Document Type : Original Article
Authors
- . Azar Tol
- . Gholamreza Sharifirad
- . Ahmadali Eslami
- . Davoud Shojaeizadeh 1
- . Fatemeh Alhani 2
- . Mohamadreza Mohajeri Tehrani 3
1 Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences,
2 Department of Nursing, School of Medicine, Tarbiat Modaress University,
3 Tehran University of Medical Sciences, Tehran, Iran
Abstract
Introduction: Considering the chronic nature of diabetes and its significant effect on
quality of life of patients, the present study was conducted to evaluate predictors of
quality of life in these patients in order to facilitate planning health promotion intervention
programs. Materials and Methods: The present study was designed as a cross-sectional
study on 140 type 2 diabetic patients of Om-ol-Banin Diabetes Center of Isfahan. Data
collection tool was a multidimensional questionnaire including demographic and disease
related data (12 items), the standard scale for diabetes distress (17 items), the standard
scale for self-efficacy in diabetic patients (8 items), and standard scale for specific
quality of life of diabetic patients (15 items). Collected data were evaluated by SPSS
version 11.5 using the Chi-square test, Independent T-test, ANOVA, Pearson correlation
and multivariate regression analysis. Results: Results showed that the quality of life of
diabetic patients had a statistically significant correlation with diabetes distress variable
(P < 0.001) and self-efficacy variable (P < 0.001). In this study R2
(predictive power) was
0.66. Multivariate regression model indicated diabetes distress (b = -0.277, P = 0.01) and
self-efficacy (b = -0.161, P < 0.001) as variables influencing adjusted self-management for
other variables. Conclusion: The result of the present study urges that in planning health
promotion interventions in the field of diabetes, more attention be paid to self-efficacy
and diabetes distress variables in order to improve the efficiency and effectiveness of the
interventions carried out.
Keywords
2010. World Diabetes Foundation. Available from: http:// www.
worlddiabetesfoundation.org. [Last accessed on 2011 May 2].
2. Abolhassani F, Mohajeri Tehrani MR, Tabatabaei O, Larijani B.
Burden of diabetes and its complications in Iran in year 2000. Journal
of Diabetes and Metabolic Disorders 2005;5:35-48.
3. Arian V. Approach on treatment and nutrition in diabetes. Tehran:
Marzedanesh Publications; 2007.
4. Esteghamati A, Gouya MM, Abbasi M, Delavary A, Alikhani S,
Alaedini F, et al. Prevalence of diabetes mellitus and impaired
fasting glucose in the adult population of Iran: The national survey
of risk factors for non-communicable disease of Iran. Diabetes Care
2008;31:96-8.
5. Deputy of Health, Deputy for research and technology. National
health situation states. Tehran: Tabalwor publishing group; 2003.
6. Mahdi Hazaveh A, Delavari A. Diabetes of prevention and control.
Tehran: Deputy of Health; 2004.
7. Rakhshandehro S, Heidarnia AR, Rajab A. Determination of health
education on quality of life in type 2 diabetic patients. Journal of
Shahed University 2006;63:15-20.
8. Bharati DR, Pal R, Rekha R, Yamuna TV. Evaluation of the burden of
type 2 diabetes mellitus in population of Puducherry South India.
Diabetes Metab Syndr 2011;5:12-6.
9. Massi-Benedetti M. The cost of diabetes type II in Europe. The
CODE-2 study. Diabetologia 2002;45:S1-4.
10. Gries FA, Alberti KG. Management of non-insulin dependent
diabetes mellitus in Europe: A consensus statement. IDF Bull
1987;32:169-74.
11. Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL,
Jameson JL. Harrison’s principles of internal medicine. 16th ed.
Columbus (OH): McGraw- Hill Publisher; 2005.
12. Saito I, Inami F, Ikebe T, Moriwaki C, Tsubakimoto A, Yonemasu K,
et al. Impact of diabetes on health-related quality of life in a
population study in Japan. Diabetes Res Clin Pract 2006;73:51-7.
13. Glasgow RE, Ruggiero L, Eakin EG, Dryfoos J, Chobanian L. Quality
of life and associated characteristics in large national sample of
adults with diabetes. Diabetes Care 1997;20:562-7.
14. Wee HL, Cheung YB, Li SC, Fong KY, Thumboo J. The impact of
diabetes mellitus and other chronic medical conditions on healthrelated quality of life: Is the whole greater than the sum of its parts?
Health Qual Life Outcomes 2005;3:2.
15. Maddigan SL, Majumdar SR, Toth EL, Feeny DH, Johnson JA.
Health-related quality of life deficits associated with varying degrees
of disease severity in type 2 diabetes. Health Qual Life Outcomes
2003;1:78.
16. Minet L, Møhler S, Vach W, Wagner L, Henriksen J. Mediating the
effect of self-care management intervention in type 2 diabetes: A
meta-analysis of 47 randomized controlled trials. Patient Educ Couns
2010;80:29-41.
17. Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metab
Res Rev 1999;15:205-18.
18. Cezaretto A, Siqueira-Catania A, de Barros CR, Salvador EP,
Cavalierf D, Ferreira SR. Benefits on quality of life concomitant to
metabolic improvement in intervention program for prevention of
diabetes mellitus. Qual Life Res 2012;21:105-13.
19. Santhanam P, Gabbay RA. Poor quality of life scores in persons
with higher A1Cs in type 2 diabetes. Diabetes Res Clin Pract
2011;92:e53-4.
20. Polonsky WH, Fisher L, Earles P, Dudl RJ, Lees J, Mullan J, et al.
Assessing psychosocial distress in diabetes: Development of the
diabetes distress scale. Diabetes Care 2005;28:626-31.
21. Lorig K. Stanford self-efficacy for diabetes. Stanford Patient
Education Research Center. Avilable from: http://patienteducation.
stanford.edu/research/diabscales.htm. [Last accessed on 2010
July 11].
22. Bradley C, Todd C, Gorton T, Symonds E, Martin A, Plowright R.
The development of an individualized questionnaire measure of
perceived impact of diabetes on quality of life: The ADDQoL. Qual
Life Res 1999;8:79-91.
23. Funnell MM, Brown T, Childs B, Hass L, Hoset G, Jensen B. National
standards for diabetes self-management education. Diabetes Care
2009;32 (Suppl 1):S89-96.24. Macrodimitris SD, Endler NS. Coping, control and adjustment in
type 2 diabetes. Health Psychol 2001;20:208-16.
25. Spenser MS, Kieffer EC, Sinco BR, Palmisano G, Guzman JR,
James SA, et al. Diabetes -specific emotional distress among African
American and hispanics with type 2 diabetes. J Health Care Poor
Underserved 2006;17:88-105.
26. Whittermore R, Melkus G, Grey M. Metabolic control, selfmanagement and psychosocial adjustment in women with type 2
diabetes. J Clin Nurs 2005;14:195-203.
27. Peyrot M, Rubin RR, Lauritzen T, Snoek FJ, Matthews DR,
Skovlund SE. Psychosocial problems and barriers to improved
diabetes management: Result of the cross-national diabetes attitude,
wishes and needs (DAWN) study. Diabet Med 2005;22:1379-85.
28. Wexler DJ, Grant RW, Wittenberg E, Bosch JL, Cagliero E,
Delahanty L, et al. Correlates of health-related quality of life in type 2
diabetes. Diabetologia 2006;49:1489-97.
29. Goldney RD, Phillips PJ, Fisher LJ, Wilson DH. Diabetes, depression,
and quality of life: A population study. Diabetes Care 2004;27:1066-70.
30. Brown GC, Brown MM, Sharma S, Brown H, Gozum M, Denton P.
Quality of life associated with diabetes mellitus in an adult
population. J Diabetes Complications 2000;14:18-24.
31. Sundaram M, Kavookjian J, Patrick JH, Miller LA, Madhavan S,
Scott V. Quality of life, health status and clinical outcomes in type 2
diabetes patients. Qual Life Res 2007;16:165-77.
32. Liu MY, Tai YK, Hung WW, Hsieh MC, Wang RH. Relationships
between emotional distress, empowerment perception and self-care
behavior and quality of life in patients with type 2 diabetes. Hu Li
Za Zhi 2010;57:49-60.
33. Skelly AH, Marshall JR, Haughey BP, Davis PJ, Dunford RG. Selfefficacy and confidence in outcomes as determinants of self-care
practices in inner-city, African-American women with non-insulindependent diabetes. Diabetes Educ 1995;21:38-46.
34. Ludlow AP, Gein L. Relationships among self-care, self efficacy
and Hb1c levels in individuals with non-insulin dependent diabetes
mellitus. Can J Diabetes Care 1995;19:10-5.
35. Cherrington A, Wallston KA, Rothman RL. Exploring the relationship
between diabetes self-efficacy, depressive symptoms, and glycemic
control among men and women with type 2 diabetes. J Behav Med
2010;33:81-9.
36. Mishalia M, Omera H, Heymann AD. The importance of measuring
self-efficacy in patients with diabetes. Fam Pract 2011;28:82-7.
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