Evaluation of the Quality of Care of Type 2 Diabetic Patients and Some Related Factors Using Structural Equation Modeling

Abstract

Background: Diabetes is a major metabolic disorder, and the number of people affected by it is continuously increasing worldwide. Numerous risk factors, such as improper nutrition and physical inactivity, play significant roles in its incidence, prevalence, and complications. Proper care and management of diabetes are essential actions in addressing this disease. Objectives: The present study aims to evaluate the quality of care provided to diabetic patients in Behbahan city. Methods: This cross-sectional study was conducted from January to March 2021 in Behbahan city (southwest of Iran). A total of 310 diabetic patients were selected using random sampling. Data were collected using a questionnaire that included demographic information, variables related to disease care, a Health-Related Quality Of Life (HRQOL) Questionnaire, and a mental distress questionnaire. For data analysis, structural equation modeling (SEM) was performed using the partial least squares (PLS) method. Results: The PLS-SEM showed the effect sizes of various factors on the quality of diabetic patient care. The effect sizes were as follows: Comorbidity (-0.29), family history (-0.30), moderate physical activity (0.20), mental distress (-0.13), marital status (0.081), physical dimension of quality of life (QOL) (0.20), and psychological dimension of QOL (0.10). The mean and standard deviation of HbA1c values — one of the most important indicators of diabetes care — were 9.71 ± 2.13. Conclusions: The quality of care for diabetic patients was found to be below desirable standards, with more than 70% of patients receiving poor quality care. Therefore, strengthening care programs for diabetic patients — particularly within the framework of the IraPEN (package of essential non-communicable) program, which includes psychosocial interventions — can help improve the quality of care for patients with type 2 diabetes.