HEALTH-RELATED QUALITY OF LIFE OF DIABETES MELLITUS PATIENTS AND NON-DIABETICS

ABSTRACT

In Sub-Saharan Africa, Nigeria has the greatest number of diabetes. Diabetes mellitus (DM) is a chronic illness that imposes severe limitations on those who suffer from it. Diabetics’ health-related quality of life can be impacted by short- and long-term issues affecting their physical, psychological, and social functioning (HRQOL). In PortHarcourt, Rivers State, Nigeria, researchers assessed and compared the HRQOL of diabetic patients and non-diabetics. The study was guided by four objectives and two null hypotheses. A descriptive cross-sectional survey design was used in this investigation. It was held at the University of Port Harcourt Teaching Hospital’s diabetic outpatient clinic in Port Harcourt. The minimum sample size for the diabetic and non-diabetic comparison groups was determined using power analysis. The diabetics who met the inclusion criteria were recruited on purpose, while non-diabetics of similar age and sex were recruited from the Catholic Community of Mater Misericordiae Catholic Church, Rumumasi, and the Anglican Community of Anglican Church of Messiah, Elekahia Housing Estate, both in Port Harcourt. Data was collected using the World Health Quality of Life-Bref (WHOQOL-BREF), a 26-item standardized questionnaire with 12 additional questions requesting demographic and clinical information. The split-half method was used to test the instrument’s reliability.

CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

[American Diabetes Association (ADA), 2004; Huang, Hwang, Wu, Lin, Leite, and Wu, 2008]. It is a life-threatening sickness with physical, social, emotional, and financial consequences. It has an impact on an individual’s quality of life and general health state, as well as direct health-care expenses and indirect costs to society due to missed productivity. It is a chronic and debilitating illness that places a great deal of strain on the individual by creating several short- and long-term problems, many of which are life-threatening. Because of the high risk of cardiovascular complications (myocardial infarction, stroke, and peripheral vascular disease) among people with diabetes, it is the main cause of non-traumatic amputation and blindness in working-age adults, as well as the third greatest cause of mortality from illnesses. Diabetes is frequently undiagnosed in the African sub-region. Most of the time, it is discovered by chance during a normal check-up or when the patient presents with difficulties (International Diabetes Federation, African Region, 2006). According to the World Health Organization (WHO), Nigeria has the largest number of diabetics in Sub-Saharan Africa (Chinenye & Ogbera, 2013). Despite extensive research and funding, the incidence and prevalence of diabetes mellitus in Nigeria continues to rise. With the present trend of disease transitioning from communicable to non-communicable, non-communicable diseases are expected to equal or even exceed communicable diseases in developing countries, including Nigeria, resulting in a twofold burden of disease (Chinenye & Ogbera, 2013)

In Port Harcourt, Nigeria, the prevalence rate of diabetes mellitus is 6.8%. ( Nyenwe, Odia, Ihekwaba, Ojule & Babatunde, 2003). With the alarming rise in the number of diabetics, effective and high-quality care has become critical. The multiple complications of the disease and its management offer problems to the quality of life of those who are afflicted, necessitating the need to assess the quality of life (QOL) of these persons.

The phrase “quality of life” (Q0L) refers to people’s emotional, social, and physical well-being, as well as their capacity to function in their daily lives (Donald, 2010). Health researchers prefer the term “health-related quality of life” (HRQ0L) since it allows them to focus on specific components. Diabetes patients have a lower HRQOL than non-diabetics, according to studies (Andayani, Ibrahim & Aside, 2010; Odili et al, 2010). In Nigeria, researchers at the University of Benin Teaching Hospital (UBTH) (Odili et al., 2010) and the University of Ilorin Teaching Hospital (UITH) have conducted HRQOL studies with diabetics (Issa & Baiyewu, 2006). Diabetes has an impact on the lives of diabetic patients, according to the UBTH study, whereas lower income, poorer education, low-rated employment, and physical difficulties have a bad effect on the HRQOL of diabetic patients, according to the UITH study. Both research focused on diabetics’ psychosocial issues. As a result, the HRQOL of diabetic patients in Port Harcourt was evaluated in this study.

STATEMENT OF PROBLEM

Diabetes mellitus is a debilitating ailment to have to deal with on a long-term basis. According to Polonsky (2000), the need for self-care can be difficult, irritating, and overwhelming for many people. On diagnosis, the individual must go through the phases of grief, which include denial, anger, bargaining, depression, and acceptance, according to Kubler Ross (1969), in Berman, Synder, Kozier, and Erb, (2008).

In order to live, people with diabetes mellitus go through a lot of stress. Due of its numerous demands, the condition, as a chronic illness, severely restricts people’s activities. People with diabetes must consider what to eat and when to consume it, exercise, determine whether to test plasma glucose and, depending on the results, schedule when to eat or take their medication.

This was dubbed “diabetes overwhelmus” by Rubin (2000). Diabetes has a significant detrimental impact on QOL in terms of social and psychological well-being, as well as physical and environmental health. As the disease progresses, psychosocial issues emerge as a result of the onset of comorbidities, medical treatment, and self-care. To what extent does the condition and its treatment have an impact on the patients’ quality of life? As a result, the HRQOL of diabetic patients was evaluated in this study.

The Study’s Objectives

The goal of this study was to compare the health-related quality of life (HRQOL) of diabetic patients who visited the diabetic clinic at the University of Port Harcourt Teaching Hospital to that of non-diabetic Port Harcourt residents.

OBJECTIVES OF THE STUDY

The study’s goals were to:

1. Compare the HRQOL scores of diabetic and non-diabetic patients in all four WHOQOL-BREF domains

 

2. Compare diabetes mellitus patients’ HRQOL scores to non-diabetic patients’ HRQOL scores in all four domains of the World Health Organization Quality Of Life-BREF (WHOQOL-BREF).

 

3. In the four domains of WHOQOL-BREF, compare the HRQOL scores of DM patients with co-morbidities to the scores of DM patients without co-morbidities.

 

4. Determine the impact of socio-demographic variables on the DM patients’ HRQOL overall mean score.

RESEARCH HYPOTHESIS

1. There is no significant difference in HRQOL ratings between diabetic and non-diabetic patients in the four domains of the questionnaire.

WHOQOL-BREF.

2. In all four dimensions of HRQOL, there is no significant difference between diabetes patients with co-morbidities and diabetic patients without co-morbidities.

WHOQOL-BREF.

SCOPE OF THE STUDY

The results of this study will reveal how diabetes people cope with life, disease, and treatment in general. The findings will focus on the physical, psychological, social, and environmental aspects of diabetic patients’ quality of life.

The study’s findings will give clinicians with critical information to aid clinical decision-making in the care of diabetics, taking into account both biological and psychosocial factors. A targeted education and management based on identified needs from the study will go a long way in assisting the patient in leading a normal life and coping with the issues connected with the illness, particularly for the nurse.

DEFINITION OF TERMS

Health-Related Life Quality (HRQOL). This is the effect of the disease (diabetes mellitus) on a person’s subjective assessment of his or her many aspects of human functioning and well-being. The four-domain World Health Organization Quality of Life (WHOQOL-BREF) instrument will be used to assess these functions in this investigation. Physical, psychological, social, and environmental aspects are included.

Diabetes Mellitus is a set of disorders marked by elevated blood glucose levels, which can be diagnosed medically if fasting blood glucose levels are 126 mg/dl (7.0 mmol/L) or above.