الفهرس 
SUBJECTS AND METHODSOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus is a major emerging clinical and public health problem accounting currently for 5.2 % of all deaths world-wide. According to WHO estimates (2007), 190 million people suffer from diabetes world-wide and about 330 million ones are expected to be diabetic by the year 2025. Egypt had been estimated to be the 9th country in the prevalence of diabetes. Recent changes in physical activity and dietary patterns have promoted the development of diabetes and if different preventive and control activities are not adopted, by the year 2025, more than 9 million Egyptians (13% of the population above 20 years old) will have diabetes. Management of diabetes is dependent to a great extent on the affected person’s own abilities to carry out self-care in his daily lives.
Diabetes-related quality of life (DRQoL) has been increasingly recognized as an important factor in outcomes assessment of individuals with diabetes. In addition, DRQoL is an index of patient’s satisfaction with their diabetes treatment, as well as their worries related to diabetes and its impact on daily life.
The general objective of the present study was to assess the quality of life of type 2 diabetes mellitus patients as an indicator for improving services provided to them at the Diabetes andMetabolism outpatient clinic, Alexandria Main University Hospital.
Material and methods
A cross-sectional study design was used. Sample of 197 type 2 diabetic patients attending the diabetes and metabolism outpatient clinic pertaining to Alexandria Main University Hospital, physicians, nurses, and social workers working at the selected clinic were targeted for this study.
Data collection was done using a structured interview questionnaire.The questionnaire was designed to collect data on personal characteristics of the study sample, assessment of SF-36 quality of life domains for type 2 diabetic patients, assessment of significant disease specific and socio-demographic predictors of QoL among type 2 diabetic patients, and assessment of patients’ and clinic health services providers’ opinions regarding the upgrading of health services to improve diabetic patients’ QoL.
The main results of this study could be summarized as follows:
Concerning patients Personal characteristics of the study sample the following main results were revealed:
1- Patients ’ age ranged from 40-80 years old with an average of 53.3+8.2. Both males and females were more or less equally distributed (49.2% and 50.8% respectively) and 80.5%of them were married.
2- The highest percentage of patients (33.5%) was illiterate and the majority of them (88.8%) had insufficient income.
3- The majority of the patients reported suffering from co-morbid disease (97.5%).
Concerning assessment of SF-36 quality of life domains for type 2 diabetic patients the following main results were revealed:
1- Concerning the quality of life the highest percentage of patients shows the lowest scores (zero) for most of their physical functioning.
2- The highest percentage of the patients (43.65) rated their health in general as poor (zero score) and reported that their physical health or emotional health problems (zero score) extremely interfered with their social activities.
3- About 70% of patients had problems with their work or other regular daily activities as result of their physical health (zero score).
4- The highest percentage of patients reported that their physical health or emotional problems extremely (zero score) interfered with their social activities including social extent (35.5%) and social time (24.9%).
5- For total sample ”.both ”physical functioning ”and ”mental health” subscales achieved the highest scores with nearly equal value (47.77+30.200 and 47.65+19,076 respectively). On the other hand ”role limitation due to physical health” and ”role limitation due to emotional health” were the subscales of the lowest score (24.24+39.359 and 28.27+41.743 respectively).
Concerning assessment of significant disease specific and socio-demograpgic predictors of QoL among type 2 diabetic patients the following main results were revealed:
1- Singles achieved the highest scores for all subscales. While illiterates showed the lowest scores for all quality of life subscales although all recorded variablities at the patient’s scores were statistically proved.
2- Patients with longer duration of illness had lower scores than those with shorter duration of illness, duration of illness was statistically significant for ”mental health”(P =0.049) and” social functioning” (P=0.00).
3- Smoking status was statistically a significantly affecting factor for ”body pain” (P=0.046). Those with enough income achieved higher scores for all subscales than those with insufficient income.
4- Regarding scores of quality of life subscales, number of co. morbidities showed a significant effect except for general health subscale (P=0.092).
Concerning assessment of patients’ and clinic health services providers’ opinions regarding the upgrading of health services to improve diabetic patients’ QoL the following main results were revealed:
1- Decrease waiting time was the suggestion of the highest frequency (21.3%) followed by free medications for patients and training sessions for health services providers with equal frequencies of 11.2%.
2- For providers’ suggestions regarding upgrading health services, free medications for patients was the suggestion of the highest frequency (66.6%).
Based on these results the following are recommended:
1. Develop diabetes management program where the implementation of primary and secondary prevention to reduce the prevalence of diabetes should be expanded.
2. Appropriate treatment of diabetic patients in early phases to avoid co- morbidity and long term complications to avoid deterioration of diabetic quality of life, in addition physician should pay especial attention to patients diabetic foot care.
3. Increase medications availability which should be affordable for patients.
4. Increase working hours of clinic to minimize patients waiting time
5. Adequate management information system for providing accurate information which will give important insights on diabetes care in Egypt.