Health-related quality of life and its influencing factors in children with type 1 diabetes in Tunisia: a cross-sectional study
Objectives Type 1 diabetes mellitus (T1DM) is a chronic disease that requires lifestyle amendment, demanding treatment and regular glycaemic control, all of which can significantly impact the health-related quality of life (HRQoL) of affected children. This study aimed to assess the HRQoL of T1DM in...
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BMJ Publishing Group
2025-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/7/e100825.full |
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| author | Samir Boukthir Salem Yahyaoui Nada Missaoui Sonia Mazigh Sofien Atitallah Farah Hassine Rania Ben Rabeh Olfa Bouyahia |
| author_facet | Samir Boukthir Salem Yahyaoui Nada Missaoui Sonia Mazigh Sofien Atitallah Farah Hassine Rania Ben Rabeh Olfa Bouyahia |
| author_sort | Samir Boukthir |
| collection | DOAJ |
| description | Objectives Type 1 diabetes mellitus (T1DM) is a chronic disease that requires lifestyle amendment, demanding treatment and regular glycaemic control, all of which can significantly impact the health-related quality of life (HRQoL) of affected children. This study aimed to assess the HRQoL of T1DM in a Tunisian paediatric population and to identify the influencing factors.Design This was a cross-sectional study.Setting The study was conducted at a tertiary care paediatric hospital in Tunis, Tunisia, over a 6-month period from November 2022 to April 2023.Participants A total of 120 children with T1DM, aged 3–17 years, and their parents were enrolled. Inclusion criteria included children with a confirmed diagnosis of T1DM and regular follow-up at the study centre.Outcome measures HRQoL of children with T1DM was assessed using the validated Tunisian version of the KINDL-R questionnaire. The KINDL-R scores range from 0 to 100, with higher scores indicating better perceived HRQoL.Results We included 120 children with T1DM. HRQoL was considered satisfactory in 94 children (78.3%), with a mean total score of 69±20.8 (range: 21.4–99.3). Parents reported significantly lower HRQoL scores compared with their children’s self-assessments, with a mean total score of 59.2±20.4 (range: 14.3–97.5). Multivariate linear regression analysis identified several factors independently associated with impaired HRQoL, including a glycated haemoglobin level >9%, a child’s age greater than 14 years, a history of ketoacidosis decompensation, a daily insulin dose ≥0.78 IU/kg/day, more than 10 hypoglycaemic episodes per month and parental divorce. Conversely, the use of insulin analogues and good academic performance were independently associated with a more satisfactory HRQoL.Conclusions T1DM is not exclusively a clinical and biological condition, but it also affects the psychological well-being of the child and the entire family dynamic. Despite its recognised importance, psychosocial support is still insufficient. Therapeutic education programmes seem to be a relevant initiative for improving the HRQoL of children with T1DM. |
| format | Article |
| id | doaj-art-e03b5c23dc2745e9a97fa12f70a51e1b |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-e03b5c23dc2745e9a97fa12f70a51e1b2025-08-20T03:51:13ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2025-100825Health-related quality of life and its influencing factors in children with type 1 diabetes in Tunisia: a cross-sectional studySamir Boukthir0Salem Yahyaoui1Nada Missaoui2Sonia Mazigh3Sofien Atitallah4Farah Hassine5Rania Ben Rabeh6Olfa Bouyahia7Pediatric Department C, Children’s Hospital Bechir Hamza, Tunis, TunisiaUniversity of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, TunisiaUniversity of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, TunisiaUniversity of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, TunisiaUniversity of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, TunisiaUniversity of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, TunisiaUniversity of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, TunisiaUniversity of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, TunisiaObjectives Type 1 diabetes mellitus (T1DM) is a chronic disease that requires lifestyle amendment, demanding treatment and regular glycaemic control, all of which can significantly impact the health-related quality of life (HRQoL) of affected children. This study aimed to assess the HRQoL of T1DM in a Tunisian paediatric population and to identify the influencing factors.Design This was a cross-sectional study.Setting The study was conducted at a tertiary care paediatric hospital in Tunis, Tunisia, over a 6-month period from November 2022 to April 2023.Participants A total of 120 children with T1DM, aged 3–17 years, and their parents were enrolled. Inclusion criteria included children with a confirmed diagnosis of T1DM and regular follow-up at the study centre.Outcome measures HRQoL of children with T1DM was assessed using the validated Tunisian version of the KINDL-R questionnaire. The KINDL-R scores range from 0 to 100, with higher scores indicating better perceived HRQoL.Results We included 120 children with T1DM. HRQoL was considered satisfactory in 94 children (78.3%), with a mean total score of 69±20.8 (range: 21.4–99.3). Parents reported significantly lower HRQoL scores compared with their children’s self-assessments, with a mean total score of 59.2±20.4 (range: 14.3–97.5). Multivariate linear regression analysis identified several factors independently associated with impaired HRQoL, including a glycated haemoglobin level >9%, a child’s age greater than 14 years, a history of ketoacidosis decompensation, a daily insulin dose ≥0.78 IU/kg/day, more than 10 hypoglycaemic episodes per month and parental divorce. Conversely, the use of insulin analogues and good academic performance were independently associated with a more satisfactory HRQoL.Conclusions T1DM is not exclusively a clinical and biological condition, but it also affects the psychological well-being of the child and the entire family dynamic. Despite its recognised importance, psychosocial support is still insufficient. Therapeutic education programmes seem to be a relevant initiative for improving the HRQoL of children with T1DM.https://bmjopen.bmj.com/content/15/7/e100825.full |
| spellingShingle | Samir Boukthir Salem Yahyaoui Nada Missaoui Sonia Mazigh Sofien Atitallah Farah Hassine Rania Ben Rabeh Olfa Bouyahia Health-related quality of life and its influencing factors in children with type 1 diabetes in Tunisia: a cross-sectional study BMJ Open |
| title | Health-related quality of life and its influencing factors in children with type 1 diabetes in Tunisia: a cross-sectional study |
| title_full | Health-related quality of life and its influencing factors in children with type 1 diabetes in Tunisia: a cross-sectional study |
| title_fullStr | Health-related quality of life and its influencing factors in children with type 1 diabetes in Tunisia: a cross-sectional study |
| title_full_unstemmed | Health-related quality of life and its influencing factors in children with type 1 diabetes in Tunisia: a cross-sectional study |
| title_short | Health-related quality of life and its influencing factors in children with type 1 diabetes in Tunisia: a cross-sectional study |
| title_sort | health related quality of life and its influencing factors in children with type 1 diabetes in tunisia a cross sectional study |
| url | https://bmjopen.bmj.com/content/15/7/e100825.full |
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