Health-related quality of life - physical dimension
The assessment of physical functioning and psychological well-being from the perspective of a person with diabetes plays an important role in describing the health status. In this context, the NVL on type 2 diabetes therapy formulates the "maintenance or recovery of quality of life" as a therapeutic goal (BÄK et al. 2013).
Key messages
- People with diabetes have a lower physical HRQol than those without diabetes.
- Women and men with diabetes provide similar ratings of their physical HRQol.
- Increasing age and lower levels of education are associated with lower ratings of physical HRQol.
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trend
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By state
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By gender
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By age
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By education group
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Results
In 2010, people with diabetes rated the physical dimension of their HRQol with a mean score of 44.8; men and women provided almost equal ratings. Ratings of physical quality of life reduce with age and are significantly lower among 65- to 79-year-olds (41.7) than among 18- to 44-year-olds (52.4). In addition, differences in physical HRQol are evident with lower score values in the lower compared to the middle and higher education group (42.9 vs 47.2). Over time, similar assessments of physical HRQol is found in 1998 and 2010. In both years, people without diabetes rated their physical HRQol higher compared to those with diabetes (age-adjusted difference in the mean sum score: 1998: 4.5; 2010: 4.3).
Conclusion
The HRQol with regard to the physical dimension is largely unchanged over time and consistently lower in people with diabetes compared to those without diabetes of comparable age. While women and men with diabetes provide similar ratings of their physical HRQol, differences were identified by age and education. Therefore, targeted measures are needed that improve the physical HRQol of people with diabetes.
Show more information on methodology and data sources
Definition
The indicator HRQol describes subjective perception of health regarding physical and mental dimensions as assessed in people diagnosed with diabetes, in comparison with people who have not been diagnosed with diabetes, and is evaluated here using two sum scores based on the Short Form 36 (SF-36) questionnaire. Higher score values indicate better HRQoL than lower values.
Operationalisation
The SF-36 questionnaire comprises 36 questions on health status that are used to create eight scales covering different dimensions of health. A factor analysis was used to assign these eight scales to two overall scales:
- (1) Physical health: The overall physical health scale (PCS) is derived from the sum of the eight scales, whereby the scales for physical function, role limitations due to physical problems, bodily pain and general health have the highest weightings.
- (2) Mental health: The overall mental health scale (MCS) is formed from the sum of the eight scales, whereby the scales for vitality, social function, role limitations due to emotional problems and mental health have the highest weightings.
- Range of values: The two overall scales can have a value ranging from 0 to 100 and have been transposed to enable a comparison between GNHIES98 (version 1 of the SF-36 questionnaire) and DEGS1 (version 2 of the SF-36 questionnaire) to a sample mean of 50 with a standard deviation of 10. The mean values from the two overall scales are shown and higher values express a better level of health-related quality of life.
Reference population
Resident population in Germany with and without known diabetes, aged 18 to 79 years
Data source
Nationwide RKI interview and examination surveys 1997-1999 (GNHIES98) and 2008-2011 (DEGS1) based on a population registry sample and self-completed questionnaire, medical interview, automated medicine registration and examination.
Number of cases
Calculation
- Description: For the indicator, the figures for total, women and men are provided and are stratified by age group, residential area and education as far as the number of cases available for the figure is ≥ 5 and the statistical uncertainty in the estimate of the indicator is not considered too large (a coefficient variation ≤ 33.5%).
- Stratification: The geographical classification of the residence of the participating person was carried out by region (north-east, north-west, middle-east, middle-west and south). Educational status was determined using the CASMIN index, which takes information on both school and vocational training into account and allows a categorisation into a low, medium and high education group.
- Weighting: In order to correct for deviations from the underlying reference population due to different participation rates or sampling probabilities, weighting factors were used when calculating the indicator. These adjust the surveys to the population structure of the reference population with regard to sex, age, federal state, German citizenship (yes / no), community type and education as of 31 December 1997 (GNHIES98) and 31 December 2010 (DEGS1). In DEGS1, the different participation probability of re-participants from GNHIES98 was also taken into account in the weighting.
- Age standardization: Age standardization and trend weighting was carried out by calculating the weighting factor in GNHIES98 using the age, sex and federal state structure of the reference population as of 31 December 2010.
Data quality
RKI interview and examination surveys provide representative results for the 18- to 79-year-old resident population of Germany. The population aged 80 years and over will only be included in future survey waves. As is the case in all population-based studies, underrepresentation of the seriously ill and those living in institutions must be assumed.
