A comparative study on quality of life among type 1 and type 2 diabetes mellitus clients at selected hospitals of district Mohali, Punjab.
Jyoti Bhardwaj1, Rashmi Choudhary2, Poonam Sharma3
1M.Sc. Nursing, Mata Sahib Kaur College of Nursing, Mohali, Punjab, India
2Associate Professor, Mata Sahib Kaur College of Nursing, Mohali, Punjab, India
3Assistant Professor, Mata Sahib Kaur College of Nursing, Mohali, Punjab, India
*Corresponding Author Email: jyotishukla2509@gmail.com
ABSTRACT:
Diabetes is the sixth leading cause of death. It is a metabolic disease characterized by high blood glucose level. This study aimed to compare quality of life among type 1 and type 2 diabetes mellitus clients at selected hospitals of district Mohali, Punjab. A quantitative approach with comparative research design was adopted for the study. 120 diabetes mellitus clients (60 type 1 and 60 type 2 diabetes mellitus clients) were selected through convenient sampling technique. Study showed that 73.3%, 23.4% and 3.3% were having fair, good and poor quality of life among type 1 diabetes clients whereas 46.7%, 35.0% and 18.3% were having poor, fair and good quality of life among type 2 diabetes mellitus clients. Comparison shows that there was significant difference between the quality of life among type 1 and type 2 diabetes mellitus clients. Clients with type 1 diabetes mellitus have better quality of life as compared to type 2 diabetes mellitus clients. Domain wise comparison indicates significant difference in quality of life among type 1 and type 2 diabetes mellitus clients in domains of role limitation due to physical health, physical endurance, general health, emotional/ mental health and diet satisfaction. There was significant association of age and education with quality of life among both type 1 and type 2 diabetes mellitus clients (p<0.05). Quality of life of type 1 diabetes mellitus clients had significant association with duration of diabetes mellitus, duration of taking treatment and duration of prescribed medication moreover among type 2 diabetes mellitus clients significant association with gender, marital status, occupation and family history of diabetes mellitus with quality of life (p<0.05).
KEYWORDS: Quality of life, type 1 diabetes mellitus clients, type 2 diabetes mellitus clients, domain wise comparison, association
INTRODUCTION:
Diabetes mellitus is a global public health problem of epidemic proportion .1Diabetes is the sixth leading cause of death and affects 246 million worldwide. According to statistics from International Diabetes Federation, India has more diabetics than any other nation of the world. Current estimates regarding the number of diabetics in the country is about 62 million. Although diabetes occurs most often in older adults, it is one of the most common chronic disorders in children. About 123,000 children and teenagers age 19 and younger have diabetes.2
Diabetes mellitus is a metabolic disease characterized by high blood glucose level that results from defects in insulin secretion or its action or both. If the insulin isn't functioning properly, glucose cannot enter the cells. This causes glucose levels in the blood to rise, creating a condition of high blood sugar or diabetes, and leaving the cells without fuel. There are the two main types of diabetes mellitus: Type 1 and Type 2 diabetes mellitus.3
As new advancement is taking place in medical technology, more aggressive treatments succeeded in increasing survival rates therefore attention increasingly turned towards quality of life of patient rather than longevity alone.4 Quality of life assessment is considered as important measure of outcome in disease management. Several studies have demonstrated that diabetes has a strong impact on quality of life. People with diabetes rate their quality of life significantly less favorable on average than people without diabetes. Hence, it is important to assess quality of life for better care and control.5
OBJECTIVES:
1. To assess the quality of life among type1 and type 2 diabetes mellitus clients.
2. To compare quality of life among type1 and type 2 diabetes mellitus clients.
3. To find out association between quality of life among type 1 and type 2 diabetes mellitus clients with selected socio-demographic variables.
MATERIAL AND METHOD:
A quantitative research approach was adopted for the study with comparative research design to achieve the objectives of the study. Non probability convenient sampling technique was used to draw sample of 120 diabetic mellitus clients (60 clients with type 1 diabetes mellitus and 60 clients with type 2 diabetes mellitus) attending OPD or admitted in IVY Hospital and Shri Guru Harkrishan Hospital of district Mohali who fulfilled inclusion criteria. Quality of life instrument for Indian diabetes patient (QOLID) standardized tool was used to assess quality of life.6
Inclusion criteria: Subjects who:
1. Gave written informed consent for participating in research study .
2. Were able to understand English/Hindi/Punjabi.
3. Were already diagnosed as client with diabetes mellitus type 1 or type 2, three months ago or more.
Exclusion criteria: Subject who were
1. Seriously ill.
2. Unconscious.
RESULTS:
Table -1: Frequency and percentage distribution of socio- demographic variables among type 1 and type 2 diabetes mellitus clients. N=120
|
Socio-demographic variables |
Type of Diabetes Mellitus |
||||
|
Type 1 diabetes mellitus ( n 1=60) |
Type 2 diabetes mellitus (n 2= 60) |
||||
|
f 1 |
% |
f 2 |
% |
||
|
Age (in years) |
|||||
|
21-30 |
29 |
48.3 |
2 |
3.3 |
|
|
31-40 |
16 |
26.7 |
4 |
6.7 |
|
|
41-50 |
12 |
20.0 |
10 |
16.7 |
|
|
51-60 |
2 |
3.3 |
21 |
35.0 |
|
|
> 60 |
1 |
1.7 |
23 |
38.3 |
|
|
Gender |
|||||
|
Male |
28 |
46.7 |
28 |
46.7 |
|
|
Female |
32 |
53.3 |
32 |
53.3 |
|
|
Marital status |
|||||
|
Unmarried |
27 |
45.0 |
2 |
3.3 |
|
|
Married |
33 |
55.0 |
46 |
76.7 |
|
|
Widow/widower |
0 |
0.0 |
12 |
20.0 |
|
|
Divorce |
0 |
0.0 |
0 |
0.0 |
|
|
Education |
|||||
|
No formal Education |
1 |
1.7 |
12 |
20.0 |
|
|
Primary |
3 |
5.0 |
14 |
23.3 |
|
|
Matric |
5 |
8.3 |
16 |
26.7 |
|
|
Senior Secondary |
26 |
43.3 |
10 |
16.7 |
|
|
Graduate & Above |
25 |
41.7 |
8 |
13.3 |
|
|
Occupation |
|||||
|
Home Maker |
18 |
30.0 |
30 |
50.0 |
|
|
Self Employed |
12 |
20.0 |
11 |
18.3 |
|
|
Private Job |
17 |
28.3 |
6 |
10.0 |
|
|
Government Job |
9 |
15.0 |
13 |
21.7 |
|
|
Unemployed |
4 |
6.7 |
0 |
0.0 |
|
|
Family Income |
|||||
|
≤15000 |
33 |
55.0 |
22 |
36.7 |
|
|
15001-30000 |
25 |
41.7 |
32 |
53.3 |
|
|
30001-45000 |
2 |
3.3 |
6 |
10.0 |
|
|
450001-60000 |
0 |
0 |
0 |
0 |
|
|
>60000 |
0 |
0 |
0 |
0 |
|
|
Socio-demographic variables
|
Type of Diabetes Mellitus |
|||
|
Type 1 diabetes mellitus (n1=60) |
Type 2 diabetes mellitus (n 2=60) |
|||
|
|
f 1 |
% |
f 2 |
% |
|
Area of Residence |
|
|||
|
Urban |
29 |
48.3 |
21 |
35.0 |
|
Rural |
31 |
51.7 |
39 |
65.0 |
|
Family history of diabetes mellitus |
||||
|
Yes |
24 |
40.0 |
22 |
36.7 |
|
No |
36 |
60.0 |
38 |
63.3 |
|
Duration of diabetes mellitus |
||||
|
<5 |
1 |
1.7 |
13 |
21.7 |
|
5-10 |
2 |
3.3 |
23 |
38.3 |
|
10-15 |
6 |
10.0 |
10 |
16.7 |
|
15-20 |
23 |
38.3 |
13 |
21.7 |
|
>20 |
28 |
46.7 |
1 |
1.7 |
|
Duration of taking treatment |
||||
|
<5 |
1 |
1.7 |
16 |
26.7 |
|
5-10 |
2 |
3.3 |
21 |
35.0 |
|
10-15 |
6 |
10.0 |
9 |
15.0 |
|
15-20 |
22 |
36.7 |
13 |
21.7 |
|
>20 |
29 |
48.3 |
1 |
1.7 |
|
Type of prescribed medication regimen for diabetes mellitus |
||||
|
Anti diabetic agents(oral) |
4 |
6.7 |
38 |
63.3 |
|
Insulin |
29 |
48.3 |
8 |
13.3 |
|
Both |
27 |
45.0 |
14 |
23.3 |
|
None |
0 |
0.0 |
0 |
0.0 |
|
Compliance with medication |
||||
|
Yes |
55 |
91.7 |
59 |
98.3 |
|
No |
5 |
8.3 |
1 |
1.7 |
|
Alternative medicine |
||||
|
Ayurvedic |
6 |
10.0 |
10 |
16.7 |
|
Homeopathic |
0 |
0.0 |
0 |
0.0 |
|
None |
54 |
90.0 |
50 |
83.3 |
|
Regular monitoring |
||||
|
Yes |
59 |
98.3 |
59 |
98.3 |
|
No |
1 |
1.7 |
1 |
1.7 |
Table 1 Majority of clients (48.3%) were in the age group of 21-30 years among type 1 diabetes mellitus whereas majority of clients (38.3%) were above 60 years of age among type 2 diabetes mellitus. Both type 1 and type 2 diabetes mellitus clients consisted of 53.3% females and 46.7% males. Majority of clients i.e. 55% were married among type 1 diabetes mellitus, whereas majority of clients i.e. 76.7% were married among type 2 diabetes mellitus.
43.3% were having education up to senior secondary closely followed by 41.7% who were graduate and above among type 1 diabetes mellitus. Majority of clients 26.7% were having education up to matric, followed by 23.3% having education up to primary level among type 2 diabetes mellitus. 30% were home maker followed by 28.3% in private job among type 1 diabetes mellitus clients, whereas 50% were home maker among type 2 diabetes mellitus clients. 55% were having family income less of than and equal to Rs15,000/ month among type 1 diabetes mellitus clients whereas 53.3% were having family income of Rs15,001-30,000 / month among type 2 diabetes mellitus.
51.7% and 65% were from rural area among type 1and type 2 diabetes mellitus clients respectively. 60% and 63.3% were not having family history of diabetes mellitus among type 1 and type 2 diabetes mellitus clients respectively. Majority of clients (46.7%) had diabetes for more than 20 years of duration among type 1 diabetes mellitus clients and majority of clients (38.3%) had duration of diabetes as 5-10 years among type 2 diabetes mellitus.
48.3% were taking treatment for diabetes more than 20 years among type 1 diabetes mellitus clients, 35% were taking treatment since 5-10 years among type 2 diabetes mellitus majority of clients. 48.3% were on insulin, closely followed by 45% who were taking both anti diabetic agents (oral) and insulin, whereas among type 2 diabetes mellitus majority of clients i.e.63.3% were on anti diabetic agents (oral). 91.7% and 98.3% were compliant with medication regimen among type 1 and type 2 diabetes mellitus clients. 90% and 83.3% took no alternative medicine for treating diabetes mellitus among type 1 and type 2 diabetes mellitus clients. 98.3% client’s regularly monitored their blood glucose level as prescribed by doctor among type 1 and type 2 diabetes mellitus clients.
Table 2: Criteria of Percentage total score obtained for quality of life N= 120
|
Level of Quality of life |
Percentage of total score obtained for quality of life |
|
Very poor |
20-40% |
|
Poor |
41-60% |
|
Fair |
61-80% |
|
Good |
81-100% |
Table 2 depicts criteria of percentage total score obtained for quality of life
Table 3: Frequency and percentage distribution of quality of life among type 1 and type 2 diabetes mellitus clients N=120
|
Type of diabetes mellitus |
Quality of life |
|||||||
|
Very poor f1 % |
Poor f2 % |
Fair f3 % |
Good f4 % |
|||||
|
Type 1 diabetes mellitus |
0 |
0 |
2 |
3.3 |
44 |
73.3 |
14 |
23.4 |
|
Type 2 diabetes mellitus |
0 |
0 |
28 |
46.7 |
21 |
35.0 |
11 |
18.3 |
|
Total |
0 |
0 |
30 |
25.0 |
65 |
54.2 |
25 |
20.8 |
Table 2. shows that 73.3% were having fair quality of life, 23.4% have good quality of life, only 3.3% were have poor quality of life among type 1 diabetes mellitus clients whereas 46.7% were having poor quality of life, 35.0% have fair quality of life and only 18.3% have good quality of life among type 2 diabetes mellitus clients.
Table 4: Comparison of quality of life among type 1 and type 2 diabetes mellitus clients N=120
|
Type of diabetes mellitus |
n |
Mean |
SD |
Unpaired t-value |
p-value |
|
|
Quality of life |
Type 1 diabetes mellitus |
60 |
126.633 |
14.534 |
4.831 |
.0001** |
|
Type 2 diabetes mellitus |
60 |
108.850 |
24.530 |
|
|
**significant (p<0.01)
Table 4 shows that there is significant difference between the quality of life among type 1 and type 2 diabetes mellitus clients. Clients with type 1 diabetes mellitus have better quality of life as compared to type 2 diabetes mellitus clients. Research hypothesis (H1) which states that there is significant difference between quality of life among type 1 and type 2 diabetes mellitus is accepted.
Table 5: Domain wise comparison of quality of life among type 1 and type 2 diabetes mellitus clients N=120
|
Domains |
Type of diabetes mellitus |
Mean |
SD |
Unpaired t-value, p-value |
|
Role limitation due to Physical Health |
Type 1 diabetes mellitus |
22.683 |
5.080 |
3.685, .0001** |
|
Type 2 diabetes mellitus |
18.366 |
7.517 |
||
|
Physical Endurance |
Type 1 diabetes mellitus |
24.400 |
3.880 |
5.942, .0001** |
|
Type 2 diabetes mellitus |
18.183 |
7.115 |
||
|
General Health |
Type 1 diabetes mellitus |
8.433 |
2.150 |
4.647, .0001** |
|
Type 2 diabetes mellitus |
6.383 |
2.655 |
||
|
Treatment Satisfaction |
Type 1 diabetes mellitus |
16.350 |
2.609 |
1.423, .157NS |
|
Type 2 diabetes mellitus |
15.616 |
3.020 |
||
|
Symptoms Botherness |
Type 1 diabetes mellitus |
12.400 |
1.498 |
1.151, .252NS |
|
Type 2 diabetes mellitus |
11.933 |
2.760 |
||
|
Financial Worries |
Type 1 diabetes mellitus |
14.033 |
2.655 |
.425, .671NS |
|
Type 2 diabetes mellitus |
14.283 |
3.696 |
||
|
Emotional/ Mental Health |
Type 1 diabetes mellitus |
19.083 |
2.423 |
3.370, .001** |
|
Type 2 diabetes mellitus |
16.766 |
4.742 |
||
|
Diet Satisfaction |
Type 1 diabetes mellitus |
9.200 |
2.081 |
4.469, .0001** |
|
Type 2 diabetes mellitus |
7.316 |
2.514 |
NS= Non Significant ,**Significant (p<0.01)
Table 5 shows that there is significant difference in quality of life among type 1 and type 2 diabetes mellitus clients in domains of role limitation due to physical health, physical endurance, general health, emotional/ mental health and diet satisfaction. But in domains of treatment satisfaction, symptom botherness and financial worries, there is no significant difference among type 1 and type 2 diabetes mellitus clients.
Table 6: Association of quality of life among type 1 clients with their selected socio-demographic variable. N= 120
|
Socio-demographic variables |
Type 1 diabetes mellitus |
Chi-square, df, p-value |
|||
|
Poor |
Fair |
Good |
|||
|
Age (in years) |
21-30 |
0 |
22 |
7 |
17.188, 8, .028* |
|
31-40 |
0 |
11 |
5 |
||
|
41-50 |
1 |
9 |
2 |
||
|
51-60 |
1 |
1 |
0 |
||
|
>60 |
0 |
1 |
0 |
||
|
Gender |
Male |
0 |
20 |
8 |
2.393, 2, 0.302NS |
|
Female |
2 |
24 |
6 |
||
|
Marital status |
Unmarried |
0 |
21 |
6 |
1.795, 2, 0.408NS |
|
Married |
2 |
23 |
8 |
||
|
Widow/widower |
0 |
0 |
0 |
||
|
Divorce |
0 |
0 |
0 |
||
|
Education |
No formal education |
1 |
0 |
0 |
45.683, 8, .000* |
|
Primary |
1 |
2 |
0 |
||
|
Matric |
0 |
4 |
1 |
||
|
Senior secondary |
0 |
23 |
3 |
||
|
Graduate and above |
0 |
15 |
10 |
||
|
Occupation |
Home maker |
1 |
13 |
4 |
4.233 , 8, 0.835NS |
|
Self employed |
1 |
10 |
1 |
||
|
Private job |
0 |
12 |
5 |
||
|
Government job |
0 |
6 |
3 |
||
|
Unemployed |
0 |
3 |
1 |
||
|
Family income per month (in rupees) |
≤15,000 |
0 |
26 |
7 |
4.188, 4, 0.381NS |
|
15,001-30,000 |
2 |
16 |
7 |
||
|
30,001-45,000 |
0 |
2 |
0 |
||
|
45,001-60,000 |
0 |
0 |
0 |
||
|
>60,000 |
0 |
0 |
0 |
||
|
Area of residence |
Urban |
2 |
18 |
9 |
4.536, 2, 0.104NS |
|
|
Rural |
0 |
26 |
5 |
|
|
Family history |
Yes |
2 |
14 |
8 |
5.942, 2, 0.051NS |
|
No |
0
|
30
|
6
|
||
|
Duration of diabetes mellitus |
<5 years |
0 |
1 |
0 |
20.846, 8, .008* |
|
5-10 years |
0 |
2 |
0 |
||
|
10-15 years |
2 |
4 |
0 |
||
|
15-20 years |
0 |
17 |
6 |
||
|
>20years |
0 |
20 |
8 |
||
|
Duration of taking treatment |
<5years |
0 |
1 |
0 |
20.803, 8, .008* |
|
5-10 years |
0 |
2 |
0 |
||
|
10-15 years |
2 |
4 |
0 |
||
|
15-20 years |
0 |
16 |
6 |
||
|
>20years |
0 |
21 |
8 |
||
|
Types of prescribed medication |
Anti diabetic agent (oral) |
1 |
1 |
2 |
9.552, 4, .049* |
|
|
Insulin |
1 |
21 |
7 |
|
|
|
Both |
0 |
22 |
5 |
|
|
|
None |
0 |
0 |
0 |
|
|
Compliance with medication |
Yes |
1 |
41 |
13 |
4.704, 2, 0.095NS |
|
|
No |
1
|
3 |
1 |
|
|
Alternative remedies for diabetes mellitus |
Ayurvedic |
1 |
4 |
1 |
3.723, 2, 0.155NS |
|
Homeopathy |
0 |
0 |
0 |
||
|
None |
1 |
40 |
13 |
||
|
Regular monitoring of blood glucose level as prescribed by doctor |
Yes |
2 |
43 |
14 |
.370, 2, 0.831NS |
|
No |
0
|
1
|
0
|
||
NS= Non significant ,Significant (p<0.05)
Table no. 7: Association of quality of life among type 2 clients with their selected socio-demographic variable. N=120
|
Socio-demographic variables |
Type 2 diabetes mellitus |
Chi-square, df, p-value |
|||
|
Poor |
Fair |
Good |
|||
|
Age (in years) |
21-30 |
0 |
0 |
2 |
43.131, 8, .000* |
|
31-40 |
0 |
3 |
1 |
||
|
41-50 |
0 |
8 |
2 |
||
|
51-60 |
7 |
9 |
5 |
||
|
>60 |
21 |
1 |
1 |
||
|
Gender |
Male |
9 |
10 |
9 |
7.842, 2, .020* |
|
Female |
19 |
11 |
|
||
|
Marital status |
Unmarried |
0 |
0 |
2 |
20.667, 4, .000* |
|
Married |
17 |
20 |
9 |
||
|
Widow/widower |
11 |
1 |
0 |
||
|
Divorce |
0 |
0 |
0 |
||
|
Education |
No formal education |
10 |
1 |
1 |
17.695, 8, .024* |
|
Primary |
8 |
4 |
2 |
||
|
Matric |
8 |
5 |
3 |
||
|
Senior secondary |
0 |
7 |
3 |
||
|
Graduate and above |
2 |
4 |
2 |
||
|
Occupation |
Home maker |
19 |
9 |
2 |
16.124, 6, .013* |
|
Self employed |
4 |
4 |
3 |
||
|
Private job |
0 |
2 |
4 |
||
|
Government job |
5 |
6 |
2 |
||
|
Unemployed |
0 |
0 |
0 |
||
|
Family income per month (in rupees) |
≤15,000 |
10 |
6 |
6 |
2.253, 4, 0.689NS |
|
15,001-30,000 |
15 |
13 |
4 |
||
|
30,001-45,000 |
3 |
2 |
1 |
||
|
45,001-60,000 |
0 |
0 |
0 |
||
|
>60,000 |
0 |
0 |
0 |
||
|
Area of residence |
Urban |
11 |
8 |
2 |
1.682, 2 , 0.431NS |
|
|
Rural |
17
|
13
|
9 |
|
|
Family history |
Yes |
6 |
9 |
7 |
6.592, 2, .037* |
|
No |
22
|
12
|
4 |
||
|
Duration of diabetes mellitus |
<5 years |
4 |
6 |
3 |
9.638, 8, 0.291NS |
|
5-10 years |
8 |
10 |
5 |
||
|
10-15 years |
5 |
4 |
1 |
||
|
15-20 years |
10 |
1 |
2 |
||
|
>20years |
1 |
0 |
0 |
||
|
Duration of taking treatment |
<5years |
5 |
7 |
4 |
10.254, 8, 0.248NS |
|
5-10 years |
7 |
10 |
4 |
||
|
10-15 years |
5 |
3 |
1 |
||
|
15-20 years |
10 |
1 |
2 |
||
|
>20years |
1 |
0 |
0 |
||
|
Types of prescribed medication |
Anti diabetic agent (oral) |
16 |
16 |
6 |
8.581, 4, 0.072NS |
|
|
Insulin |
3 |
1 |
4 |
|
|
|
Both |
9 |
4 |
1 |
|
|
|
None |
0 |
0 |
0 |
|
|
Compliance with medication |
Yes |
27 |
21 |
11 |
1.162, 2, 0.559NS |
|
|
No |
1
|
0
|
0 |
|
|
Alternative remedies for diabetes mellitus |
Ayurvedic |
4 |
5 |
1 |
1.340, 2, 0.512NS |
|
Homeopathy |
0 |
0 |
0 |
||
|
None |
24 |
16 |
10 |
||
|
Regular monitoring of blood glucose level as prescribed by doctor |
Yes |
28 |
20 |
11 |
1.889, 2, 0.389NS |
|
No |
0
|
1
|
0
|
||
NS= Non significant, Significant (p<0.05)
CONCLUSION:
· Quality of life among majority of type 1 diabetes mellitus clients was fair i.e. 73.3% followed by good quality of life in 23.3% clients whereas majority of clients 46.7% with type 2 diabetes mellitus clients were having poor quality of life followed by fair quality of life in 35% clients.
· Unpaired t-test value shows significant difference between quality of life among type 1 and type 2 diabetes mellitus clients.
· Domain wise comparison highlighted significant difference in role limitation due to physical health, physical endurance, general health, emotional/ mental health and diet satisfaction among type 1 ad type 2 diabetes mellitus.
DISCUSSION:
· A cross sectional study conducted in Spain among 67 patients with type 1 diabetes mellitus clients, result revealed that 68.5% of the patients reported that diabetes had changed their lives, 83.5% identified complications as their most important long-term concern and 59.7% said that they needed more training to manage the disease.7
· A descriptive study conducted in Cartagena de Indias, Colombia among 315 type 2 diabetic mellitus patients, results revealed that 196 (62.2%) of patients have a good quality of life.8
· A cross- sectional study conducted among type 1 and type 2 diabetic clients in Portuguese revealed the same results i.e. people with type 2 diabetes mellitus have poor quality of life than type 1.9
· A cross- sectional descriptive survey in Sargodha City, Pakistan among 392 type 2 diabetes mellitus clients revealed that gender, marital status, education, monthly income, occupation, location and duration of the disease were reported to be significantly associated with HRQoL.10
ACKNOWLEDGEMENT:
I would like to express my sincere gratitude to the participants of study who had spent their valuable time for giving the information. Grateful acknowledgement is extended to Mr. Rajesh Kumar for the valuable help in statistical analysis.
CONFLICT OF INTEREST:
There was no conflict of interest in the study.
SOURCE OF FUNDING:
Self.
ETHICAL CLEARANCE:
Permission for the research study was taken from ethical and research committee of Mata Sahib Kaur College of Nursing Balongi, Mohali to conduct research study.
Permission from the Nagpal J. was taken to use “Quality of life instrument for Indian diabetes patient” as a tool in this study.
A formal written permission was obtained from the Nursing Superintendent Indus Superspeciality Hospital, Phase-1, Mohali to conduct pilot study.
A formal written permission was obtained from the Nursing Superintendent of Sri Guru Harkrishan Hospital Sohana, Mohali and IVY Hospital, Sector-71, Mohali for main study.
Written informed consent was obtained from all diabetes mellitus clients.
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Received on 06.10.2017 Modified on 20.12.2017
Accepted on 14.01.2018 ©A&V Publications All right reserved
Asian J. Nursing Education and Research. 2018; 8(1): 152-158.
DOI: 10.5958/2349-2996.2018.00032.0