Prevalent Obstacles and Predictors for People Living with Type 2 Diabetes

Abstract

Background. Type 2 diabetes (T2DM) is a chronic, progressive disease with serious micro- and macrovascular complications. A person affected by T2DM should learn to accept the new restricted lifestyle. Aims. The aim of the study was to identify the prevalence of obstacles in coping with daily life for people with T2DM and the magnitude of the relationships of the obstacles with various patient characteristics. Methods. Participants were recruited from randomly selected GPs' lists in Estonia. Respondents completed the Estonian version of the Diabetes Obstacles Questionnaire (DOQ). The statements were assessed on a 5-point scale. Biomedical and clinical variables were measured. The central tendency statistics and skewness and kurtosis for all statements were computed to find out those that reflect obstacles. Then obstacles of the DOQ were stratified. Multinomial logistic regression (MLR) was computed to estimate the influences of descriptive variables on the statements. Results and Conclusions. Altogether, 138 diabetic patients were enrolled in the study. Fourteen statements were identified as obstacles. Variables such as age, type of diabetes treatment, and BMI had significant effects on five of them. Younger age, BMI, and insulin nonuse were revealed as the strongest predictive characteristics for perceiving obstacles more often in coping with daily life.

Diabetes-related quality of life in six European countries measured with the DOQ-30

“…In other studies, PWDs expressed uncertainty about diabetic medication: older patients about sulphonylurea [ 19 ] and younger patients about insulin [ 20 ]. The diabetic medication interferes negatively with these patients` ideas about how they want to live their everyday lives [ 8 , 21 , 22 ]. In contrast, a significant number of PWDs not receiving insulin in Japan were prepared to start injections if they were prescribed [ 23 ].…”

Development and validation of the short version of the diabetes obstacles questionnaire (DOQ-30) in six European countries

“…Researchers gave a study kit comprising an information leaflet, a questionnaire, extract from their medical records with their latest clinical results, and prepaid, self-addressed envelopes to participants. The method is described elsewhere (31)(32)(33). The questionnaire was translated into native languages and back into English in all six countries.…”

“…The DOQ was further validated in the UK, Belgium and Estonia (31-33). The Pearson correlation coefficient was calculated between the DOQ and PAID, ADDQoL, and HbA1c in the UK and the Belgian sample to determine construct validity (31,32). A broad variety of obstacles was demonstrated by Estonian sample (33).…”

Patients` Experiences and Needs with Lifestyle Counselling in Family Practices

“…According to Pertel et al (2010) Estonian primary health care workers acknowledge that patient-side barriers are the main obstacles to efficient lifestyle counselling and their own counselling skills are considered quite well, although family nurses counselling mainly involves just sharing advices. According to Pilv et al (2012) patients with type II diabetes feel that the most important obstacles in coping with everyday life are related to not being able to make lifestyle changes according to the advices, the way how it is told that they have diabetes and self-management of diabetes. It shows that there might have been a gap in the explanation of different treatment options already from the very beginning of the disease.…”

“…However, this requires deep understanding and good counselling skills from the specialist to encourage patients in increasing selfefficacy and provide support in finding the motivation necessary for self-management. (Pilv et al, 2012). The patients' unwillingness to change may be frustrating for the health care workers and may neglect lifestyle counselling deeming it inept (Jallinoja et al, 2007).Nurses have pointed out that due to a high work load they have less time to deal with questions regarding lifestyle changes while remaining confident in their counselling skills (Carlfjord et al, 2012).…”