title: Establishing the thematic framework for a diabetes-specific health-related quality of life item bank for use in an english-speaking asian population.
abstract: OBJECTIVE
  To establish a thematic framework for a Diabetes Mellitus (DM)-specific health-related quality of life (HRQoL) item bank by identifying important HRQoL themes and content gaps in existing DM-specific HRQoL measures and determining whether Patient-Reported Outcomes Measurement Information System (PROMIS) item banks are useful as a starting point.
  
  
  METHODS
  English-speaking Type 2 DM patients were recruited from an outpatient specialist clinic in Singapore. Thematic analysis was performed through open coding and axial coding. Items from four existing DM-specific measures and PROMIS Version 1.0 and 2.0 item banks were compared with identified themes and sub-themes.
  
  
  RESULTS
  42 patients participated (25 men and 17 women; 28 Chinese, 4 Malay, 8 Indians, 2 other ethnicities). Median age was 53.70 years (IQR45.82-56.97) and the median disease duration was 11.13 (SD9.77) years. 10 subthemes (neutral emotions, coping emotions, empowered to help others, support from family, spend more time with family, relationships, financial burden on family, improved relationship, social support and religion/spirituality) were not covered by existing DM-specific measures. PROMIS covered 5 of 6 themes, 15 of 30 subthemes and 19 of 35 codes identified. Emotional distress (frustration, fear and anxiety) was most frequently mentioned (200 times).
  
  
  CONCLUSIONS
  We had developed a thematic framework for assessing DM-specific HRQoL in a multi-ethnic Asian population, identified new items that needed to be written and confirmed that PROMIS was a useful starting point. We hope that better understanding and measurement of HRQoL of Asian DM patients will translate to better quality of care for them.
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Odelia
authors.initials: O
authors.lastname: Koh
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Lee
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
authors.forename: Maudrene L S
authors.initials: ML
authors.lastname: Tan
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore; Division of Endocrinology, Department of Medicine, National University Hospital, Singapore, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: E-Shyong
authors.initials: ES
authors.lastname: Tai
authors.affiliation: Department of Corporate Planning and Development, National University Hospital, Singapore, Singapore.
authors.forename: Ce Jin
authors.initials: CJ
authors.lastname: Foo
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Kok Joon
authors.initials: KJ
authors.lastname: Chong
authors.affiliation: Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
authors.forename: Su-Yen
authors.initials: SY
authors.lastname: Goh
authors.affiliation: Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
authors.forename: Yong Mong
authors.initials: YM
authors.lastname: Bee
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore; Office of Clinical Sciences, Duke-NUS Graduate Medical School Singapore, Singapore, Singapore.
authors.forename: Julian
authors.initials: J
authors.lastname: Thumboo
authors.affiliation: Centre for Quantitative Medicine, Duke-NUS Graduate Medical School Singapore, Singapore, Singapore; International Health, University of Tampere, Tampere, Finland.
authors.forename: Yin-Bun
authors.initials: YB
authors.lastname: Cheung
authors.affiliation: Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore.
authors.forename: Avjeet
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore; Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore.
authors.forename: Hwee-Lin
authors.initials: HL
authors.lastname: Wee
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011788:Quality of Life; D057566:Self Report; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult