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Difficulties in daily life and the association with self-care ability in adults with type 1 diabetes mellitus in Japan: A cross-sectional study.

ABSTRACT: Aim:To identify the unique contents of difficulties experienced in daily life among adult type 1 diabetes mellitus patients and to determine how basic characteristics and diabetic-related self-care agency are associated with difficulties in daily life. Methods:This study used two surveys: "Difficulties in Daily Life," which was a questionnaire developed for this survey and "Instrument of Diabetes Self-Care Agency." These two measures were then used with demographic information for cross-sectional analysis. Result:The final sample included 321 type 1 diabetes mellitus patients. Difficulties in daily life were composed of four factors: "Difficulties in diseases disclosure," "Difficulties accommodating diabetes into daily life," "Difficulties in employment or continuing education" and "Lack of knowledge of diabetes." The instrument of Diabetes Self-Care Agency was found to be associated with all four factors of difficulties in daily life. In addition, sex and diabetes duration were shown to be important predictors.

SUBMITTER: Umeda E

PROVIDER: S-EPMC7308687 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Difficulties in daily life and the association with self-care ability in adults with type 1 diabetes mellitus in Japan: A cross-sectional study.

Umeda Eiko E Shimizu Yasuko Y Kawai Nobuko N

Nursing open 20200318 4

<h4>Aim</h4>To identify the unique contents of difficulties experienced in daily life among adult type 1 diabetes mellitus patients and to determine how basic characteristics and diabetic-related self-care agency are associated with difficulties in daily life.<h4>Methods</h4>This study used two surveys: "Difficulties in Daily Life," which was a questionnaire developed for this survey and "Instrument of Diabetes Self-Care Agency." These two measures were then used with demographic information for ...[more]

PMID: 32587712

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Project description:OBJECTIVES:To compare the effect of a 6-month community-based intervention with that of usual care on quality of life, depressive symptoms, anxiety, self-efficacy, self-management, and healthcare costs in older adults with type 2 diabetes mellitus (T2DM) and 2 or more comorbidities. DESIGN:Multisite, single-blind, parallel, pragmatic, randomized controlled trial. SETTING:Four communities in Ontario, Canada. PARTICIPANTS:Community-dwelling older adults (≥65) with T2DM and 2 or more comorbidities randomized into intervention (n = 80) and control (n = 79) groups (N = 159). INTERVENTION:Client-driven, customized self-management program with up to 3 in-home visits from a registered nurse or registered dietitian, a monthly group wellness program, monthly provider team case conferences, and care coordination and system navigation. MEASUREMENTS:Quality-of-life measures included the Physical Component Summary (PCS, primary outcome) and Mental Component Summary (MCS, secondary outcome) scores of the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12). Other secondary outcome measures were the Generalized Anxiety Disorder Scale, Center for Epidemiologic Studies Depression Scale (CES-D-10), Summary of Diabetes Self-Care Activities (SDSCA), Self-Efficacy for Managing Chronic Disease, and healthcare costs. RESULTS:Morbidity burden was high (average of eight comorbidities). Intention-to-treat analyses using analysis of covariance showed a group difference favoring the intervention for the MCS (mean difference = 2.68, 95% confidence interval (CI) = 0.28-5.09, P = .03), SDSCA (mean difference = 3.79, 95% CI = 1.02-6.56, P = .01), and CES-D-10 (mean difference = -1.45, 95% CI = -0.13 to -2.76, P = .03). No group differences were seen in PCS score, anxiety, self-efficacy, or total healthcare costs. CONCLUSION:Participation in a 6-month community-based intervention improved quality of life and self-management and reduced depressive symptoms in older adults with T2DM and comorbidity without increasing total healthcare costs.

Project description:BackgroundAlthough the province of Newfoundland and Labrador has the highest rates of chronic disease in Canada, the current state of many chronic diseases in the province, including diabetes mellitus, has not been well explored. We profiled the demographic characteristics associated with, and the management of, diabetes in Newfoundland and Labrador, including any rural-urban differences.MethodsWe performed a population-based, cross-sectional analysis using data from the provincial Chronic Disease Registry for fiscal year 2015/16. Patients in the study sample were 20 years of age or older, with documented identifiers for age, sex and geographic location. We examined demographic characteristics, results of screening and diabetes clinical tests (glycated hemoglobin [HbA1c], low-density lipoprotein [LDL] cholesterol and urine albumin-to-creatinine ratio) and hospitalization rates. We described and compared demographic, clinical and hospitalization variables across urban and rural residents of the province.ResultsThe study sample consisted of 66 325 individuals with diabetes in Newfoundland and Labrador (mean age 64.1 yr; 56.3% rural residents). Larger proportions of rural than urban residents with diabetes were aged 65 to 79 years (41.2% v. 37.5%), were female (50.2% v. 48.7%) and were identified as having the disease by laboratory tests only (19.6% v. 13.1%). Rural residents had worse clinical test outcomes than their urban counterparts, specifically with respect to HbA1c (mean and standard deviation [SD], 7.41% [SD 1.49] v. 7.26% [SD 1.50]) and LDL cholesterol (mean 2.46 [SD 0.95] v. mean 2.36 [SD 0.94] mmol/L). A total of 13.7% of individuals were admitted to hospital during the cohort year, with slightly more rural residents admitted for renal disease (standardized difference 0.021, 95% confidence interval 0.005 to 0.036).InterpretationFor many individuals with diabetes in Newfoundland and Labrador, recommended targets for diabetes management are not being met, and residents in rural areas have poorer clinical outcomes. To inform the development and implementation of targeted provincial strategies for chronic disease management, further research is needed to determine how outcomes relate to the availability of primary health care services.

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Dataset Information

Difficulties in daily life and the association with self-care ability in adults with type 1 diabetes mellitus in Japan: A cross-sectional study.

Publications

Difficulties in daily life and the association with self-care ability in adults with type 1 diabetes mellitus in Japan: A cross-sectional study.

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