Date of Award

2014

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

Abstract

Complications of type 2 diabetes (T2DM) are severe but can be minimized through excellent glycemic control, optimally achieved by using intensive, or basal-bolus, insulin management. The quality of life (QOL) effects of basal-bolus insulin management are not fully known. This cross-sectional, observational study was based on the Revised Wilson and Cleary Model for Health Related Quality of Life, which measures five QOL domains (biological function, symptoms, functional status, general health perceptions, and overall QOL). The study aims were to describe, compare, and predict QOL in persons with T2DM based on type of insulin management (oral meds only, basal insulin only, or basal-bolus insulin). A convenience sample of adults with T2DM (n=107; 76% women; 84% non-Hispanic whites) completed self-report surveys (Chronic Illness Resources Survey, Diabetes Symptom Checklist-Revised, Well-Being Questionnaire 12, SF-12 Health Survey-version 2, Self-Care Inventory-Revised, Appraisal of Diabetes Scale, Quality of Life Index: Diabetes Version) and a bloodspot HBA1c test via postal mail. The sample reported high QOL (21.8±4.7). Female participants reported lower well-being (23.0 vs 27.5, p<.01), greater negative well-being (2.2 vs 1.0, p<.05), and lower QOL than study males (21.1 vs 24.0, p<.01). Per multiple regression, general well-being (β = .51, p<.001) and appraisal of diabetes (β = -.23, p<.05) predicted QOL [R2 = .49, F (5, 90) = 17.04, p< .001]. Multiple regression analysis revealed that self-care

moderates the relationship between general well-being and QOL [R2 = .45, F (3, 102) = 27.73, p<.001]. No significant differences were detected in QOL between insulin management groups. This study may provide greater insight into the QOL in adults with T2DM.

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