Factors influencing quality of life among elderly population with type 2 diabetes mellitus: a clinic based cross sectional study in Kathmandu Valley
Keywords:Quality of life, Type 2 Diabetes mellitus, Ageing, Nepal
Purpose - Diabetes is one of the four priority non-communicable diseases whose worldwide prevalence is at an increasing trend and is accompanied by deterioration of quality of life especially that of the elderly population. Several factors contribute to influence quality of life among the elderly. This study aims to identify the factors that influence quality of life among elderly population of Kathmandu valley, Nepal.
Design/methodology/approach - A cross-sectional survey was conducted among random sample of 310 elderly diabetic patients visiting diabetic clinic of Kathmandu Diabetes and Thyroid center in Kathmandu valley, Nepal. Translated Nepali version of WHOQOL BREF was taken from previous studies’ validated questionnaire and was administered through face to face interview in order to obtain the data. Association of independent and dependent variables were assessed in bivariate analysis using Independent sample t-test, ANOVA and Pearson correlation and multivariate analysis was done using multiple linear regression analysis with estimation of five models.
Findings - Descriptive analysis showed that more than half of the respondents had moderate quality of life and analytical statistics showed that factors such as age, sex, marital status, income, educational level, lifestyle, diabetes self-management, fasting blood sugar level, complications, convenient hours of operation to be significantly associated with total score of quality of life.
Originality/value - Several factors contributed to influence quality of life and in addition to health attention should be paid to other aspects of their life also. Among several factors diabetes self-management is one critical factor among diabetic population which is essential to enhance wellbeing, better glycemic control, fewer complication and hence improve quality of life. Therefore, self-management training with an effort to enhance coping skills should be incorporated and effective strategies should be formulated in order to deal with several aspects of life of elderly population that could influence their quality of life.
2. World Health Organiztion [WHO]. Global report on diabetes. Geneva: WHO; 2016.
3. Aryal KK, Mehata S, Neupane S, Vaidya A, Dhimal M, Dhakal P, et al. The burden and determinants of non communicable diseases risk factors in Nepal: findings from a nationwide STEPS survey. PLoS One. 2015; 10(8): e0134834. doi: 10.1371/journal.pone.0134834
4. Chhetri MR, Chapman RS. Prevalence and determinants of diabetes among the elderly population in the Kathmandu Valley of Nepal. Nepal Med Coll J. 2009 Mar; 11(1): 34-8.
5. Kiadaliri AA, Najafi B, Mirmalek-Sani M. Quality of life in people with diabetes: a systematic review of studies in Iran. J Diabetes Metab Disord. 2013 Dec; 12(1): 54. doi: 10.1186/2251-6581-12-54
6. Tajvar M, Arab M, Montazeri A. Determinants of health-related quality of life in elderly in Tehran, Iran. BMC Public Health. 2008 Sep; 8: 323. doi: 10.1186/1471-2458-8-323
7. Glasgow RE, Ruggiero L, Eakin EG, Dryfoos J, Chobanian L. Quality of life and associated characteristics in a large national sample of adults with diabetes. Diabetes Care. 1997 Apr; 20(4): 562-7.
8. Al-Khawaldeh OA, Al-Hassan MA, Froelicher ES. Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus. J Diabetes Complications. 2012 Jan-Feb; 26(1): 10-6. doi: 10.1016/j.jdiacomp.2011.11.002
9. Steiner JL, Crowell KT, Lang CH. Impact of alcohol on glycemic control and insulin action. Biomolecules. 2015 Sep; 5(4): 2223-46. doi: 10.3390/biom5042223
10. Boyer JG, Earp JA. The development of an instrument for assessing the quality of life of people with diabetes: Diabetes-39. Med Care. 1997 May; 35(5): 440-53.
11. Agency for Healthcare Researchand Quality [AHRQ]. National health care quality report. Rockvill, MD: AHRQ; 2013.
12. Winnipeg Regional Health Authority [WRHA]. Chronic disease: access to health care and barriers to self management. Cananda: Community Health Advisory Councils, Winnipeg Regional Health Authority; 2010.