes Dependent Quality of Life questionnaire and for measuring satisfaction with their treatment regimen, the Diabetes Treatment Satisfaction Questionnaire status version was used. General satisfaction with the treatment was significantly higher in people with diabetes, who implemented regular self-monitoring of the concentration of glucose in plasma (SMPG). We also demonstrated low adherence in the frequency of SMPG. 17% of respondents in our study performed daily SMPG. However, 52% respondents reported adaptation of insulin dosage in relation to factors such as carbohydrate intake, glycaemia values or degree of physical activity. Differences in quality of life due to performing the regular self-monitoring of glycaemia, adjustments of insulin doses in specific situations as well as carbohydrate counting were not significant. Performing the regular self-monitoring of glycaemia was associated only with higher treatment satisfaction. No significant improvement in quality of life was seen in people performing the regular self-monitoring of glycaemia, adjustments of insulin doses in specific situations or carbohydrate counting.

Highlights

The emphasis in diabetes care has been shifting over the past decade towards providing a primary care diabetes service which has patient education and self-management at the forefront of policy initiatives[1,2]
Three persons with diabetes (PWD) indicated any benefits of having diabetes
17% of respondents in our study reported that they perform daily SMPG but 52% respondents reported adaptation of insulin dosage in relation to factors, such as carbohydrate intake, glycaemia values or degree of physical activity

Summary

Introduction

The emphasis in diabetes care has been shifting over the past decade towards providing a primary care diabetes service which has patient education and self-management at the forefront of policy initiatives[1,2]. This emphasis on active self-management and empowerment requires appropriate support for patients from healthcare professionals to enable them to engage confidently and competently in managing the complex metabolic condition of diabetes. The chronicity of diabetes and potential for serious complications often require life long self-management[2,6], major lifestyle changes for patients and their families[7] and present disease management challenges to physicians and patients[6,8]

Methods

Results

Conclusion