Monitoring and Discussing Health-Related Quality of Life in Adolescents With Type 1 Diabetes Improve Psychosocial Well-Being

Abstract

OBJECTIVE -To test the effects of monitoring and discussing of health-related quality of life (HRQoL) in adolescents with type 1 diabetes in a multicenter randomized controlled trial.RESEARCH DESIGN AND METHODS -Four centers were randomly assigned to the HRQoL intervention (46 adolescents) or control (45 adolescents) group, with three regular visits scheduled within 12 months in both groups. In the HRQoL intervention group, HRQoL of adolescents was assessed using the Pediatric Quality of Life Inventory, and outcomes were discussed face-to-face during the consultation. The control group received care as usual. Mean differences between the groups at 12 months in physical and psychosocial well-being (Child Health Questionnaire [CHQ]-CF87/PF50, Diabetes-Specific Family Conflict Scale, and Center for Epidemiological Studies Scale for Depression), satisfaction with care (Patients' Evaluation of the Quality of Diabetes Care), and A1C were determined, controlling for baseline scores.RESULTS -Mean scores on the CHQ subscales of psychosocial health (P Ͻ 0.001), behavior (P Ͻ 0.001), mental health (P Ͻ 0.001), and family activities (P Ͻ 0.001) improved in the HRQoL intervention group, except for adolescents with the highest A1C values. Adolescents in the HRQoL intervention group reported higher self-esteem (CHQ) at follow-up (P ϭ 0.016), regardless of A1C, and were more satisfied with care (P ϭ 0.009) than control subjects. No significant differences between the two groups over time were observed in A1C levels.CONCLUSIONS -Periodic monitoring and discussion of HRQoL in adolescents with diabetes is appreciated and has positive effects on their psychosocial well-being, except for those in poorest control.

A longitudinal, observational study examining the relationships of patient satisfaction with services and mental well‐being to their clinical course in young people with Type 1 diabetes mellitus during transition from child to adult health services

“…De Wit et al . 14 also found no association between HbA 1c and satisfaction with care. We hypothesized that young people with Type 1 diabetes and higher well‐being would be more likely to experience a satisfactory clinical course during transition than those with lower well‐being.…”

“…However, it is unclear whether this is so. Reduced well‐being in rheumatological problems is associated with more active disease 12 but in diabetes the picture is less clear with two studies showing no associations 13, 14, and another showing a positive association between well‐being and better disease control as measured by HbA 1c 15. De Wit et al .…”

Validation of the Arabic and Tunisian Arabic version of the KINDL questionnaires for children with diabetes type 1

“…HRQOL has increasingly been acknowledged as an essential health outcome measure in pediatric medicine [2]. The development and use of pediatric HRQOL measures are important for identifying at-risk children and applying early intervention programs [3]. …”

Using guided individualised feedback to review self-reported quality of life in health and its importance

“…Although person-centred studies have examined the effects of QoL assessment on individual patient satisfaction (De Wit et al, 2008;Gutteling et al, 2008;Hilarius, Kloeg, Gundy, & Aaronson, 2008;Mills, Murray, Johnston, Cardwell, & Donnelly, 2009;Rosenbloom, Victorson, Hahn, Peterman, & Cella, 2007), few have specifically examined whether patients' QoL can improve as an consequence of completing a QoL measure and receiving feedback about it. This represents an intervention in its own right, and evidence for its efficacy is contradictory.…”