Health-related quality of life - mental 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 poorer mental HRQol than those without diabetes.
- Women with diabetes rate their mental HRQol lower than men with diabetes.
- Very few differences in mental HRQol were identified by age and education.
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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 provided their mental dimension of their HRQol with a mean score of 48.6; the figure was lower among women than men (46.9 vs 50.5). Hardly any differences in the mental HRQol were observed by age or education group. Over time, similar assessments of mental HRQol were found in 2010 and 1998. In 2010, people without diabetes reported a slightly higher mental HRQol than those with diabetes (age-adjusted difference in the mean sum score: 1998: 1.6; 2010: 1.7).
Conclusion
The HRQol with regard to the mental dimension among people with diabetes in Germany have remained largely unchanged over time and it is consistently lower in persons with diabetes compared to those without diabetes of a comparable age. Women with diabetes rated their mental HRQol lower than men. Therefore, targeted measures should be implemented to improve the mental 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.
