DETERMINANTS OF THE QUALITY-OF-LIFE OF PATIENTS WITH DIABETES UNDER INTENSIFIED INSULIN THERAPY

OBJECTIVE - The concept of quality of life (QOL) is understood as a mu ltidimensional construct made up of physiological, psychological, and social aspects, but their particular weightings for the global QOL are rarely investigated. We examined 1) the general QOL of patients with diabetes, 2) the significance of the individual QOL aspects for the ov erall assessment of QOL, and 3) the modulating function of coping mech anism and particular personality traits. RESEARCH DESIGN AND METHODS - A total of 116 diabetes patients under intensified insulin therapy we re studied, as were 107 patients with inflammatory bowel disease, 66 p atients with chronic hepatitis C, and 229 students who served as contr ol subjects. The examination was based on eight standardized QOL and p ersonality questionnaires (354 items) and assessed by means of linear structural regression models (AMOS 3.6). RESULTS - The QOL of diabetes patients appears to be higher than the QOL of other chronically ill p atients. Social, psychological, and physical aspects contribute to the overall QOL, although physical complaints receive a comparatively low weighting. Coping behavior and particular personality traits covary w ith all QOL aspects, giving these variables greater significance for t he QOL than the existence of secondary illnesses. CONCLUSIONS - The hy pothesis that the various factors involved in the multidimensional con struct QOL receive different weightings was confirmed, making a simple summary score for the general QOL appear unjustifiable. in addition, all aspects that are commonly understood as parameters of QOL are infl uenced by external factors, such as coping behavior, based on individu al personality characteristics.