Health-related quality of life in Indonesian type 2 diabetes mellitus outpatients measured with the Bahasa version of EQ-5D (original) (raw)
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Journal of preventive medicine and public health, 2023
Objectives: Diabetes mellitus (DM) is a serious public health issue that places a heavy financial, social, and health-related burden on individuals, families, and healthcare systems. Self-reported health-related quality of life (HRQoL) is extensively used for monitoring the general population's health conditions and measuring the effectiveness of interventions. Therefore, this study investigated HRQoL and associated factors among patients with type 2 DM at a primary healthcare center in Indonesia. Methods: A cross-sectional study was conducted in Klaten District, Central Java, Indonesia, from May 2019 to July 2019. In total, 260 patients with DM registered with National Health Insurance were interviewed. HRQoL was measured with the EuroQol Group's validated Bahasa Indonesia version of the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) with the Indonesian value set. Multivariate regression models were used to identify factors influencing HRQoL. Results: Data from 24 patients were excluded due to incomplete information. Most participants were men (60.6%), were aged above 50 years (91.5%), had less than a senior high school education (75.0%), and were unemployed (85.6%). The most frequent health problems were reported for the pain/discomfort dimension (64.0%) followed by anxiety (28.4%), mobility (17.8%), usual activities (10.6%), and self-care (6.8%). The average EuroQoL 5-Dimension (EQ-5D) index score was 0.86 (95% confidence interval [CI], 0.83 to 0.88). In the multivariate ordinal regression model, a higher education level (coefficient, 0.08; 95% CI, 0.02 to 0.14) was a significant predictor of the EQ-5D-5L utility score. Conclusions: Patients with diabetes had poorer EQ-5D-5L utility values than the general population. DM patients experienced pain/ discomfort and anxiety. There was a substantial positive relationship between education level and HRQoL.
BMC Research Notes, 2015
Background: The management of diabetes requires a fundamental change in the lifestyle of patients, and one of the important outcome criteria is the quality of life. We assessed the health-related quality of life (HR-QoL) and examined the factors associated with it in type 2 diabetes. Methods: An analytical cross-sectional study was conducted among 500 type 2 diabetes patients (age >25 years and duration of diabetes >1 year). They were selected conveniently from the OutPatient department of the Bangladesh Institute of Health Sciences Hospital. The HR-QoL was assessed using an adapted and validated Bangla version of the EQ-5D (© 1990 EuroQol Group. EQ-5D ™) questionnaire. It has five domains: mobility, self-care, usual activities, pain/ discomfort, and anxiety/depression and two levels (problem and no problem) on each dimension. The responses to the EQ-5D were further translated into a single summary EQ-5D index using the UK TTO value set. Results: Of the patients, 50.2 % were female, and 49.4 % were aged >55 years. Only 28.4 % had completed higher secondary education, and 50.8 % were from lower-middle-income families. Around 78.8 % either had overweight or were obese. About 50.4 % had problems in mobility, 28.2 % in self-care, 47.6 % in usual activities, 72.8 % in pain/ discomfort, and 73.6 % in anxiety/depression. Results of binary logistic regression analysis showed that age, gender, lower-middle income, and HbA1 C were significantly (p < 0.05) associated with mobility. Self-care was significantly (p < 0.05) related to age, family history and duration of diabetes mellitus (DM). Gender, family history of DM, and lower-middle income had a significant (p < 0.05) association with usual activities. Pain was significantly (p < 0.05) associated with age, lower-middle income, and upper-middle income. Rural area, higher education, and HbA1 C were significantly (p < 0.05) related to anxiety. Results of multiple linear regression analysis showed that age (p = 0.0001), female gender (p = 0.0001), and prescribed treatment (p = 0.048) were associated with the EQ-5D index. Conclusions: The large majority (73 %) of the patients had problems in pain/discomfort and anxiety/depression; 50 % had problems in mobility and usual activities; and three in ten in self-care. Age, female gender, income, education, family history and duration of DM, and prescribed treatment are important factors that are associated with the HR-QoL in type 2 diabetes.
Examining the Problem Areas In Diabetes scale (MY-PAID-20) among Malay T2DM patients
The Problem Areas in Diabetes Scale (PAID) was translated using forward and backward translations following a predefined set of guidelines. The sample consists of 46 Malay patients from a public hospital in Malaysia. The PAID scale was found to have high internal consistency (Cronbach's Alpha value = 0.921). The patients suffered from mild diabetes distress having an average PAID score of 39.4. The findings gave support of convergent validity with a significant association (Pearson correlation = 0.081; p<0.05) between PAID score and HbA 1c values. The Malay version of PAID was found to be reliable and valid among Type 2 Diabetes Mellitus patients.
Validation of Brunei's Malay EQ-5D Questionnaire in Patients with Type 2 Diabetes
PloS one, 2016
The Malay spoken in Brunei a South East Asian country where Malay is the national language is distinctive and different from Malay spoken in Malaysia, Singapore and Indonesia. This study aimed to develop a Brunei Malay version of the 5-level EQ-5D questionnaire (EQ-5D-5L) and to assess its psychometric properties among patients with type 2 diabetes mellitus (T2DM). The Brunei Malay EQ-5D-5L was developed by culturally adapting two existing Malay versions. A total of 154 Bruneians with T2DM completed the questionnaire in two different points of time with one week apart. Known-groups validity of the utility-based EQ-5D-5L index and visual analogue scale (EQ-VAS) was evaluated by comparing subgroups of patients known to differ in health status. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC) or Cohen's kappa. As hypothesized, patients known to have 'better' health had higher EQ-5D-5L index scores than those having 'worse' heal...
2015
Background: Patients with type 2 diabetes mellitus (T2D) often experienced change in life, altered self-esteem and increased feelings of uncertainty about the future that challenge their present existence and their perception of quality of life (QoL). There was a dearth of data on the association between diabetes-related distress (DRD) and health-related quality of life (HRQoL). Objective: This study examined the determinants of HRQoL, in particular the association between DRD and HRQoL by taking into account the socio-demographic-clinical variables, including depressive symptoms (DS) in adult patients with T2D. Methods: This cross-sectional study was conducted in 2012-2013 in three public health clinics in Malaysia. The World Health Organization Quality of Life-Brief (WHOQOL-BREF), 17-items Diabetes Distress Scale (DDS-17), and 9-items Patient Health Questionnaire (PHQ-9) were used to measure HRQoL, DRD and DS, respectively. The aim of this research was to examine the association between the socio-demographic-clinical variables and HRQoL as well as each of the WHOQOL-BREF domain score using multivariable regression analyses. Results: The response rate was 93.1% (700/752). The mean (SD) for age was 56.9 (10.18). The majority of the patients were female (52.8%), Malay (53.1%) and married (79.1%). About 60% of the patients had good overall HRQoL. The mean (SD) for Overall QoL, Physical QoL, Psychological QoL, Social Relationship QoL and Environmental QoL were 61.7 (9.86), 56.7 (10.64), 57.9 (11.73), 66.8 (15.01) and 65.3 (13.02), respectively. The mean (SD) for the total DDS-17 score was 37.1 (15.98), with 19.6% (136/694) had moderate distress. DDS-17 had a negative association with HRQoL but religiosity had a positive influence on HRQoL (B ranged between 3.07 and 4.76). Women, especially younger Malays, who had diabetes for a shorter period of time experienced better HRQoL. However, patients who were not married, had dyslipidaemia, higher levels of Total-C and higher PHQ-9 scores had lower HRQoL. Macrovascular complications showed the largest negative effect on the overall HRQoL (adjusted B= -4.98, 95% CI -8.56 to -1.40). Conclusion: The majority of primary care adult with T2D had good overall HRQoL. Furthermore, the independent determinants for HRQoL had also concurred with many past studies. In addition, the researchers found that DRD had negative effects on HRQoL, but religiosity had positive influence on HRQoL. Appropriate support such as primary care is needed for adult patients with T2D to improve their life and their HRQoL.
International Journal of Environmental Research and Public Health, 2019
Diabetes complications, medication adherence, and psychosocial well-being have been associated with quality of life (QOL) among several Western and Asian populations with diabetes, however, there is little evidence substantiating these relationships among Malaysia's unique and diverse population. Therefore, a cross-sectional study was conducted in a Malaysian public primary care clinic among 150 patients diagnosed with type 2 diabetes mellitus (T2DM). Structured and validated questionnaires were used to investigate the associations between demographic, clinical, and psychological factors with QOL of the study participants. Approximately three-quarters of patients had a good-excellent QOL. Diabetes-related variables that were significantly associated with poor QOL scores included insulin containing treatment regimens, poor glycemic control, inactive lifestyle, retinopathy, neuropathy, abnormal psychosocial well-being, higher diabetes complication severity, and nonadherence (p < 0.05). The main predictors of a good-excellent QOL were HbA1c ≤ 6.5% (aOR = 20.78, 95% CI = 2.5175.9, p = 0.005), normal anxiety levels (aOR = 5.73, 95% CI = 1.8-18.5, p = 0.004), medication adherence (aOR = 3.35, 95% CI = 1.3-8.7, p = 0.012), and an aDCSI score of one and two as compared to those greater than or equal to four (aOR = 7.78, 95% CI = 1.5-39.2, p = 0.013 and aOR = 8.23, 95% CI = 2.1-32.8, p = 0.003), respectively. Medication adherence has also been found to be an effect modifier of relationships between HbA1c, depression, anxiety, disease severity, and QOL. These predictors of QOL are important factors to consider when managing patients with T2DM.
Journal of Epidemiology and Public Health, 2020
Background: Diabetes mellitus is a chronic disease that cannot be cured entirely, which greatly affects the quality of life. People with diabetes mellitus will experience a negative impact on the quality of life. This is because the patient experiences changes in his life. Measuring the quality of life in diabetic patients is very important, considering that diabetes mellitus sufferers are increasing every year. The purpose of this study was to analyze the factors that affect the quality of life in patients with type 2 DM. Subjects and Method: This was a crosssectional study conducted at Dr. Moewardi Hospital, Central Java, from February to March 2020. A sample of 120 patients with type 2 DM aged >18 years were selected by simple random sampling. The dependent variable was the quality of life. The independent variables were self-care, family support, peer support, length of disease, body mass index, and education. The data were collected by questionnaire and data analysis using path analysis with Stata 13 was used to collect data. Results: Good quality of life in patient with type 2 DM improved with good self-care (b= 2.66; 95% CI= 0.38 to 4.94; p = 0.022), strong family support (b= 3.07; 95% CI= 1.09 to 5.05; p= 0.002), strong peer support (b= 3.43; 95% CI= 1.14 to 5.72; p= 0.003), time period of diagnosis time <6 years (b=-2.90; 95% CI=-5.00 to-0.78; p= 0.007), normal body mass index (b=-2.53; 95% CI=-4.57 to-0.50; p= 0.014), and education ≥senior high school (b= 2.46; 95% CI= 0.72 to 4.21; p= 0.006). Conclusion: Good quality of life in patients with type 2 DM increases with good self-care, strong family support, strong peer support, time period of diagnosis <6 years, normal body mass index, and education level ≥ senior high school.
Health and Quality of Life Outcomes, 2020
BackgroundThe EuroQoL five-dimensional instrument (EQ-5D) is the favoured preference-based instrument to measure health-related quality of life (HRQoL) in several countries. Two versions of the EQ-5D are available: the 3-level version (EQ-5D-3 L) and the 5-level version (EQ-5D-5 L). This study aims to compare specific measurement properties and scoring of the EQ-5D-3 L (3 L) and EQ-5D-5 L (5 L) in Indonesian type 2 diabetes mellitus (T2DM) outpatients.MethodsA survey was conducted in a hospital and two primary healthcare centres on Sulawesi Island. Participants were asked to complete the two versions of the EQ-5D instruments. The 3 L and 5 L were compared in terms of distribution and ceiling, discriminative power and test-retest reliability. To determine the consistency of the participants’ answers, we checked the redistribution pattern, i.e., the consistency of a participant’s scores in both versions.ResultsA total of 198 T2DM outpatients (mean age 59.90 ± 11.06) completed the 3 L and 5 L surveys. A total of 46 health states for 3 L and 90 health states for 5 L were reported. The ‘11121’ health state was reported most often: 17% in the 3 L and 13% in the 5 L. The results suggested a lower ceiling effect for 5 L (11%) than for 3 L (15%). Regarding redistribution, only 6.1% of responses were found to be inconsistent in this study. The 5 L had higher discriminative power than the 3 L version. Reliability as reflected by the index score was 0.64 for 3 L and 0.74 for 5 L. Pain/discomfort was the dimension mostly affected, whereas the self-care dimension was the least affected.ConclusionsThis study suggests that the 5 L-version of the EQ-5D instrument performs better than the 3 L-version in T2DM outpatients in Indonesia, regarding measurement and scoring properties. As such, our study supports the use of the 5 L as the preferred health-related quality of life measurement tool.We did not do a trial but this study was approved by the Medical Ethics Committee of Universitas Gadjah Mada Yogyakarta, Indonesia (document number KE/FK/1188/EC, 12 November 2014, amended 16 March 2015).
Asian Journal of Pharmaceutical and Clinical Research, 2018
Objective: High prevalence of diabetes mellitus in Malaysia demands the appropriate interventions to alleviate or postpone its burden on patients’ health-related quality of life (HRQoL). The studies which provide useful knowledge about the components of such interventions are important. The aim of this study was to describe how demographic and clinical characteristics of diabetes patients influence their HRQoL using EQ-5D.Methods: This study used the baseline data of a randomized controlled study carried out to examine the impact of a pharmacist intervention on poorly controlled diabetes patients. A generic HRQoL tool EQ-5D was used to report the data. Logistic regression was used to identify the predictors of problems in individual EQ-5D domains, and ANCOVA was undertaken to examine the effect of patients’ characteristic on EQ-5D mean scores and visual analog scale (VAS) mean scores.Results: Pain discomfort was reported to be significantly predicted by high HbA1c levels. Increasi...
The Malaysian journal of medical sciences : MJMS, 2018
The quality of life (QoL) describes the multidimensional self-perceived well-being of a person, which is an important diabetes outcome. This study aimed to measure the QoL scores among patients with type 2 diabetes mellitus (T2DM), as well as their clinical and sociodemographic predictors. This cross-sectional study involved 180 randomly sampled patients at a primary care clinic on the East Coast of Peninsular Malaysia. A self-administered questionnaire containing the Audit of Diabetes Dependent Quality of Life-18 (ADDQoL-18) was used. Most of the respondents (96.7%) were Malay, with a median (interquartile range, IQR) age of 54.0 (14.0) years old. The majority of them were females (60.0%), married (81.1%) and from low-income families (63.3%), who attained a secondary education or lower (75.6%). Only 49.4% of them were employed. The mean (standard deviation, SD) ADDQoL-18 average weighted impact score was -4.58 (2.21) and all 18 domains were negatively affected, particularly the liv...