title: Unhealthy days and quality of life in Irish patients with diabetes.
abstract: OBJECTIVE
  To study the determinants of health-related quality of life (HRQoL) in Irish patients with diabetes using the Centres for Disease Controls' (CDC's) 'Unhealthy Days' summary measure and to assesses the agreement between this generic HRQoL measure and the disease-specific Audit of Diabetes Dependant Quality of Life (ADDQoL) measure.
  
  
  METHODS
  Data were analysed from the Diabetes Quality of Life Study, a cross-sectional study of 1,456 people with diabetes in Ireland (71% response rate). Unhealthy days were assessed using the CDC's 'Unhealthy days' summary measure. Quality of life (QoL) was also assessed using the ADDQoL measure. Analyses were conducted primarily using logistic regression. The agreement between the two QoL instruments was measured using the kappa co-efficient.
  
  
  RESULTS
  Participants reported a median of 2 unhealthy days per month. In multivariate analyses, female gender (P = 0.001), insulin use (P = 0.030), diabetes complications (P = <0.001) were significantly associated with more unhealthy days. Older patients had fewer unhealthy days per month (P = 0.003). Agreement between the two measures of QoL (unhealthy days measure and ADDQoL) was poor, Kappa = 0.234.
  
  
  CONCLUSIONS
  The findings highlight the determinants of HRQoL in patients with diabetes using a generic HRQoL summary measure. The 'Unhealthy Days' and the ADDQoL have poor agreement, therefore the 'Unhealthy Days' summary measure may be assessing a different construct. Nonetheless, this study demonstrates that the generic 'Unhealthy Days' summary measure can be used to detect determinants of HRQoL in patients with diabetes.
authors.affiliation: Department of Nutrition & Dietetics, South Infirmary Victoria University Hospital, Cork, Ireland ; Department of Epidemiology & Public Health, University College Cork, Cork, Ireland.
authors.forename: Emma Louise
authors.initials: EL
authors.lastname: Clifford
authors.affiliation: University of California Co-Operative Extension, Sonora, California, United States of America.
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Collins
authors.affiliation: Department of Epidemiology & Public Health, University College Cork, Cork, Ireland.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Buckley
authors.affiliation: Department of Epidemiology & Public Health, University College Cork, Cork, Ireland ; Department of Statistics, University College Cork, Cork, Ireland.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Fitzgerald
authors.affiliation: Department of Epidemiology & Public Health, University College Cork, Cork, Ireland.
authors.forename: Ivan J
authors.initials: IJ
authors.lastname: Perry
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006304:Health Status; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult