Factors Associated with Diabetic Peripheral Neuropathy and Quality of Life Among Type 2 Diabetes Patients in Saudi Arabia
[Thesis]
Ibraheem, Awatef B.
Penckofer, Sue
Loyola University Chicago
2020
293 p.
Ph.D.
Loyola University Chicago
2020
Evidence has suggested that diabetic peripheral neuropathy (DPN) is associated with decreased quality of life (QoL) and impaired physical and emotional health. About 82% of the diabetic population in Saudi Arabia show signs of DPN. However, it is under-recognized and undertreated. Further, DPN is linked to several clinical and metabolic risk factors. However, there is minimal evidence from Saudi Arabia on the impact of DPN on the individual's QoL. The aims of this current study were to (1) examine the impact of DPN symptoms on functioning, health perception, and QoL and (2) explore the biologic and individual factors associated with DPN symptoms. This study was guided by the revised Wilson and Cleary Health-Related Quality of Life (HRQoL) Model and included assessment of the biologic functions, symptom status, functional status, health perception, QoL, and the individual and environmental characteristics. This was a cross-sectional descriptive study conducted at a regional diabetes center in Saudi Arabia. The total sample size was 120 participants with T2DM who reported neuropathy symptoms or had confirmed DPN diagnosis. Data collected included: biologic function (e.g., HbA1c), symptoms of DPN (Michigan Neuropathic Symptom Inventory, Numerical Pain Rating Scale, Short-Leeds Assessment of Neuropathy Signs and Symptoms), functional status (Summary of Diabetes Self-care Activities-foot care subscale), and health perceptions and QoL (the Short Form-12v2). Individual (age and gender) and environmental characteristics (Medical Outcome Study-Social Support Survey and Chronic Illness Resources) were also collected. Regression analyses identified a significant relationship between DPN symptoms, foot self-care, health perception, and QoL (mental and physical). Thus worse neuropathy symptoms were associated with more foot self-care practice, poorer health perception, mental and physical QoL among the population of people with T2DM living in Saudi Arabia. Furthermore, more neuropathy symptoms were associated with poor glycemic control, presence of comorbidity, being inactive and a male. The findings suggested that in Saudi Arabia, similar to other countries, DPN causes mild to moderate QoL impairment. This study identified factors associated with the development of neuropathy among the persons living in Saudi. These findings have significant implications on nursing care, education, and future research. This study was the first that explored the impact of DPN on QoL among the population of Saudi Arabia.