Self-perception of health status, mental health and quality of life among adults with diabetes residing in a metropolitan area.

AIM: The study aimed to compare the self-perception of health, physiological distress and health-related quality of life (HRQL) in subjects with and without diabetes residing in a large metropolitan area (the city of Madrid), and to identify the variables associated with the poorest HRQL among diabetes patients. METHODS: In this case-control epidemiological study, we selected 358 patients with diabetes from the Madrid City Health Survey. For every patient, two controls without diabetes were randomly selected from the same database and matched for age, gender and health district. The resultant study population comprised 1074 subjects, who were analyzed according to their self-rated health status, with mental health assessed by the 12-item General Health Questionnaire (GHQ-12) and HRQL by the COOP/WONCA questionnaire. Independent variables included sociodemographic characteristics, lifestyle variables, associated chronic diseases and consumption of medications. Multivariate analyses were conducted using ANCOVA tests. RESULTS: The prevalence of health perceived as fair or poor was 64.12% in those with diabetes vs 38.57% in those without diabetes (P<0.05). The GHQ-12 results showed that mental health was also significantly worse among diabetes sufferers, and the COOP/WONCA questionnaire results indicated significantly poorer HRQL in those with diabetes. The variables that determined a poorer perception of HRQL among diabetes sufferers were female gender, older age, obesity, lack of physical exercise, coexistence of depression, use of sleeping pills, and Alzheimer's and cerebrovascular diseases. CONCLUSION: Self-rated health and psychological well-being, and HRQL, are all considerably poorer among patients with diabetes vs those without diabetes. The poorest quality of life among those with diabetes associated with female gender, depression, lack of exercise and obesity.

Impact of the most frequent chronic health conditions on the quality of life among people aged >15 years in Madrid.

BACKGROUND: This study sought to ascertain to what degree health-related quality of life (HRQL) in the City of Madrid was affected by each of the most frequent chronic health conditions, and the specific quality-of-life (QL) domains on which such health conditions had the greatest impact, taking co-morbidity and socio-demographic variables into account. METHODS: A descriptive, analytical, cross-sectional study was conducted covering 7341 subjects aged >or=16 years in the City of Madrid. Data were collected on self-reported diagnosed morbidity, including hypertension, hypercholesterolaemia, varicose veins, diabetes, chronic asthma/bronchitis, myocardial infarction/angina pectoris, stomach problems, allergy, arthrosis/arthritis or rheumatism, depression/anxiety, cataracts, cerebrovascular accidents (CVACs), chronic constipation, osteoporosis and Alzheimer's disease or dementia. HRQL was measured using the COOP/WONCA questionnaire. The effects of diagnosis, age, social class, gender and the co-morbidity were analysed using a multivariate analysis of covariance (ANCOVA). RESULTS: The chronic health conditions that registered the worst overall mean scores on the COOP/WONCA questionnaire were Alzheimer's disease or dementia, Parkinson's disease, fibromyalgia, CVACs and depression, with scores of over 26 points in all cases. After the introduction of socio-demographic variables in the model, the highest values of Snedecor's F-test corresponds to depression (F = 461.63), 'arthrosis/arthritis or rheumatism' (F = 175.41), Alzheimer's disease or dementia (F = 65.70), gastric disorders (F = 65.17), cancer (F = 43.08) and CVACs (F = 41.65). CONCLUSIONS: Depression and 'arthrosis/arthritis or rheumatism' are the two chronic health conditions, which have the greatest impact on HRQL in Madrid's citizens, therefore is mandatory to propose and implement public health strategies that would reduce the prevalence and morbidity of such disorders.

[Motives for consultation and demographic characteristics of a community of "undocumented" immigrants in the district of Usera-Villaverde (Madrid)]. / Motivos de consulta y características demográficas de una comunidad de inmigrantes "sin papeles" en el distrito de Usera-Villaverde (Madrid).

OBJECTIVE: The objectives of the present study are to describe to the social particularizations, reasons for consultation and diagnoses conducted in the adult immigrants without regularizing that they went to this doctor's office in the district of Villaverde-Usera (Madrid), excluding the data from obstetrics-gynecology and pediatric. DESIGN: One is a descriptive observational study, based on the registry of the daily activity of the consultation from 1996 to 1999. SETTING: Primary level of attention in the area of influence of the municipal districts of Villaverde-Usera. PARTICIPANTS: 1496 consultations to immigrants without regularizing adults, taken care of in our consultation are described in the mentioned period. MEASUREMENTS AND RESULTS: By means of the registry of daily activity social and demographic variables took shelter, of reason and type of consultation, as well as of the main diagnosis that brought to them to the consultation, en 1496 consultations of illegal immigrants (533 people). 31% of the consultations were new and a 14% of absences to the citation were registered. 67% of the consultations made women, the average age was of 34.9 years and in a 76% it referred like South America origin. The diseases that more consultations generated were acute respiratory infection 18%, depressives disorders 11% and the backache with also a 11%. The 48% the reasons for the consultation were acute and 60% took place to free demand. CONCLUSIONS: The group of consultations taken care of responds to the profile of a young South American woman, that fundamentally consults by acute respiratory infections, and very in proximity by depressive-anxious upheavals and lumbar affections, problems very in relation to his situation of immigrant. The irregularity adds to a risk when making difficult the access, most of the consultations are precise, failing in elevated occasions to the programmed consultation.

Motivos de consulta y características demográficas de una comunidad de inmigrantes 'sin papeles' en el distrito de Usera-Villaverde (madrid) / Reasons for medical consultation and demographic characteristics in the ilegal situation inmigrants comunity of usera-villaverde (madrid), spain

Objetivo. Los objetivos del presente estudio son describir las particularidades sociales, motivos de consulta y diagnósticos efectuados en los inmigrantes adultos sin regularizar que acudieron a este consultorio en el distrito de Villaverde-Usera (Madrid), excluyéndose los datos de obstetricia-ginecología y pediatría. Diseño. Se trata de un estudio observacional descriptivo, basado en el registro de la actividad diaria de la consulta desde 1996 a 1999. Emplazamiento. Nivel primario de atención en el área de influencia de los distritos municipales de Villaverde-Usera. Pacientes u otros participantes. Se describen 1.496 consultas a inmigrantes sin regularizar, adultos, atendidos en nuestra consulta, en el citado período. Medición y resultados. Mediante el registro de actividad diaria se recogieron variables sociodemográficas, de motivo y tipo de consulta, así como del principal diagnóstico que les trajo a la consulta, en 1.496 consultas de inmigrantes sin regularizar (533 personas). Un 31 por ciento de las consultas fueron nuevas y se registró un 14 por ciento de ausencias a la citación. El 67 por ciento de las consultas las realizaron mujeres, la edad media fue de 34,9 años y en un 76 por ciento refirió como procedencia Sudamérica. Las enfermedades que más consultas generaron fueron infección respiratoria aguda (18 por ciento), trastornos depresivos (11 por ciento) y dolor de espalda (11 por ciento). En un 48 por ciento los motivos de la consulta fueron agudos y el 60 por ciento se produjo a libre demanda. Conclusiones. El grupo de consultas atendido responde al perfil de una mujer joven, sudamericana, que consulta fundamentalmente por infecciones respiratorias agudas y casi en el mismo grado a causa de trastornos depresivo-ansiosos y lumbalgias, problemas muy en relación con su situación de inmigrante. La irregularidad añade un riesgo al dificultar el acceso; la mayor parte de las consultas son puntuales, pero en muchas ocasiones no se presentan a la consulta programada (AU)