Factors Affecting The Family Burden On Type 2 Diabetics With Chronic Complications

Background:Diabetes mellitus is one of the most familiar endocrine metabolismdisease. The prevalence of Chronic Diabetic Complications is high. ChronicDiabetic Complications have became the main reason of death and disabilityfor diabetics and influenced the human health and quality of life greatly.Today, in our country, the diabetic nephropathy is a main cause of toxuria, and the diabetic retinopathy is a leading cause of blindness. Chronic DiabeticComplications not only threaten the human health but also result in the hugeloss of workforce and the increase of medical cost. So the economic burdenon the patients, the patients'family and society has become extremely heavy.In a statistics, the medical cost of diabetics who with the complications ofmicrovascular, macrovascular and both are 1.7, 2.0, 3.5 times than whowithout them.The complications'cost of hospitalization are 2.1, 3.1, 5.5 timesthan non-complications'. Furthermore, the duration of hospitalization islonger and the frequency of it is higher in diabetics than in non-diabetics.Nowadays, the most studies of disease burden on diabetes and itscomplications are limited to the group of patients, and they mainly evaluateabout the death and the disability caused by the disease. So the study offamily burden on diabetes is not enough. Today, the disease model haschanged greatly, more and more diabetics need the care and support of theirfamily and society. The problems of family and society burden has also become prominent exceedingly.So in this investigation, the family burden ofChronic Diabetic Complications will be researched initially.Objectives1. To describe and analyze the family burden on type 2 diabetics withchronic complications;2. To disscuss the factors which may affect the family burden and exploresome ways to relieve it. To provide statistics to allocate and utilize the healthresources.Methods1. Cross-sectional studyThe questionnaires of "The family burden scale of patient with diabeticcomplications" and "The social support scale"will be used to investigate thefamily members of type 2 diabetics with chronic complications who are inthe endocrinology department of West China Hospital of Sichuan Universty.2. Location: the endocrinology department of West China Hospital ofSichuan Universty3. Research object: type 2 diabetics with chronic complications and theirfamily members.4. Sample size: According to the method of estimating the sample size ofmultiplicity, the sample size is at least 5-10 times than the numbers ofvariable.This research needs to analyze 34 items, the 5 times of which is 170, then attach the lose rate at 10%, so the sample size is 187.5. Data analysis:After data collection and coding, all the data were imput intocomputer to set up a database, and SPSS 13.0 statistical package was used toanalyze. Percentage, mean, standard deviation, media and inter-quartile rangewere used to describe the patients and family members' common situation.T-test, analysis of variance and nonparametric test were used to compare theburden level of different patients and their family members. Use correlationto analyze the dependablity between family burden and each factor. Use stepwise regression to analyze the influencing factors of family burden.Results1. The positive answer rate of family burden is 94.2%.The total score of bur-den in type 2 diabetics with chronic complications is lower than that in schi-zophrenia, dementia and injured patients' respectively, which were investigat-ed with the same scale in internal.2. The positive answer rate of the each dimension is all above 50%, exceptthe dimension of the impact on the psychological health of the members ofthe patient's family, and the positive answer rate of it is 49.7%.3. The 5 items which scores are all higher than the others are all belong to thedimension of the impact on patient's family economy which score is higherthan other 5 dimensions. There is no statistical significanca between the sco-res of the impact on the patient family's routine life and the impact on the pat-ient family's entertainment, but the both scores are higher than the impact onthe relationship between the members of the patient's family, the impact onthe physiological health of the members of the patient's family and the impacton the psychological health of the members of the patient's family.4. Univariate analysis revealed a significant association between burden andthe age of patient, the self-care ability of patient, the drug therapeuticregimen, the number of complications, whether have the diabetic oculopathyor not, the course of diabetic oculopathy, whether have the diabetic footdisease or not, the course of diabetic foot disease, the times of admission dueto Chronic Diabetic Complications, the days of hospitalization because ofChronic Diabetic Complications, the total cost of treatment according toChronic Diabetic Complications, the hours which family member spend intake care of patient, the acquired social support of the family member and theper capita revenue of family of one year.5. Multivariate analysis revealed that the age of patient, the self-care abilityof patient, the number of complications, the total costs of treatment because of Chronic Diabetic Complications and the acquired social support of thefamily member are the important influencing factors of family burden.Conclusion1. The family burden of type 2 diabetics with chronic complications iscommon.2. The family burden of type 2 diabetics with chronic complications areexisted in every dimensions.3. The descending order of the severity of the six dimensions of family burd-en is the impact on patient's family economy, the impact on the patient fam-ily's routine life, the impact on the patient family's entertainment, the impacton the psychological health of the members of the patient's family, the impacton the physiological health of the members of the patient's family, the impacton the relationship between the members of the patient's family.4. The main influencing factors of family burden are the following such as th-e age of patient, the self-care ability, the number of complications, the total c-osts of treatment according to Chronic Diabetic Complications and the acqui-red social support of the family member.Significance1. To offer basic data and method reference for study of family burden of Ch-ronic Diabetic Complications; to offer local data for large-scalely study offamily burden of Chronic Diabetic Complications.2. To reveal the current status of the patient's family and its problems whichcan provide objective reference for the health administration department toallocate and utilize health resources reasonably.3. To offer reference for professionals of health care in finding and makingmeasurement to relieve the family burden.