Application of a health‐related quality of life conceptual model in community‐dwelling older C hinese people with diabetes to understand the relationships among clinical and psychological outcomes

Aims/Introduction The present study applied the W ilson– C leary model of health‐related quality of life ( HRQOL ) by using the structural equation modeling ( SEM ) approach to understand the interrelationships among clinical, sociodemographic and psychological characteristics in older people with diabetes. Materials and Methods This was a cross‐sectional study with 452 C hinese older people with diabetes recruited from three primary care clinics. A series of assessments were made, including four instruments: the C hinese version of the S hort F orm 36 H ealth S urvey, O lder A merican R esources and S ervices M ultidimensional F unctional A ssessment Q uestionnaire, R and M ental H ealth I nventory and M edical O utcomes S tudy S ocial S upport S urvey; and clinical outcomes (diabetes‐related characteristics and physiological data). Results In the present study, we identified six patient individual and environmental characteristics, namely, age, sex, physical activity, psychological distress, social support and adequacy of income, that significantly influence HRQOL directly or by way of physical functional status and general health perception. Conclusions Improving social and financial support as well as providing interventions to promote physical activity and to cope with psychological distress in this patient population might be effective to eventually enhance their HRQOL . The present findings add to the literature the underlying complex biological and psychological processes of HRQOL , and take the body of knowledge in HRQOL of older people with diabetes to a theoretical level, and provide insights for development of appropriate strategies to optimize their HRQOL .