Understanding health-related quality of life trajectories among older adults with diabetes mellitus: Mixed methods research

Abstract

Aim: To examine health-related quality of life trajectories among older adults with diabetes mellitus (DM). Design: A sequential explanatory mixed method study protocol. Methods: In the quantitative phase, health-related quality of life trajectory over 5 years, from 2009 to 2013, of a national representative sample (N = 440) of older adults with DM was analysed using group-based modelling. Next, a qualitative multiple case study (N = 10) was conducted between November 2017 and April 2018. In the mixed phase, by linking the quantitative and qualitative data, similarities and differences among the four trajectories were identified. Results: Four distinctive health-related quality of life trajectories could be distinguished: high then decrease, high stable, medium stable and low then increase. These differed in attitude towards DM, self-management of DM-related tasks, comorbidity-related health-related quality of life, coping with DM and financial concerns about medical needs. Relevance to Clinical Practice: Our results help illuminate the heterogeneity of health-related quality of life trajectories in older adults with DM. This research may help healthcare providers understand the need to assess the HR–QoL comprehensively and promote HR–QoL for older adults with DM.