Spiritual Suffering and Its Relationship with Glycemic Control and Health-Related Quality of Life: Comparing Two Mexican Adult Populations with Type 2 Diabetes

Reynaga-Ornelas, Luxana

Friday, 24 July 2015

Luxana Reynaga-Ornelas, PhD, MSN, RN
Departamento de Enfermería y Obstetricia Sede León. Cuerpo Académico Salud Integral, Universidad de Guanajuato Campus León. División de Ciencias de la Salud, León, Gto, Mexico
Ma. de Jesús Ruiz-Recéndiz, MSN, RN
Facultad de Enfermería y Obstetricia, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacan, Mexico
Carol M. Baldwin, PhD, RN, AHN-BC, FAAN
College of Health Solutions and College of Nursing & Health Innovation; Southwest Borderlands Scholar; Director, Center for World Health Promotion & Disease Prevention, Arizona State University, Phoenix, AZ
Nicolás Padilla-Raygoza, MD
Department of Nursing and Obstetrics. Health Sciences and Engineering Division., Universidad de Guanajuato Campus Celaya-Salvatierra, Celaya, Guanajuato., Mexico
Karla Susana Vera-Delgado, MSc, RN
University of Guanajuato, Guanajuato, Guanajuato, Mexico
Adriana Dávalos-Pérez, PhD, MSN, RN, RN
Bulevard Puente del Milenio 1001. Fracción Predio San Carlos, Universidad de Guanajuato Campus León. División de Ciencias de la Salud, León, Guanajuato, Mexico

Purpose:

Spiritual suffering (SS) may play an important role in the health-related quality of life (HRQOL) among persons with type 2 diabetes (T2D). The purpose of this study is to explore the association between SS with glycemic control (GC) and with the HRQOL among two populations with T2D who reside in central Mexico.

Methods:

This cross-sectional pilot study included outpatients with T2D residing in two locations in central Mexico. There were 140 persons from location 1 (L1) and 212 persons from location (L2). We used the Spiritual Well-being Scale that consists of two dimensions: religious SS (RSS) and existential SS (ESS). The five-dimension Diabetes 39 Boyer instrument was used to measure HRQOL; GC was assessed with glycosylated hemoglobin (HbA1c) measured in the point of care by the Nycocard® Reader II.

Results:

A total of 352 adults (66% women; mean age of 57.5) were included in the study. Of the participants, 62.5% were married, and a majority (88%) were Catholic. The prevalence of SS in the total population was 85% (94.2% in location 1 and 78.7% in location 2; p=.0001); we found a higher prevalence of mild RSS in L1 (76.4%) and a higher prevalence of mild ESS in L2 (82.5%,p = 0.0001). The HRQOL was noted to be poorer among persons in L2, particularly in the dimensions of overall quality of life and severity of diabetes (mean 52.1 and 52.4 respectively on a scale of 0 to 100). The GC was poorly controlled in 85% of the participants residing in L2; however, the HbA1c levels were high in both locations (mean 7.25±9.49). Statistically significant associations were identified in L2 between SS and GC (Chi square = 4.9824, p= 0.026, OR= 2.52, 95% CI 1.10-5.78 and FAe % 60.3), as well as between SS and HRQOL in the energy and mobility dimensions (Chi square = 4.8903, p=0.027, OR =3.23, 95% CI 1.09-9.57 and FAe % 68.73). An association was also noted between persons reporting mild SS and overall HRQOL (Chi square = 8.61, p=0.01) in L2.

Conclusions:

Participants diagnosed with T2D in L2, who reported spiritual suffering were noted to be more likely to have poorer glycemic control and lowere perceived quality of life compared to participants in L1. Reasons for these differences are not known. Further studies are required to determine differences in social determinants of health between regions.

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