Subjective Well-Being of Persons with Type 2 Diabetes Mellitus

Both health and quality of life have commonly been defined as well-being. Subjective well-being concerns peoples' self-reported assessment of their own well-being. ¹ Well-being is a concept that encompasses an individual's subjective perception of physical, emotional, and social status, including both satisfaction and happiness. ² Having good subjective well-being has always been desirable for humans, and the concept of a good life and the ways to achieve it have become important over the years. Subjective well-being is an issue of concern for persons with type 2 diabetes mellitus (DM).

Type 2 DM is a chronic disease that affects persons' general health and well-being in various ways. ³ However, little is known about the subjective well-being of persons with diabetes during the course of the disease. This study was undertaken to assess the level of subjective well-being in persons with diabetes.

We performed a descriptive study in the University Research and Practice Hospital in Kocaeli, Turkey, during October 2013. The study was conducted using a convenience sample of persons followed in the diabetes outpatient clinic. Participants volunteered to take part in the study; inclusion criteria were literacy, being older than 18 years of age, and not being pregnant. Data were gathered using Patient Information Form and the BBC Subjective Well-being (BBC-SWB) scale. Consent was obtained from participants to use their answers for the purpose of this study. Statistical analysis was performed using the SPSS, version 16.0 (SPSS Inc., an IBM company, Chicago, IL).

The BBC-SWB scale has been used to identify the general well-being of populations. ⁴ Respondents were required to select the answer that best describes their experience from among 5 options. The item concerning anxiety and depression was reversed scored. Higher scores reflect a higher degree of general well-being. It has previously been shown to be a reliable and valid measure of subjective well-being in the general population with good psychometric properties. ⁴ In this study, Cronbach α coefficients calculated using the whole sample (n=120) revealed high levels of internal consistency for the total scale (Cronbach α=.86, 24 items).

Mean age of the study participants was 51.9±1.1 years (range: 21–85 years), 65.8% (n=79) were female, 40.0% (n=48) were in the age range of 51–61 years, 87.5% (n=105) were married, and 31.7% (n=38) had two children. With regard to educational status, 42.5% (n=51) were primary school graduates. With regard to the treatment regimen, 51.7% (n=62) of patients were on oral antidiabetic drugs. The average duration of type 2 DM was 6.9±0.6 years.

The mean score was 3.17±0.58 (range 2.45±1.08 to 4.11±0.84). Mean scores were 3.10 (standard deviation [SD]=0.61) for the psychological well-being domain, 3.03 (SD=0.66) for the physical health and well-being domain, and 3.57 (SD=0.77) for the relationships domain.

The mean item score for the BBC-SWB was 3.17±0.58, which is higher than that reported by Pontin et al (3.05±0.70). ⁴ In our study, questions related to relationships received higher scores (3.57±0.77), and questions related to physical health and well-being received low scores (3.03±0.66). This result is not similar to that found in the study conducted among populations in England by Pontin et al. ⁴ In that study, questions related to general well-being received low scores. ⁴

It is notable that, in each case, the ranges were extremely similar. In terms of perceptions of well-being profiles of persons with diabetes, a median of 4 (range ≤4) was recorded for items 10,13,15,16,17,18,19, and 24, which was significantly better than what was recorded for items 1, 2, 3, 4, 6, 7, 8, 9, 11, 12, 14, 20, 21, 22, and 23 (a median of 3 [range ≤4]). In terms of well-being perception profiles of participants in the Pontin et al study, a mean of 2 was recorded for items 1, 2, 8, 9, 10, 11, 19, and 20, and a mean of 3 was recorded for the other items. In our study, a median of 2 (range ≤4) was recorded for 5 items. These findings were in concordance with reports from previous studies. ⁵ An important finding was that persons with diabetes were more likely to focus on low items.

Subjective well-being was less than ideal in the study population, indicating the need to improve subjective well-being care to maintain a desirable subjective well-being as a first step in persons with diabetes. When working with persons with diabetes, as soon as the diagnosis has been made, it is recommended that information on perceptions of the general well-being status be evaluated and objective data (metabolic control values) be gathered.