TABLE OF CONTENTS
Title Page
Approval page
Certification
Dedication
Acknowledgement
Table of Content
List of Tables
List of Figures
Abstract
CHAPTER ONE: INTRODUCTION
Background to the Study
Statement of Problem
Purpose of the Study
Objectives of the study
Hypotheses
Scope of the study
Significance of the Study
Operational Definition of Terms
CHAPTER TWO: LITERATURE REVIEW
Conceptual Review
Concept of Diabetes Mellitus
Classification of Diabetes Mellitus
Concept of Quality of Life
Diabetes and Health Related Quality of Life
Diabetes and Physical Functioning
Diabetes and Psychological Functioning
Diabetes and Social Functioning
Dimensions of Health Related Quality of Life
Measures of Health Related Quality of Life
Theoretical Review
Model of the Study
The WHOQOL-BREF Model
Empirical Review
Summary
CHAPTER THREE: RESEARCH METHODS
Research Design
Area of the Study
Population of the Study
Sample
Sampling Procedure
Inclusion Criteria
Instrument for Data Collection
Validity of the Instrument
Reliability of Instrument
Ethical Consideration
Procedure for Data Collection
Method of Data Analysis
CHAPTER FOUR: ANALYSES OF DATA AND PRESENTATION OF DATA
Test of Hypotheses
Summary of Results
CHAPTER FIVE: DISCUSSION OF FINDINGS
Discussion of Major Findings
Implication of the Findings
Limitations to the Study
Suggestion for Further Studies
Recommendations
Summary
Conclusion
References
Appendixes
ABSTRACT
Nigeria has the highest number of diabetics in Sub-Saharan Africa. As a chronic illness, diabetes mellitus (DM) places serious constraints on the people living with diabetes mellitus. The short-term and long-term complications affecting the physical, psychological and social functioning of diabetics can impinge on their health-related quality of life (HRQOL). This study assessed and compared the HRQOL of diabetic patients and non-diabetics in Port Harcourt, Rivers State, Nigeria. Four objectives and two null hypotheses were formulated to guide the study. The study adopted a descriptive cross sectional survey design. It was conducted at the diabetic out- patient clinic of the University of Port Harcourt Teaching Hospital, Port Harcourt. Power analysis was used to determine the minimum sample size of 200 each for the diabetic and the non-diabetic comparison group. The diabetics who met the inclusion criteria were purposively recruited, while the age and sex matched non-diabetics were recruited from Catholic Community of Mater Misericordiae Catholic Church, Rumumasi and Anglican Community of Anglican Church of Messiah, Elekahia Housing Estate, all in Port Harcourt. The World Health Quality of Life-Bref, (WHOQOL-BREF) a 26 item standardized questionnaire with 12 additional questions soliciting demographic and clinical data was used for data collection. The reliability of the instrument was carried out using split-half method.The Cronbach’s alpha coefficient of reliability was 0.70 for physical domain, 0.76 for psychological domain, 0.78 for social domain and 0.70 for environmental domain.. Instrument was interviewer administered and data collected were subjected to descriptive and inferential statistics using Chi-square, student t-test and analysis of variance at alpha significant level of P<0 .05.="" differences="" no="" p="" significant="" there="" were=""> 0.05) between the diabetics and the non-diabetics in their demographic variables. The mean scores for diabetics in the four domains of the WHOQOL-BREF were: physical 23.17 ± 3.39, Psychological 20.06 ± 3.32, social 10.20 ± 2.47 and environmental 28.00 ± 5.15. The mean scores for non-diabetics in the four domains were: physical 24.17 ± 2.42, psychological 21.53
± 2.51, social 11.43 ± 1.87 and environmental 28.68 ± 5.044. The diabetic group had less HRQOL (p < 0.05) than the non- diabetic group in the physical, psychological and social domains. Out of the 200 diabetics, 92 reported co-morbidities. The mean scores of diabetics with co-morbidities in the four domains were: physical 22.73 ±3.30, psychological 19.63 ± 3.08, social 9.96 and environmental 27.41 ± 4.98. The mean scores of diabetics without co-morbidities in the four domains were: physical 23.55 ± 3.43, psychological 20.39 ± 3.48, social 10.40 ± 2.62 and environmental 28.50± 5.25. There was no significant difference (p > 0.05) between the diabetic patients with co-morbidities and the diabetics without co-morbidities in all the four domains. The diabetics with post-secondary education had a significant higher mean score (3.93 ± 0.81) than those with secondary and primary education (3.75 ±1.12 and 3.37 ± 1.06 respectively). In conclusion, DM impacts negatively on the HRQOL of the patients. Efforts to enhance diabetic HRQOL should be promoted.
CHAPTER ONE
INTRODUCTION
Background to the Study
Diabetes mellitus is defined as a group of metabolic diseases characterized by increased level of glucose in the blood resulting from defects in insulin secretion or insulin action or both [American Diabetic Association (ADA), (2004); Huang, Hwang, Wu, Lin, Leite & Wu, (2008)]. It is a devastating illness that has physical, social, emotional and economic implications. It impinges on the quality of life and overall health status of the individuals, as well as direct health care cost and indirect costs to the society when related to lost productivity. It is a chronic and distressing illness that makes demands on the individual by causing a lot of short-term and long-term complications that is life threatening. Diabetes mellitus is the leading cause of non-traumatic amputation and blindness in working age adults and the third leading cause of death from diseases primarily, because of the high rate of cardiovascular complications (myocardial infarction, stroke, and peripheral vascular disease) among people with diabetes (Smeltzer, Bare, Hinkle & Cheever, 2010).
Studies have shown that the incidence of diabetes is on the increase. The centre for Disease Control and Prevention (CDC) (2011), stated that in 2010, an estimated 79 million American adults aged 20years or older with pre-diabetes. In 2000, the world-wide estimate of the prevalence of diabetes was 171 million people, and by 2030, this is expected to increase to 366 million (Wild, Roglic, Green et al, 2004). The International Diabetes Federation (IDF) estimated that 194 million people had diabetes in the year 2003, and about two thirds of these people lived in developing countries of which Nigeria is one. The President of IDF (2006-2009), warned that if left unchecked, the number of people with diabetes will reach.......
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