Study on Diet-related Quality of Life in Online Self-help Diabetes Mellitus Patients Who Practice Dietary Regimen

식사요법을 실천중인 당뇨병 자조모임 환자의 식사관련 삶의 질에 관한 연구

  • Lee, Han-Sul (Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University) ;
  • Joo, Jin-Hee (Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University) ;
  • Choue, Ryo-Won (Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University)
  • 이한슬 (경희대학교 동서의학대학원 의학영양학과) ;
  • 주진희 (경희대학교 동서의학대학원 의학영양학과) ;
  • 조여원 (경희대학교 동서의학대학원 의학영양학과)
  • Received : 2010.12.20
  • Accepted : 2011.02.07
  • Published : 2011.02.28

Abstract

Assessment of quality of life (QOL) is a new method to investigate the effectiveness of dietary regimen. Particularly, diet-related QOL is the most appropriate method to estimate social and psychological problems originated from dietary regimen practice. The purpose of this study was to evaluate the diet-related QOL and the correlation between diet-related QOL and health-related QOL, and dietary regimen practice in online diabetes self-help patients who practice the dietary regimen. Sixty one subjects who intended to practice dietary regimen were recruited from online diabetes self-help community, and instructed to fill-up the self report questionnaires. Contents of questionnaire were comprised of general characteristics, clinical characteristics, dietary compliance, and dietary regimen practice. As a result, the mean score of the 'Dietary impact' among the diet-related QOL sub-scales was the lowest suggesting most of the subjects suffer from burden of dietary regimen practice. The "Dietary impact" was correlated with "Taste", "Convenience" and "Cost" (p < 0.05). "Self-care" and "Satisfaction" were positively associated with well-controlled blood glucose and dietary regimen compliance, but negatively associated with "Dietary impact". Diet-related QOL was significantly correlated with the Health-related QOL, particularly the mental and social component (p < 0.05). Diet-related QOL was negatively associated with BMI, and self monitoring blood glucose was negatively correlated with "Self-care" (p < 0.05). In conclusion, Diet-related QOL might be appropriate to evaluate the effects of dietary regimen or nutrition education. The need for dietary education of cognitive-behavioral strategies and problem-solving ability is required.

Keywords

References

  1. Ahn Y, Kwon E, Shim JE, Park MK, Joo Y, Kim K, Park C, Kim DH (2007): Validation and reproducibility of food frequency questionnaire for Korean genome epidemiologic study. Eur J Clin Nutr 61(12): 1435-1441 https://doi.org/10.1038/sj.ejcn.1602657
  2. American Diabetes Association (2009): Standards of medical care in diabetes-2009. Diabetes Care 32(Suppl 1): S13-61 https://doi.org/10.2337/dc09-S013
  3. Barr JT, Schumacher GE (2003): The need for a nutrition-related quality-of-life measure. J Am Diet Assoc 103(2): 177-180 https://doi.org/10.1053/jada.2003.50058
  4. Barr JT, Schumacher G, Myers EF (2001): Case problem: quality of life outcomes assessment. How can you use it in medical nutrition therapy? J Am Diet Assoc 101(9): 1064-6 https://doi.org/10.1016/S0002-8223(01)00262-0
  5. Cho YI (2004): A structural model promotion behaviors and the quality of life of patients with type 2 diabetes mellitus. Ph.D thesis, Kyung Hee University
  6. Cho YY, Lee MK, Jang HC, Rha MY, Kim JY, Park YM, Sohn CM (2008): The clinical and cost effectiveness of medical nutrition therapy for patients with type 2 diabetes mellitus. Korean J Nutr 41(2): 147-155
  7. Chun JH, Jung SB, Sohn HS (1999): Self-care and related factors in patients with diabetes. Korean Diabetes J 23(2): 254-261
  8. Chung SO, Song OK, Ko JM, Wi JH, Lee TH, Yum JY, Cho DK, Son JH, Nam HW, Yoo HJ, Lee YN, Kim SG, Moon HK, Kim ES (2000): The effects of teaching methods on the dietary compliance and hemoglobin A1c level in patients with diabetes mellitus. J Korean Diabetes Assoc 24(5): 560-573
  9. Delahanty LM, Hayden D, Ammerman A, Nathan DM (2002): Medical nutrition therapy for hypercholesterolemia positively affects patient satisfaction and quality of life outcomes. Ann Behav Med 24(4): 269-278 https://doi.org/10.1207/S15324796ABM2404_03
  10. Evans JM, Newton RW, Ruta DA, MacDonald TM, Stevenson RJ, Morris AD (1999): Frequency of blood glucose monitoring in relation to glycaemic control: observational study with diabetes database. BMJ 319(7202): 83-86 https://doi.org/10.1136/bmj.319.7202.83
  11. Franciosi M, Pellegrini F, De Berardis G, Belfiglio M, Cavaliere D, Di Nardo B, Greenfield S, Kaplan SH, Sacco M, Tognoni G, Valentini M, Nicolucci A; QuED Study Group (2001) The impact of blood glucose self-monitoring on metabolic control and quality of life in type 2 diabetic patients: an urgent need for better educational. Diabetes Care 24(11): 1870-1877 https://doi.org/10.2337/diacare.24.11.1870
  12. Gerteis M, Edgman-Levitan S, Daley J, Delbanco TL (1993): Through the patient's eyes. understanding and promoting patientcentred care. Jossey-Bass Inc, San Francisco
  13. Glasgow RE, Wilson W, McCaul KD (1985): Regimen adherence: a problematic construct in diabetes research. J Chronic Dis 8(3): 399-412
  14. Goodall TA, Halford WK (1991): Self-management of diabetes mellitus: a critical review. Health Psychol 10(1): 1-8 https://doi.org/10.1037/0278-6133.10.1.1
  15. Harris MI (2001): Frequency of blood glucose monitoring in relation to glycemic control in patients with type 2 diabetes. Diabetes Care 24(6): 979-82 https://doi.org/10.2337/diacare.24.6.979
  16. Hatton DC, Haynes RB, Oparil S, Kris-Etherton P, Pi-Sunyer FX, Resnick LM, Stern JS, Clark S, McMahon M, Morris C, Metz J, Ward A, Holcomb S, McCarron DA (1996): Improved quality of life in patients with generalized cardiovascular metabolic disease on a prepared diet. Am J Clin Nutr 64(6): 935-943 https://doi.org/10.1093/ajcn/64.6.935
  17. Jackson JA, Kinn S, Dalgarno P (2005): Patient-centred outcomes in dietary research. J Hum Nutr Diet 18(2): 83-92 https://doi.org/10.1111/j.1365-277X.2004.00581.x
  18. Jun JE (2007): A study on barriers and problem solving related to dietary therapy in diabetics mellitus patients. MS thesis, Kyungwon University
  19. Kim JH (2002): Effect of nutrition education in knowledge, attitude and behavior about dietary therapy and blood glucose control in type 2 diabetic patients. MS thesis, Keimyung University
  20. Kim JH (2008): A study on factors affecting quality of life of employees with diabetes. MS thesis, Ewha Womens University
  21. Kim TY, Um SH, Kim WY, Chang NS (2004): Group lunch visits at the public health center improve glycemic control in older adults with type 2 diabetes mellitus. Korean J Nutr 37(4): 302-309
  22. Korea Centers for Disease Control and Prevention (2007): The fourth Korea national health and nutrition examination survey (KNHANES IV-1)
  23. Korean Dietetic Association (2008): Manual of medical nutrition therapy the 3rd, Seoul
  24. Lee SL, Kim YL, Lee SJ, Cho TK, Choi YK, Chun DH, Chang YK (2004): Effects of diabetes education on diabetic management in non-insulin-dependent diabetics mellitus patients. J Korean Diet Assoc 10(3): 300-308
  25. Lee YW, Hwang WS, Choe SJ, Lee DH, Kim DH, Lee EH, Hong EG, Noh HL, Chung YS, Lee KW, Kim HM (2003): The effect of intensive education on glycemic control in type 2 diabetic patients. J Korean Endocr Soc 18(1): 63-72
  26. Lim HS, Chyun JH, Kim YS, Nam MS (2001): Effect of nutrition education on diabetic management in diabetic patients. Korean J Nutr 34(1): 69-78
  27. Park BS, Jin GN, Choi YC, Chung JH, Kim KH, Lee MY, Koh JH, Chung CH (2005): Self-management and health-related quality of life in adolescent and adulthood diabetic patients. Korean Diabetes J 29(3): 254-261
  28. Park CO, Baik HY, Lee HK, Min HK (1988): The effect of knowledge and dietary compliance on diabetic control in non - insulin dependent diabetics. Korean Diabetes J 12(1): 79-88
  29. Rubin RR, Peyrot M (2001): Psychological issues and treatments for people with diabetes. J Clin Psychol 57(4): 457-478 https://doi.org/10.1002/jclp.1041
  30. Sato E, Suzukamo Y, Miyashita M, Kazuma K (2004): Development of a diabetes diet-related quality-of-life scale. Diabetes Care 27(6): 1271-1275 https://doi.org/10.2337/diacare.27.6.1271
  31. Song MS, Song KH, Ko SH, Ahn YB, Kim JS, Shin JH, Cho YK, Yoon KH, Cha BY, Son HY, Lee DH (2005): The long-term effect of a structured diabetes education program for uncontrolled type 2 diabetes mellitus patients-a 4-year follow-up. Korean Diabetes J 29(2): 140-150
  32. Song OK, Nam HW, Moon DH, Lim KH, Moon HK, Kim ES (1998): Perceived barriers to dietary practice adherence among persons with diabetes. Korean Diabetes J 22(3): 381-391
  33. Song OK (1999): The effect of teaching methods on diet compliance and hemoglobin $A_{1c}$ level in patients with diabetes mellitus. Ph.D, Dankook University
  34. Splett P, Myers EF (2001): A proposed model for effective nutrition care. J Am Diet Assoc 101(3): 357-363 https://doi.org/10.1016/S0002-8223(01)00093-1
  35. Stewart M, Brown JB, Weston WW, McWhinney I, McWilliam CL, Freeman TR (1995) : Patient-centred Medicine. Transforming the clinical method. Sage Publications Inc, Thousand Oaks
  36. Tunbridge R, Wetherill JH (1970): Reliability and cost of diabetic diets. BMJ 2(5701): 78-80 https://doi.org/10.1136/bmj.2.5701.78
  37. Ware JE Jr, Sherbourne CD (1992): The MOS 36-item short-form health survey (SF-36). I. conceptual framework and item selection. Med Care 30(6): 473-483 https://doi.org/10.1097/00005650-199206000-00002
  38. Weinberger M, Kirkman MS, Samsa GP, Cowper PA, Shortliffe EA, Simel DL, Feussner JR (1994): The relationship between glycemic control and health-related quality of life in patients with non-insulin-dependent diabetes mellitus. Med Care 32(12): 1173-1181 https://doi.org/10.1097/00005650-199412000-00002
  39. Wiser NA, Shane JM, McGuigan AT, Memken JA, Olsson PJ (1997): The effects of a group nutrition education program on nutrition knowledge, nutrition status, and quality of life in hemodialysis patients. J Ren Nutr 7(4): 187-193 https://doi.org/10.1016/S1051-2276(97)90017-0
  40. Wolffenbuttel BHR, Weber RFA, van Koetsveld PM, Verschoor L (1989): A randomised crossover study of sulfonylurea and insulin treatment in patients with type II diabetes poorly controlled on dietary therapy. Diabetic Med 6(6): 520-525 https://doi.org/10.1111/j.1464-5491.1989.tb01220.x
  41. Woo YJ, Lee HS, Kim WY (2006): Individual diabetes nutrition education can help management for type 2 diabetes. Korean J Nutr 39(7): 641-648