Diabetes Attitudes, Wishes and Needs second study (DAWN2™): cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes

Diabet Med. 2013 Jul;30(7):767-77. doi: 10.1111/dme.12245.

Abstract

Aims: The second Diabetes Attitudes, Wishes and Needs (DAWN2) study aimed to assess psychosocial outcomes in people with diabetes across countries for benchmarking.

Methods: Surveys included new and adapted questions from validated questionnaires that assess health-related quality of life, self-management, attitudes/beliefs, social support and priorities for improving diabetes care. Questionnaires were conducted online, by telephone or in person.

Results: Participants were 8596 adults with diabetes across 17 countries. There were significant between-country differences for all benchmarking indicators; no one country's outcomes were consistently better or worse than others. The proportion with likely depression [WHO-5 Well-Being Index (WHO-5) score ≤ 28] was 13.8% (country range 6.5-24.1%). Diabetes-related distress [Problem Areas in Diabetes Scale 5 (PAID-5) score ≥ 40] was reported by 44.6% of participants (17.2-67.6%). Overall quality of life was rated 'poor' or 'very poor' by 12.2% of participants (7.6-26.1%). Diabetes had a negative impact on all aspects investigated, ranging from 20.5% on relationship with family/friends to 62.2% on physical health. Approximately 40% of participants (18.6-64.9%) reported that their medication interfered with their ability to live a normal life. The availability of person-centred chronic illness care and support for active involvement was rated as low. Following self-care advice for medication and diet was most common, and least common for glucose monitoring and foot examination, with marked country variation. Only 48.8% of respondents had participated in diabetes educational programmes/activities to help manage their diabetes.

Conclusions: Cross-national benchmarking using psychometrically validated indicators can help identify areas for improvement and best practices to drive changes that improve outcomes for people with diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cost of Illness
  • Depression / epidemiology
  • Diabetes Mellitus / psychology*
  • Diabetes Mellitus / therapy
  • Diabetes Mellitus, Type 1 / psychology
  • Diabetes Mellitus, Type 1 / therapy
  • Diabetes Mellitus, Type 2 / psychology
  • Diabetes Mellitus, Type 2 / therapy
  • Diet
  • Exercise
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Priorities
  • Health Status
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • International Cooperation
  • Male
  • Middle Aged
  • Patient Education as Topic
  • Quality of Life
  • Self Care
  • Social Support
  • Surveys and Questionnaires

Substances

  • Hypoglycemic Agents