The Impact of Education, COVID-19 and Risk Factors on the Quality of Life in Patients with Type 2 Diabetes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Tools
2.2. Ethical Consideration
2.3. Statistical Analysis
3. Results
3.1. Socio-Demographic Characteristics
3.2. Diabetes Health Parameters before and after Education and during the COVID-19 Period
3.3. Quality of Life by Domains before and after Education and in the COVID-19 Period, and Differences Regarding Gender, Place of Residence and Age
3.4. Self-Assessment of Behavior during the COVID-19 Pandemic
3.5. Predictors of Worse Quality of Life in Patients with Type 2 Diabetes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Sociodemographic Characteristics | [n (%)] |
---|---|
Gender [n (%)] | |
Male | 111 (54) |
Female | 94 (46) |
Age [n (%)] | |
up to 50 years | 23 (11) |
51–60 years | 73 (36) |
61–70 years | 73 (36) |
71 and older | 36 (18) |
Level of education [n (%)] | |
Unfinished primary school | 14 (7) |
Elementary school | 54 (26) |
High school education | 99 (49) |
Higher education | 37 (18) |
Place of residence [n (%)] | |
Rural | 123 (60) |
Urban | 82 (40) |
Marriage status [n (%)] | |
Unmarried | 19 (9) |
Married | 149 (73) |
Divorced | 7 (3) |
Widower | 29 (14) |
Minor children in the family [n (%)] | 46 (22) |
Family members over the age of 60 [n (%)] | 93 (45) |
Duration of diabetes (years) [n (%)] | |
Up to a year | 25 (13) |
2–5 | 83 (41) |
6–10 | 50 (25) |
11–15 | 23 (11) |
≥16 | 21 (10) |
Health Parameters | Median (Interquartile Range) | p * | Effect Size (Cohen’s d) | ||||
---|---|---|---|---|---|---|---|
Before Education (1) | After Education (2) | COVID-19 Period (3) | 1 vs. 2 | 1 vs. 3 | 2 vs. 3 | ||
Blood glucose [fasted] | 7.3 (6.2–8.7) | 7.1 (6.1–8.3) | 7 (5.8–8.3) | 0.34 | 0.01 | 0.07 | 0.11 |
HbA1c [%] | 6.7 (6–7.7) | 6.6 (6–7.3) | 6.4 (5.7–7.1) | 0.002 † | 0.19 | 0.04 | 0.08 |
Systolic pressure (mmHg) | 130 (120–140) | 130 (120–140) | 130 (120–140) | 0.54 | 0.10 | 0.12 | 0.03 |
Diastolic pressure (mmHg) | 80 (75–90) | 80 (75–90) | 80 (80–90) | 0.53 | 0.03 | 0.14 | 0.09 |
Weight (kg) | 90 (78–102) | 89 (76.8–100) | 88 (75–102) | <0.001 † | 0.07 | 0.02 | 0.05 |
BMI (kg/m2) | 31 (27.6–34) | 30.8 (27.5–34) | 31 (27.5–34) | 0.008 ‡ | 0.06 | 0.02 | 0.03 |
Satisfaction with the Surrounding Life | Median (Interquartile Range) | p * | Effect Size (Cohen’s d) | ||||
---|---|---|---|---|---|---|---|
Before Education (1) | After Education (2) | COVID-19 Period (3) | 1 vs. 2 | 1 vs. 3 | 2 vs. 3 | ||
Health and functioning | 21.3 (17.8–24.4) | 21.5 (18.4–24.8) | 13.4 (12.3–15.2) | <0.001 † | 0.06 | 2.12 | 2.19 |
Male | 20.8 (17.7–24.0) | 21.3 (18–24.4) | 13.1 (11.9–14.5) | <0.001 † | 0.03 | 2.20 | 2.25 |
Female | 22.3 (18.0–24.6) | 22.4 (19.1–25.3) | 14.4 (12.8–16) | <0.001 ‡ | 0.10 | 2.07 | 2.17 |
Rural | 20.9 (17.5–24.0) | 21.3 (18–24.4) | 13.4 (12–15.2) | <0.001 † | 0.05 | 1.98 | 2.05 |
Urban | 22.4 (18.0–24.8) | 22.2 (18.6–25.7) | 13.5 (12.4–15.5) | <0.001 † | 0.08 | 2.36 | 2.43 |
Age up to 62 years | 21.8 (18.5–24.4) | 21.9 (19.1–25.1) | 13.4 (12.4–15.2) | <0.001 † | 0.08 | 2.32 | 2.35 |
≥62 years | 20.8 (17.2–24.4) | 20.7 (17.2–24.4) | 13.4 (11.7–15.3) | <0.001 † | 0.04 | 1.93 | 2.02 |
Socioeconomic domain | 21.6 (18–26) | 22.1 (17.9–25.8) | 23.3 (19.5–26.6) | <0.001 ‡ | 0.01 | 0.24 | 0.23 |
Male | 21.3 (17.6–25) | 21.93 (17.6–25) | 22.7 (18.9–26.5) | <0.001 ‡ | 0.002 | 0.19 | 0.20 |
Female | 22.1 (18.6–26.3) | 22.3 (18.9–26.2) | 23.9 (19.9–26.9) | <0.001 ‡ | 0.03 | 0.29 | 0.27 |
Rural | 20.7 (17.5–24.6) | 20.8 (17.6–24.5) | 22.6 (18.7–26.3) | <0.001 ‡ | 0.004 | 0.31 | 0.33 |
Urban | 23.6 (18.8–27.5) | 23.9 (18.9–27.4) | 24 (19.8–27) | 0.91 | 0.04 | 0.14 | 0.10 |
Age up to 62 years | 23 (18.4–26.3) | 23.2 (18.9–26.2) | 23.7 (19.9–27.8) | 0.003 ‡ | 0.02 | 0.25 | 0.24 |
≥62 years | 20.3 (17.2–25) | 20.5 (17.2–25) | 22.6 (16.7–25.5) | 0.001 ‡ | 0.001 | 0.23 | 0.23 |
Psychological/spiritual domain | 23.1 (19.2–26.6) | 23.6 (19.3–27) | 22.1 (18.2–25.5) | <0.001 ‡ | 0.009 | 0.20 | 0.21 |
Male | 22.8 (17.6–26.7) | 23.1 (17.7–26.4) | 21.9 (17.9–25) | 0.03 ‡ | 0.04 | 0.19 | 0.16 |
Female | 23.9 (20–26.6) | 24.3 (20.5–27.5) | 22.5 (18.3–26.3) | <0.001 ‡ | 0.07 | 0.21 | 0.28 |
Rural | 23.1 (18.6–26.3) | 23.1 (18.7–26.1) | 21.7 (17.8–24.2) | <0.001 ‡ | 0.03 | 0.29 | 0.26 |
Urban | 23.9 (19.8–28.3) | 24.3 (20.7–28.8) | 24.3 (18.6–26.8) | 0.05 | 0.07 | 0.07 | 0.15 |
Age up to 62 years | 23.1 (18.5–27) | 23.7 (18.9–27.7) | 23.0 (20.0–26.1) | 0.12 | 0.04 | 0.05 | 0.09 |
≥62 years | 23.6 (19.7–26.6) | 23.6 (19.8–26.1) | 20.7 (17.2–25.0) | <0.001 ‡ | 0.04 | 0.39 | 0.36 |
Family domain | 24.8 (21.4–28.5) | 24.6 (21.7–28.5) | 15.3 (13.2–17.3) | <0.001 ‡ | 0.04 | 2.33 | 2.42 |
Male | 24.3 (21.4–28.8) | 24 (21.2–28.3) | 14.4 (12.9–16.8) | <0.001 ‡ | 0.02 | 2.43 | 2.44 |
Female | 25.1 (21.3–27.7) | 25.2 (22.2–28.5) | 16.1 (13.8–18.3) | <0.001 ‡ | 0.11 | 2.24 | 2.45 |
Rural | 24.6 (21.4–28.6) | 24.1 (21.5–28.5) | 15.1 (13–17.1) | <0.001 ‡ | 0.02 | 2.19 | 2.25 |
Urban | 25.2 (21.3–28.2) | 25.3 (22.3–28.5) | 15.4 (13.2–17.6) | <0.001 ‡ | 0.08 | 2.58 | 2.76 |
Age up to 62 years (n = 112) | 25.2 (21.6–28.8) | 25.3 (21.6–28.8) | 15.4 (13.5–17.3) | <0.001 ‡ | 0.06 | 2.30 | 2.43 |
≥62 years (n = 93) | 24.6 (20.7–27.9) | 24 (21.5–27.7) | 15.2 (12.6–17.2) | <0.001‡ | 0.01 | 2.36 | 2.43 |
Quality of life | 22.4 (18.6–25.4) | 22.6 (18.8–25.6) | 17.7 (15.8–19.8) | <0.001 † | 0.04 | 1.29 | 1.32 |
Male | 22.2 (18.6–25) | 22.2 (18.6–24.8) | 17.3 (15.3–19.2) | <0.001 ‡ | 0.001 | 1.33 | 1.30 |
Female | 22.71 (19–25.7) | 23.1 (19.5–26.1) | 18.2 (16.1–20.5) | <0.001 † | 0.09 | 1.27 | 1.37 |
Rural | 22.1 (18.3–24.8) | 22.3 (18.3–24.7) | 17.6 (15.3–19.3) | <0.001 † | 0.02 | 1.24 | 1.23 |
Urban | 22.9 (19.2–26.6) | 23.5 (19.9–26.7) | 18 (16.1–20.4) | <0.001 † | 0.08 | 1.40 | 1.49 |
Age up to 62 years | 22.5 (18.9–25.8) | 23.1 (19.5–25.9) | 18.3 (16.0–20.2) | <0.001 ‡ | 0.06 | 1.28 | 1.32 |
≥62 years | 21.9 (18.5–25.2) | 21.9 (18.5–24.9) | 17.6 (15.4–19.0) | <0.001 ‡ | 0.01 | 1.32 | 1.34 |
Number (%) of Participants | ||||||
---|---|---|---|---|---|---|
Entirely Incorrect (0) | 1 | 2 | 3 | Entirely Exactly (4) | In Total | |
Because of the COVID-19 pandemic, I follow the news more than I normally do | 12 (8.8) | 10 (7.4) | 24 (17.6) | 41 (30.1) | 49 (36) | 136 (100) |
I do not think it is more dangerous than the flu | 1 | 2 | 3 | Much more dangerous from the flu | In total | |
To what extent do you believe that COVID-19 is more dangerous than the common flu? | 9 (6.7) | 10 (7.4) | 24 (17.8) | 55 (40.7) | 37 (27.4) | 135 (100) |
Not at all worried | 1 | 2 | 3 | Very worried | In total | |
How worried are you about the COVID-19? | 8 (5.9) | 17 (12.5) | 20 (14.7) | 42 (30.9) | 49 (36) | 136 (100) |
Not at all worried | 1 | 2 | 3 | Very worried | In total | |
What is the probability that you become infected with the COVID-19 virus? | 8 (5.9) | 18 (13.3) | 36 (26.7) | 48 (35.6) | 25 (18.5) | 135 (100) |
How likely is it that a member of your family is infected with the COVID-19 virus? | 11 (8.3) | 21 (15.8) | 37 (27.8) | 46 (34.6) | 18 (13.5) | 133 (100) |
Number (%) | |
---|---|
Diabetes mellitus | 56 (27.3) |
Lung diseases | 52 (25.4) |
Hypertension | 25 (12.2) |
Age | 21 (10.2) |
Heart disease | 20 (9.8) |
Any chronic disease | 20 (9.8) |
Malignant diseases | 17 (8.3) |
Asthma | 7 (3.4) |
Obesity | 6 (2.9) |
Compromised immune system | 3 (1.5) |
Internal organs diseases | 2 (1) |
Autoimmune diseases | 1 (0.5) |
There are no risky diseases | 3 (1.5) |
I do not know | 12 (5.9) |
ß | Standard Error | Wald | OR | 95%CI for ß | p | |
---|---|---|---|---|---|---|
Quality of life | ||||||
Male | 1.31 | 0.46 | 7.97 | 3.69 | 1.49 to 9.13 | 0.005 |
Rural | 1.15 | 0.51 | 5.06 | 3.14 | 1.16 to 8.52 | 0.02 |
Intercept | −4.07 | 0.78 | 26.8 | 0.02 | 0.004 to 0.07 | <0.001 |
Health and functioning | ||||||
Male | 0.44 | 0.17 | 6.54 | 1.56 | 1.11 to 2.21 | 0.01 |
Intercept | −1.5 | 0.26 | 32.5 | 0.22 | 0.13 to 0.37 | <0.001 |
Socioeconomic domain | ||||||
- | - | - | - | - | - | - |
Psychological/spiritual domain | ||||||
Male | 1.14 | 0.52 | 4.81 | 3.11 | 1.13 to 8.57 | 0.03 |
Duration of the disease (≤ 5 years) | 2.25 | 1.04 | 4.61 | 9.51 | 1.22 to 74.31 | 0.03 |
Intercept | −4.98 | 1.26 | 15.5 | 0.007 | 0.001 to 0.08 | <0.001 |
Family domain | ||||||
Male | 0.89 | 0.23 | 14.3 | 2.43 | 1.53 to 3.85 | <0.001 |
Marital status (married) | −0.65 | 0.32 | 4.29 | 0.52 | 0.28 to 0.96 | 0.04 |
Intercept | −1.75 | 0.29 | 34.8 | 0.17 | 0.09 to 0.31 | <0.001 |
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Gvozdanović, Z.; Farčić, N.; Šimić, H.; Buljanović, V.; Gvozdanović, L.; Katalinić, S.; Pačarić, S.; Gvozdanović, D.; Dujmić, Ž.; Miškić, B.; Barać, I.; Prlić, N. The Impact of Education, COVID-19 and Risk Factors on the Quality of Life in Patients with Type 2 Diabetes. Int. J. Environ. Res. Public Health 2021, 18, 2332. https://doi.org/10.3390/ijerph18052332
Gvozdanović Z, Farčić N, Šimić H, Buljanović V, Gvozdanović L, Katalinić S, Pačarić S, Gvozdanović D, Dujmić Ž, Miškić B, Barać I, Prlić N. The Impact of Education, COVID-19 and Risk Factors on the Quality of Life in Patients with Type 2 Diabetes. International Journal of Environmental Research and Public Health. 2021; 18(5):2332. https://doi.org/10.3390/ijerph18052332
Chicago/Turabian StyleGvozdanović, Zvjezdana, Nikolina Farčić, Hrvoje Šimić, Vikica Buljanović, Lea Gvozdanović, Sven Katalinić, Stana Pačarić, Domagoj Gvozdanović, Željka Dujmić, Blaženka Miškić, Ivana Barać, and Nada Prlić. 2021. "The Impact of Education, COVID-19 and Risk Factors on the Quality of Life in Patients with Type 2 Diabetes" International Journal of Environmental Research and Public Health 18, no. 5: 2332. https://doi.org/10.3390/ijerph18052332