PURPOSE: The study examined characteristics (sociodemographic and number and types of study-focused comorbidities) associated with health related quality of life and the relationships between general health-related (MOS SF-36) and diabetes specific (Diabetes Quality of Life Measure - DQOL) quality of life, and tested the revised Wilson and Cleary model proposed by Ferrans et al. utilizing the Structure Equation Modeling (SEM) in individuals with type-2 diabetes and hypertension and/or hyperlipidemia. Type-2 diabetes impairs health and quality of life with potentially devastating consequences occurring as a result of diabetes-related comorbidities. Wilson and Cleary proposed a comprehensive conceptual model for HRQoL. The model had not been tested in diabetes.
METHODS: Three hundred twenty-one subjects with type-2 diabetes and hypertension and/or hyperlipidemia were included in this secondary data analysis. The parent study examined the impact of a problem-solving based, multi-component telephone intervention on adherence to multiple medications in subjects with type-2 diabetes and hypertension and/or hyperlipidemia. Baseline data from the parent study were utilized in the current study.
RESULTS: Characteristics significantly related (p < .01) to general health related and/or diabetes specific quality of life included gender, age, income, marital status, household size, the number of study-focused comorbidities, peripheral vascular disease, renal disease, history of stroke/TIA, psychological problems and arthritis. Most correlations between SF-36 subscale and DQOL subscale/total scores were statistically significant (p < .01). Following considerable modifications to both the measurement and structural equation model (i.e., addition of correlated errors, omission of measured variables, and addition of new variables), the revised Wilson and Cleary model was valid for explaining the relationships between the selected observed variables and their relationship to overall quality of life ( = 203.986, CMIN/DF = 2.081, CFI = 0.952, SRMR = 0.0549 and RMSEA = 0.058 with 90% CI = 0.047 - 0.069).
CONCLUSIONS: The SF-36 was more sensitive to sociodemographic variables and the presence of study-focused comorbidities than the DQOL. After data modifications, the revised Wilson and Cleary model provided a good fit to the data in these subjects with type-2 diabetes and hypertension and/or hyperlipidemia. These findings need to be confirmed in a larger independent study.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-06072007-092944 |
| Date | 13 June 2007 |
| Creators | Chia, Lichun |
| Contributors | Sandra Engberg, PhD, RN, CRNP, Jacqueline Dunbar-Jacob, PhD, RN, FAAN, Susan M. Sereika, PhD, Eric Rodriguez, MD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-06072007-092944/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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