. 2018 Nov 19;16(1):215.

doi: 10.1186/s12955-018-1044-2.

Patient reported barriers are associated with low physical and mental well-being in patients with co-morbid diabetes and chronic kidney disease

Edward Zimbudzi^{1

2}, Clement Lo^{1

3}, Sanjeeva Ranasinha¹, Gregory Fulcher^{4

5}, Martin Gallagher^{6

7}, Stephen Jan^{6

8}, Peter G Kerr^{2

9}, Helena J Teede^{1

3}, Kevan R Polkinghorne^{2

9}, Grant Russell¹⁰, Rowan G Walker¹¹, Sophia Zoungas^{12

13

14}

Affiliations

¹ School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
² Department of Nephrology, Monash Health, Melbourne, VIC, Australia.
³ Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia.
⁴ Department of Diabetes and Endocrinology, Royal North Shore Hospital, Sydney, NSW, Australia.
⁵ Northern Clinical School, University of Sydney, Royal North Shore Hospital, Sydney, NSW, Australia.
⁶ The George Institute for Global Health, University of NSW, Sydney, NSW, Australia.
⁷ Concord Clinical School, University of Sydney, Sydney, NSW, Australia.
⁸ Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
⁹ Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia.
¹⁰ School of Primary Health and Allied Health Care, Monash University, Melbourne, VIC, Australia.
¹¹ Department of Renal Medicine, Alfred Hospital, Melbourne, VIC, Australia.
¹² School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. sophia.zoungas@monash.edu.
¹³ Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia. sophia.zoungas@monash.edu.
¹⁴ The George Institute for Global Health, University of NSW, Sydney, NSW, Australia. sophia.zoungas@monash.edu.

PMID: 30454062
PMCID: PMC6245917
DOI: 10.1186/s12955-018-1044-2

Patient reported barriers are associated with low physical and mental well-being in patients with co-morbid diabetes and chronic kidney disease

Edward Zimbudzi et al. Health Qual Life Outcomes. 2018.

. 2018 Nov 19;16(1):215.

doi: 10.1186/s12955-018-1044-2.

Authors

Affiliations

¹ School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
² Department of Nephrology, Monash Health, Melbourne, VIC, Australia.
³ Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia.
⁴ Department of Diabetes and Endocrinology, Royal North Shore Hospital, Sydney, NSW, Australia.
⁵ Northern Clinical School, University of Sydney, Royal North Shore Hospital, Sydney, NSW, Australia.
⁶ The George Institute for Global Health, University of NSW, Sydney, NSW, Australia.
⁷ Concord Clinical School, University of Sydney, Sydney, NSW, Australia.
⁸ Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
⁹ Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia.
¹⁰ School of Primary Health and Allied Health Care, Monash University, Melbourne, VIC, Australia.
¹¹ Department of Renal Medicine, Alfred Hospital, Melbourne, VIC, Australia.
¹² School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. sophia.zoungas@monash.edu.
¹³ Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia. sophia.zoungas@monash.edu.
¹⁴ The George Institute for Global Health, University of NSW, Sydney, NSW, Australia. sophia.zoungas@monash.edu.

PMID: 30454062
PMCID: PMC6245917
DOI: 10.1186/s12955-018-1044-2

Abstract

Background: Little is known about how patient reported barriers to health care impact the quality of life (HRQoL) of patients with comorbid disease. We investigated patient reported barriers to health care and low physical and mental well-being among people with diabetes and chronic kidney disease (CKD).

Methods: Adults with diabetes and CKD (estimated Glomerular Filtration Rate < 60 ml/min/1.73m²) were recruited and completed a questionnaire on barriers to health care, the 12-Item HRQoL Short Form Survey and clinical assessment. Low physical and mental health status were defined as mean scores < 50. Logistic regression models were used.

Results: Three hundred eight participants (mean age 66.9 ± 11 years) were studied. Patient reported 'impact of the disease on family and friends' (OR 2.07; 95% CI 1.14 to 3.78), 'feeling unwell' (OR 4.23; 95% CI 1.45 to 12.3) and 'having other life stressors that make self-care a low priority' (OR 2.59; 95% CI 1.20 to 5.61), were all associated with higher odds of low physical health status. Patient reported 'feeling unwell' (OR 2.92; 95% CI 1.07 to 8.01), 'low mood' (OR 2.82; 95% CI 1.64 to 4.87) and 'unavailability of home help' (OR 1.91; 95% CI 1.57 to 2.33) were all associated with higher odds of low mental health status. The greater the number of patient reported barriers the higher the odds of low mental health but not physical health status.

Conclusions: Patient reported barriers to health care were associated with lower physical and mental well-being. Interventions addressing these barriers may improve HRQoL among people with comorbid diabetes and CKD.

Keywords: Chronic kidney disease; Diabetes; Health related quality of life; Mental well-being; Patient reported barriers; Physical well-being.

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Conflict of interest statement

Ethics approval and consent to participate

Approval for the Diabetes Renal Project was obtained from Monash University (CF12/4030–2,012,001,924), Monash Health (12,340 L), Alfred Health (526/12), Royal North Shore Hospital (1212-431 M), University of Sydney (2013/672) and Concord Hospital (LNRSSA/13/CRGH/139).

Consent for publication

All eligible patients provided a written informed consent after receiving an explanation of study procedures and aims and after having an opportunity to ask questions.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

**Fig. 2**
Patient reported barriers associated with low physical health status

**Fig. 3**
Patient reported barriers associated with low mental health status

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Patient reported barriers are associated with low physical and mental well-being in patients with co-morbid diabetes and chronic kidney disease

Affiliations

Patient reported barriers are associated with low physical and mental well-being in patients with co-morbid diabetes and chronic kidney disease

Authors

Affiliations

Abstract

Conflict of interest statement

Ethics approval and consent to participate

Consent for publication

Competing interests

Publisher’s Note

Figures

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Cited by

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical