Health-related Quality Of Life Of Diabetes Mellitus Patients And Non-diabetics

Health-related Quality Of Life Of Diabetes Mellitus Patients And Non-diabetics

Abstract

Nigeria has the loftiest number of diabetics inSub-Saharan Africa. As a habitual illness, diabetes mellitus( DM) places serious constraints on the people living with diabetes mellitus. The short- term and long- term complications affecting the physical, cerebral and social functioning of diabetics can bump on their health- related quality of life( HRQOL). This study assessed and compared the HRQOL of diabetic cases andnon-diabetics in Port

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Harcourt, Rivers State, Nigeria. Four objects and two null suppositions were formulated to guide the study. The study espoused a descriptive cross sectional check design. It was conducted at the diabetic eschewal- case clinic of the University of Port Harcourt Teaching Hospital, Port Harcourt. Power analysis was used to determine the minimal sample size of 200 each for the diabetic and thenon-diabetic comparison group. The diabetics who met the addition criteria were intentionally signed , while the age and coitus matchednon-diabetics were signed from Catholic Community of Mater Misericordiae Catholic Church, Rumumasi and Anglican Community of Anglican Church of Messiah, Elekahia Housing Estate, all in Port Harcourt. The World Health Quality of Life- Bref,( WHOQOL- BREF) a 26 item formalized questionnaire with 12 fresh questions soliciting demographic and clinical data was used for data collection. The trustability of the instrument was carried out using split- halfmethod.The Cronbach’s nascence measure of trustability was0.70 for physical sphere,0.76 for cerebral sphere,0.78 for social sphere and0.70 for environmental sphere. Instrument was canvasser administered and data collected were subordinated to descriptive and deducible statistics using ki- forecourt, pupil t- test and analysis of friction at nascence significant position of P<0.05. There were no significant differences( p>0.05) between the diabetics and thenon-diabetics in their demographic variables. The mean scores for diabetics in the four disciplines of the WHOQOL- BREF were physical23.17 ±3.39, Cerebral20.06 ±3.32, social10.20 ±2.47 and environmental28.00 ±5.15. The mean scores fornon-diabetics in the four disciplines were physical24.17 ±2.42, cerebral21.53

±2.51, social11.43 ±1.87 and environmental28.68 ±5.044. The diabetic group had lower

HRQOL( p<0.05) than the non- diabetic group in the physical, cerebral and social disciplines. Out of the 200 diabetics, 92 reportedco-morbidities. The mean scores of diabetics withco-morbidities in the four disciplines were physical22.73 ±3.30, cerebral19.63 ±3.08, social9.96 and environmental27.41 ±4.98. The mean scores of diabetics withoutco-morbidities in the four disciplines were physical23.55 ±3.43, cerebral20.39 ±3.48, social10.40 ±2.62 and environmental28.50 ±5.25. There was no significant difference( p>0.05) between the diabetic cases withco-morbidities and the diabetics withoutco-morbidities in all the four disciplines. The diabetics withpost-secondary education had a significant advanced mean score(3.93 ±0.81) than those with secondary and primary education(3.75 ±1.12 and3.37 ±1.06 independently). In conclusion, DM impacts negatively on the

HRQOL of the cases. sweats to enhance diabetic HRQOL should be promoted

Chapter One

Preface

Background to the Study

Diabetes mellitus is defined as a group of metabolic conditions characterized by increased position

of glucose in the blood performing from blights in insulin stashing or insulin action or both

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American Diabetic Association( ADA),( 2004); Huang, Hwang, Wu, Lin, Leite & Wu,( 2008)). It’s a ruinous illness that has physical, social, emotional and profitable counteraccusations . It impinges on the quality of life and overall health status of the individualities, as well as direct health care cost and circular costs to the society when related to lost productivity. It’s a habitual and distressing illness that makes demands on the individual by causing a lot of short- term and long- term complications that’s life hanging . Diabetes mellitus is the leading cause ofnon-traumatic amputation and blindness in working age grown-ups and the third leading cause of death from conditions primarily, because of the high rate of cardiovascular complications( myocardial infarction, stroke, and supplemental vascular complaint) among people with diabetes( Smeltzer, Bare, Hinkle & Cheever, 2010).

Studies have shown that the prevalence of diabetes is on the increase. The centre for Disease Control and Prevention( CDC)( 2011), stated that in 2010, an estimated 79 million American grown-ups aged 20 times or aged withpre-diabetes. In 2000, the world-wide estimate of the frequence of diabetes was 171 million people, and by 2030, this is anticipated to increase to 366 million( Wild, Roglic, Green et al, 2004). The International Diabetes Federation( IDF) estimated that 194 million people had diabetes in the time 2003, and about two thirds of these people lived in developing countries of which Nigeria is one. The President of IDF( 2006- 2009), advised that if left unbounded, the number of people with diabetes will reach 380million in lower than 20 times. This will mean 1 out of 14 grown-ups worldwide will have diabetes in the times 2025. The loss of earnings and life will be hard to bear.

Diabetes mellitus was formerly regarded as a complaint of the rich but is now extensively visible as a growing health problem in developing husbandry as nearly 80 of diabetes deaths do in low and middle income countries, of which Nigeria is one( Diabetes Atlas, 2006). Available data suggests that it’s arising as a major health problem in Africa, including Nigeria. In the

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Africansub-region, diabetes is constantly undiagnosed. In utmost cases, it’s diagnosed apropos during routine check- up or when the case presents with the complications( International Diabetes Federation, African Region, 2006). The World Health Organization( WHO) statistics indicates that Nigeria has the loftiest number of diabetics inSub-Saharan Africa( Chinenye & Ogbera, 2013). The prevalence and frequence of diabetes mellitus in Nigeria continues to increase despite great deal of exploration and coffers. With current trend of transition from transmissible tonon-communicable complaint, it’s projected thatnon-communicable conditions will equal or indeed exceed transmissible conditions in developing nations, including Nigeria therefore climaxing in double burden of complaint( Chinenye & Ogbera, 2013). The crude frequence rate of diabetes mellitus in Port Harcourt, Nigeria is6.8( Nyenwe, Odia, Ihekwaba, Ojule & Babatunde, 2003). With the intimidating growth in the number of people suffering from diabetes, effective and quality care come imperative. The multitudinous complications of the complaint and its operation poses challenges on the quality of life of the individualities suffering from the complaint, thus the need to assess the quality of life( QOL) of these individualities becomes necessary.

Quality of life( Q0L) is a descriptive term that refers to people’s emotional, social and physical well- being and their capability to serve in the ordinary task of living( Donald, 2010). Health affiliated quality of life( HRQ0L) is preferred by health experimenters because it’s used to constrict the compass to aspects of performing directly related to conditions and or medical treatment( Odili, Ugboka & Oparah, 2010).

Studies of quality of life are performed for two reasons. First, they’re conducted to estimate the psychosocial functioning of patient group and to identify specific problems and requirements of cases at different stages of the complaint process. Secondly, and most frequently, HRQOL studies

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are conducted to compare the impact of different rules on the case’s well- being and the treatment satisfaction( Snoek, 2000).

Experimenters report lower HRQOL in people diagnosed with diabetes than fornon-diabetic( Andayani, Ibrahim & Away, 2010; Odili et al, 2010). In Nigeria, studies of HRQOL with diabetics have been carried out at the University of Benin Teaching Hospital( UBTH)( Odili etal., 2010) and University of Ilorin Teaching Hospital( UITH)( Issa & Baiyewu, 2006). UBTH study concluded that diabetes impacts on the lives of diabetic cases while UITH study concluded that lower income, lower education, low rated employment and physical complications negatively affect the HRQOL of cases with diabetes mellitus. Both studies dwelt on the psychosocial aspects of the diabetics. This study thus assessed the HRQOL of cases with diabetes mellitus in Port Harcourt.

Statement of Problem

Diabetes mellitus is a chronically distressful illness with which to live. Polonsky,( 2000) stated that for numerous cases the demand of tone- care can be burdensome, frustrating and inviting. According to Kubler Ross,( 1969), in Berman, Synder, Kozier & Erb,( 2008), the existent has to pass through the stages of grief which are denial, wrathfulness, logrolling, depression and acceptance on opinion.

People living with diabetes mellitus pass through a lot of stress in order to live. The complaint, as a habitual illness, places serious constraints on the peoples ’ conditioning due to its multifarious demands. individualities with diabetes have to suppose of what to eat and when to eat, exercise, decide whether to test tube glucose and depending on the result, plan when to eat or take their medicines( insulin or tablets). They also carry along with them glucose drinks for fear of hypoglycaemia and generally stop to check the symptoms of hypo or hyperglycaemia. To

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crown it all, they’re always gripped with the fear of complications especially bottom complications and amputation. A good number of cases come frustrated, discouraged and/ or engaged with a complaint that frequently doesn’t feel to respond to their stylish sweats. This, Rubin( 2000), appertained to as “ diabetes overwhelmus ”. Diabetes can ply an enormous negative impact on QOL in the area of social and cerebral well- being, as well as physical ill- health and environmental health. As the complaint progresses, psychosocial problems imernate from onset of complications, medical and tone- operation. To what extent do the complaint and its operation impact on the QOL of the cases? This study thus assessed the HRQOL of cases with diabetes mellitus.

Purpose of the Study

The purpose of this study was to assess the health- related quality of life( HRQOL) of cases with diabetes mellitus attending the diabetic clinic of the University of Port Harcourt Teaching Hospital, and compare with that ofnon-diabetic persons occupant in Port Harcourt. Thenon-diabetics are similar normal persons drawn from the same catchment area of the sanitarium. They’re matching group.

Objects of the Study

The study objects were to

1. Determine the HRQOL scores of cases with diabetes mellitus and thenon-diabetic group in all the four disciplines of the WHOQOL- BREF.

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2. Compare the HRQOL scores of diabetes mellitus cases withnon-diabetic group in all the four disciplines of the World Health Organization Quality Of Life- BREF( WHOQOL- BREF).

3. Compare the HRQOL scores of DM cases withco-morbidities with the scores of DM cases withoutco-morbidities in the four disciplines of WHOQOL- BREF.

4. Determine the influence of socio- demographic variables on the HRQOL overall mean score of the DM cases.

suppositions

1. There’s no significant difference between the HRQOL scores of cases with diabetes mellitus and that of thenon-diabetic group in the four disciplines of the

WHOQOL- BREF.

2. There’s no significant difference between the HRQOL scores of diabetic cases withco-morbidities and those withoutco-morbidities in all the four disciplines of the

WHOQOL- BREF.

Compass of the Study

This study was carried out at the University of Port Harcourt Teaching Hospital using diabetic cases attending the diabetic clinic that hold on Wednesdays. Only persons 30 times and over were signed . Thenon-diabetic group was signed from the unqualified community of Mater Misericordiae Catholic Church Rumumasi, Port Harcourt and Anglican community of the Anglican Church of Messiah, Port Harcourt. Anglican and unqualified churches are the two biggest churches in this area.

Significance of the Study

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Findings from the present study will reveal generally how diabetic cases manage with life, complaint and treatment. The findings will specifically reveal quality of life of diabetic cases with respects to physical sphere, cerebral sphere, social sphere and environmental sphere.

Findings from the study will give clinicians with important information demanded to support clinical decision- timber, taking both biomedical and psychosocial aspects into consideration in the operation of diabetics. To the nanny in particular, a acclimatized education and operation grounded on linked requirements from the study will go a long way in helping the case to lead a normal life and manage with the problems associated with the disease.