[Glycemic control, psychosocial factors, and quality of life among people with diabetes in primary health care settingsControl de la glucemia, factores psicosociales y calidad de vida en personas con diabetes en entornos de atención primaria de salud].

Abstract

Objectives: To examine the mediating role of psychosocial factors in the association between glycemic control and health-related quality of life (HRQoL) among people with diabetes living in the east side of Manaus, Amazonas, Brazil.

Methods: A cross-sectional study was conducted involving 288 people with diabetes aged 18 or older, of both sexes, who were patients at Family Health Units providing primary health care (PHC). Data collection involved individual interviews using validated instruments, such as the WHOQoL-bref for HRQoL, the SOC-13 for sense of coherence (SOC), and the Medical Outcomes Study - Social Support Survey for social support. Data on glycated hemoglobin were collected from the e-SUS APS Health Information System. A descriptive analysis was conducted, followed by structural equation modeling.

Results: The mean age was 59.0 ± 11.3 years; 110 participants (38.2%) were male and 178 (61.8%) were female. With regard to glycemic control, 89 (31.0%) had adequate glycated hemoglobin levels (below 7.0%), while 199 (69.0%) had inadequate levels (7.0% or higher). The means and standard deviations for SOC, social support, and HRQoL were 59.2 ± 16.8; 71.9 ± 26.5; and 52.6 ± 16.4, respectively. Glycemic control was directly associated with HRQoL (β = 0.185; p < 0.05) and indirectly mediated by SOC (β = -0.200; p < 0.01) and social support (β = -0.096; p < 0.05).

Conclusion: SOC and social support proved to be key mediators of the association between glycemic control and HRQoL, and are factors that could be taken into account in clinical practice.