Quality of life among type 2 diabetes mellitus patients at Kamuzu Central Hospital in Lilongwe, Malawi: A mixed-methods study.
Quality of life among type 2 diabetes mellitus patients at Kamuzu Central Hospital in Lilongwe, Malawi: A mixed-methods study.
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DOI：
10.1371/journal.pgph.0002367
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发表时间：
2023
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II型糖尿病（T2 DM）显著影响生活质量（QoL），但缺乏马拉维这些患者的数据。本研究旨在评估T2 DM患者的生活质量。在马拉维利隆圭的Kamuzu中心医院（KCH）进行了一项混合方法横断面研究。数据收集采用改良的糖尿病生活质量（MDQoL）-17问卷进行定量数据，而深入访谈和日记方法用于定性数据。使用描述性统计量和推断性统计量（使用t检验和ANOVA）总结人口统计学数据。定性数据采用专题分析。招募了339名参与者（平均年龄50.3±15.5）。总体而言，平均QoL评分为中度（平均QoL 63.91±19.54）。健康保险的人生活质量更好（生活质量76.71，C.I. 69.22-84.19，p值0.005）。此外，没有合并症与更好的QoL相关（QoL 71.18，C.I. 66.69-75.67，p值< 0.0001）。定性而言，T2 DM与患者的健康状况、压力水平增加和独立性丧失相关。在T2 DM患者中存在促进生活质量的因素，如糖尿病健康讲座、家庭支持和遵循医院建议。抑制因素包括药物短缺、社会观念、久坐不动的生活方式、压力和医院的建议。在KCH接受治疗的T2 DM患者的总体QoL为中度。T2 DM患者的生活质量受相关因素影响，需要多学科团队护理来优化这些患者的生活质量。在治疗T2 DM患者时，卫生工作者需要采取整体方法，例如管理合并症，包括评估QoL，行为改变措施，如体育锻炼和健康饮食。
Type II diabetes mellitus (T2DM) significantly impacts quality of life (QoL) yet data among these patients in Malawi are lacking. This study was conducted to assess QoL among patients with T2DM. A mixed-method cross-section study was conducted at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. Data collection was done using a modified diabetes quality of life (MDQoL)-17 questionnaire for quantitative data while in-depth interviews and diary methods were used for qualitative data. Demographic data were summarized using descriptive statistics and inferential statistics using t-tests and ANOVA. Thematic analysis was utilized for qualitative data. A sample of 339 participants (mean age 50.3±15.5) was recruited. Overall, the mean QoL score was moderate (mean QoL 63.91±19.54). Those on health insurance had better QoL (QoL 76.71, C.I. 69.22–84.19, p-value 0.005) compared to those without health insurance. Furthermore, the absence of comorbidities was associated with having better QoL (QoL 71.18, C.I. 66.69–75.67, p-value < 0.0001). Qualitatively, T2DM was associated with patients’ health status, increased stress levels, and loss of independence. There were QoL-promoting factors among T2DM patients such as diabetes health talks, having a supportive family, and following hospital advice. Inhibiting factors include drug shortages, societal perceptions, a sedentary lifestyle, stress, and despising hospital advice. Overall QoL in patients with T2DM receiving treatment at KCH is moderate. QoL of patients with T2DM is influenced by interrelated factors which require multidisciplinary team care to optimize the QoL among these patients. Health workers need to adopt a holistic approach when treating patients with T2DM, such as managing comorbidities and including assessment of QoL, behavioral change measures like physical exercises, and a healthy diet.