AIM: To assess the diabetes empowerment scores and its correlated factors among type 2 diabetes patients in a primary care clinic in Malaysia.
METHODS: This is a cross sectional study involving 322 patients with type 2 diabetes mellitus (DM) followed up in a primary care clinic. Systematic sampling method was used for patient recruitment. The Diabetes Empowerment Scale (DES) questionnaire was used to measure patient empowerment. It consists of three domains: (1) Managing the psychosocial aspect of diabetes (9 items); (2) Assessing dissatisfaction and readiness to change (9 items); and (3) Setting and achieving diabetes goal (10 items). A score was considered high if it ranged from 100 to 140. Data analysis was performed using SPSS version 25 and multiple linear regressions was used to identify the predictors of total diabetes empowerment scores.
RESULTS: The median age of the study population was 55 years old. 56% were male and the mean duration of diabetes was 4 years. The total median score of the DES was 110 [interquartile range (IQR) = 10]. The median scores of the three subscales were 40 with (IQR = 4) for "Managing the psychosocial aspect of diabetes"; 36 with (IQR = 3) for "Assessing dissatisfaction and readiness to change"; and 34 with (IQR = 5) for "Setting and achieving diabetes goal". According to multiple linear regressions, factors that had significant correlation with higher empowerment scores among type 2 diabetes patients included an above secondary education level (P < 0.001), diabetes education exposure (P = 0.003), lack of ischemic heart disease (P = 0.017), and lower glycated hemoglobin (HbA1c) levels (P < 0.001).
CONCLUSION: Diabetes empowerment scores were high among type 2 diabetes patients in this study population. Predictors for high empowerment scores included above secondary education level, diabetes education exposure, lack of ischemic heart disease status and lower HbA1c.
METHODS: A clinic based, cross sectional study using the Short Form-36 (SF-36) questionnaire was conducted in two primary care health clinics in Hulu Langat, Selangor, Malaysia over a period of 8 months. The nurses and medical assistants were involved in recruiting the patients while the family physicians conducted the interview.
RESULTS: A total 151 respondents were recruited. The mean age was 65.6 +/- 10.8 years with females constituted 119 (78.8%) of the patients. The mean duration of knee pain was 4.07 +/- 2.96 years. Half of the patients were overweight and majority, 138 (91.4%), had at least one co-morbidity, the commonest being hypertension. The physical health status showed lower score as compared to mental health component. The domain concerning mental health components showed positive correlation with age. There was a significant negative correlation between age and physical functioning (p < 0.0005) which indicated the deterioration of this domain as patients became older. Male respondents had better scores in most of the QOL dimensions especially in the physical functioning domain (p = 0.03). There was no significant association between QOL with different education levels, employment status and marital status. Patients with higher body mass index (BMI) and existence co-morbidities scored lower in most of the QOL domains.
CONCLUSIONS: This study has shown that patients with knee OA attending primary care clinics have relatively poor quality of life pertaining to the physical health components but less impact was seen on the patients' mental health.
Methods: We enrolled and reviewed 122 biopsy-proven NAFLD patients. Advanced fibrosis was defined as fibrosis stages 3-4. Noninvasive assessments included aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, AST-to-platelet ratio index (APRI), AST/ALT ratio, diabetes (BARD) score, fibrosis-4 (FIB-4) score, and NAFLD fibrosis score.
Results: FIB-4 score had the highest area under the receiver operating characteristic curve (AUROC) and negative predictive value (NPV) of 0.86 and 94.3%, respectively, for the diagnosis of advanced fibrosis. FIB-4 score care setting, with further stratification of those in the indeterminate group using clinical predictors of NASH, can help in the development of a simplified strategy for a public health approach in the management of NAFLD.