Development of a novel scale to assess the quality of life in type 1 diabetic patients for beta cell replacement therapy
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The main purpose of beta cell replacement therapy for type 1 diabetic patients is to improve their health-related quality of life (HR-QoL). Previous HR-QoL surveys for beta cell replacement therapy on the point of familial support and public understanding have not been studied adequately. We hypothesize that familial support and public understanding have a significant impact on HR-QoL of type 1 diabetic patients, and low HR-QoL assessed with a new scale is associated with seeking a new therapy. The initial questionnaire with 26 items was created after content validation based on 778 inquiries from patients or associates. One hundred five type 1 diabetic patients answered the questionnaire as well as separate questions about their opinions on beta cell replacement therapy. Finally, the new scale, named the Japanese Insulin-Dependent Diabetic Patient QoL (JAPID-QoL) scale, consisted of 19 items with the following three subscales: diabetes status, familial support and social acceptance. Cronbach’s α for overall scale was 0.878, and those for three subscales were over 0.70. All items were satisfied with convergent validity. Lower scores on the JAPID-QoL scale were associated with higher interest in and acceptance of beta cell replacement therapy (Spearman’s coefficients; r = −0.25, p < 0.001 and r = −0.33, p < 0.001, respectively) and also correlated with the necessity of psychosomatic care (r = −0.49, p < 0.001). Our newly proposed JAPID-QoL scale showed enough reliability and validity to assess HR-QoL of type 1 diabetic patients. The patients who had a low HR-QoL on the JAPID-QoL scale desired to receive beta cell replacement therapy and psychosomatic care.
KeywordsType 1 diabetes Quality of life Familial support Social acceptance Transplantation therapy
This study was supported in part by the Health Labour Sciences Research Grant for Research on Basic Researches from the Japanese Ministry of Health, Labour and Welfare (H19-Trans-General-004) and All Saints Health Foundation (Fort Worth, TX). The authors thank the non-profit organization, Japan IDDM network, for its cooperation. The authors wish to thank Mr. Jeffrey A. SoRelle for editing this manuscript.
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