title: Health-related quality of life in diabetic patients and controls without diabetes in refugee camps in the Gaza strip: a cross-sectional study.
abstract: BACKGROUND
  Prevalence of diabetes mellitus is increasing in developed and developing countries. Diabetes is known to strongly affect the health-related quality of life (HRQOL). HRQOL is also influenced by living conditions. We analysed the effects of having diabetes on HRQOL under the living conditions in refugee camps in the Gaza strip.
  
  
  METHODS
  We studied a sample of 197 diabetic patients who were recruited from three refugee camps in the Gaza strip and 197 age- and sex-matched controls living in the same camps. To assess HRQOL, we used the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) including four domains (physical health, psychological, social relations and environment). Domain scores were compared for cases (diabetic patients) and controls (persons without diabetes) and the impact of socio-economic factors was evaluated in both groups.
  
  
  RESULTS
  All domains were strongly reduced in diabetic patients as compared to controls, with stronger effects in physical health (36.7 vs. 75.9 points of the 0-100 score) and psychological domains (34.8 vs. 70.0) and weaker effects in social relationships (52.4 vs. 71.4) and environment domains (23.4 vs. 36.2). The impact of diabetes on HRQOL was especially severe among females and older subjects (above 50 years). Low socioeconomic status had a strong negative impact on HRQOL in the younger age group (<50 years).
  
  
  CONCLUSIONS
  HRQOL is strongly reduced in diabetic patients living in refugee camps in the Gaza strip. Women and older patients are especially affected.
authors.affiliation: Faculty of Nursing, The Islamic University of Gaza, Gaza strip, Palestinian Territories. aajedi19772@hotmail.com
authors.forename: Ashraf
authors.initials: A
authors.lastname: Eljedi
authors.forename: Rafael T
authors.initials: RT
authors.lastname: Mikolajczyk
authors.forename: Alexander
authors.initials: A
authors.lastname: Kraemer
authors.forename: Ulrich
authors.initials: U
authors.lastname: Laaser
mesh_terms: D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000191:economics / Q000453:epidemiology / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000191:economics / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D014943:Global Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data; D017678:Sex Distribution; D018434:Sickness Impact Profile; D012923:Social Class; D011795:Surveys and Questionnaires