Background and aims: Diabetes mellitus (DM) patients have a lower quality of life. This study aimed to examine the direct and indirect effect of eight domains score of the SF-36 questionnaire on two main factors, i.e., overall physical health (GH_M) and overall mental health (MH_M), in DM patients. To the best of our knowledge, this issue has been rarely studied so far.
Material and method: A total of 1037 DM patients filled out the Persian version of the SF-36 questionnaire. The path analysis was used in this study.
Results: In this research, only social functioning (SF) domain has significantly lower the men compared to women (P=0.06). Physical functioning (PF), bodily pain (BP), general health (GH) and vitality (VT) have a negative significant direct effect on the GH_M factor. GH domain also has a positive indirect and total effect on MH_M factor, and other domains have no significant total effect on MH_M factor.
Conclusion: It is better that physicians, focus on regulating physical activity and reducing body pain in diabetes patients, which have the most direct impact on HRQoL, to achieve a more effective outcome in improving quality of life in this patient.
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1.American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care 23: S32 2000
2. Esteghamati A Gouya MM Abbasi M et al. Prevalence of diabetes and impaired fasting glucose in the adult population of Iran: the national survey of risk factors for non-communicable diseases of Iran. Diabetes Care 31(1): 96-8 2008
3. Nyanzi R Wamala R Atuhaire LK. Diabetes and quality of life: a Ugandan perspective. J Diabetes Res 2014: p402012 2014
4. Al Hayek AA Robert AA Al Saed A Alzaid AA Al Sabaan AS. Factors associated with health-related quality of life among Saudi patients with type 2 diabetes mellitus: a cross-sectional survey. Diabetes Metab J 38(3): 220-229 2014
5. Daniele TM Bruin VM Oliveira DS Pompeu CM Forti AC. Associations among physical activity comorbidities depressive symptoms and health-related quality of life in type 2 diabetes. Arg Bras Endocrinol Metab 57(1): 44-50 2013
6. Boyer JG Earp JA. The development of an instrument for assessing the quality of life of people with diabetes: Diabetes-39. Med Care 35(5): 440-453 1997
7. Weinberger M Kirkman MS Samsa GP et al. The relationship between glycemic control and health-related quality of life in patients with non-insulindependent diabetes mellitus. Med Care 32(12): 1173-1181 1994
8. Rubin RR Peyrot M. Quality of life and diabetes. Diabetes Metab Res Rew 15(3): 205-218 1999
9. World Health Organization.Constitution of the world health organization. 1995.
10. Testa MA. Quality-of-life assessment in diabetes research: interpreting the magnitude and meaning of treatment effects. Diabetes Spectrum 13(1): 29-35 2000
11. Hörnquist JO Wikby A Andersson PO Dufva AM. Insulin-pen treatment quality of life and metabolic control: retrospective intra-group evaluations. Diabetes Res Clin Pract 10(3): 221-230 1990
12. Andersson PO Wikby A Sternstomb U Horniquist JO. Pen injection and change in metabolic control and quality of life in insulin dependent diabetes mellitus. Diabetes Res Clin Pract 36(3): 169-172 1997
13. Testa MA Simonson DC. Health economic benefits and quality of life during improved glycemic control in patients with type 2 diabetes mellitus: a randomized controlled double-blind trial. Jama 280(17): 1490-1496 1998
14. Golicki D Dudsinzka M Zwolak A Tarach JS. Quality of life in patients with type 2 diabetes in Poland-comparison with the general population using the EQ-5D questionnaire. Adv Clin Exp Med 24(1): 139-46 2015
15. Ware Jr JE. SF-36 health survey update. Spine 25(24): 3130-3139 2000
16. Bradley C Lewis K. Measures of psychological well-being and treatment satisfaction developed from the responses of people with tablet-treated diabetes. Diabetic Med 7(5): 445-451 1990
17. Jacobson AM De Groot M Samson JA. The evaluation of two measures of quality of life in patients with type I and type II diabetes. Diabetes Care 17(4): 267-274 1994
18. Wändell PE. Quality of life of patients with diabetes mellitus an overview of research in primary health care in the Nordic countries. Scand J Prim Health Care 23(2): 68-74 2005
19. Schram MT Baan CA Pouwer F. Depression and quality of life in patients with diabetes: a systematic review from the European depression in diabetes (EDID) research consortium. Curr Diabetes Rew 5(2): 112-119 2009
20. 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 20(4): 562-567 1997
21. Ware Jr JE. How to score the revised MOS short-form health scale (SF-36®). New Engl Med Centr Hosp 10: 17-18 1988
22. Ware Jr JE Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 30 (6): 473-483 1992
23. Montazeri A Goshtasebi A Vahdaninia M Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Qual Life Res 14(3): 875-882 2005
24. Jafari H Lahsaeizadeh S Jafari P Karimi M. Quality of life in thalassemia major: reliability and validity of the Persian version of the SF-36 questionnaire. J Postgard Med 54(4): 273-5 2008
25. Hamta A Khalilian AR Farhadi R Ranjbaran H. Path Analysis of the Risk of Low Birth Weight for Multipara. Iran Red Crescent Med J 15(6): 462-6 2013
26. Vasconcelos AG Almeida RM Nobre FF. The path analysis approach for the multivariate analysis of infant mortality data. Ann Epidemiol 8(4): 262-71 1988
27. Goldsmith JR. Paths of association in epidemiological analysis: application to health effects of environmental exposures. Int J Epidemiol 6(4): 391-399 1977
28. Goldsmith JR. Berglund K. Epidemiological approach to multiple factor interactions in pulmonary disease: the potential usefulness of path analysis. Ann N Y Acad Sci 221: 361-375 1974
29. Bagheri Z Jafari P Faghih M Allahyari E Dehesh T. Testing measurement equivalence of the SF-36 questionnaire across patients on hemodialysis and healthy people. Int Urol Nephrol 47(12): 2013-2021 2015
30. Gift HC Atchison KA. Oral health health and health-related quality of life. Med Care 30(1): NS57-NS77 1995
31. Sepúlveda E Poinhos R Constante M Pais-Ribiero J Freitas P Carvalho D. Health-related quality of life in type 1 and type 2 diabetic patients in a Portuguese central public hospital. Diab Metab Syndr Obes 8: 219 2015
32. Klein BE Klein R Moss SE. Self-rated health and diabetes of long duration: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Diabetes Care 21(2): 236-240 1998
33. Peyrot M Rubin RR. Levels and risks of depression and anxiety symptomatology among diabetic adults. Diabetes Care 20(4): 85-590 1997
34. Goldney RD Phillips PJ Fishel LJ Wilson DH. Diabetes depression and quality of life: a population study. Diabetes Care 27(5): 1066-1070 2004
35. Kakhki AD. Health-related quality of life of diabetic patients in Tehran. Int J Endocrinol metab 11(4): e7945 2013
36. Olobatuyi ME.A user's guide to path analysis. Lanham MD : University Press of America 2006