title: Identification of physical and psychosocial problems associated with diabetic nephropathy using the International Classification of Functioning, Disability and Health Core Set for Diabetes Mellitus.
abstract: BACKGROUND
  We previously demonstrated validation of the Comprehensive International Classification of Functioning, Disability and Health Core Set for Diabetes Mellitus (ICF-CS for DM) in patients with diabetic nephropathy (DMN). The objective of the present study was to identify differences in experience of physical and psychosocial problems between DMN patients with and without hemodialysis (HD), and diabetes patients without nephropathy using the ICF-CS for DM.
  
  
  METHODS
  A total of 302 diabetes outpatients (men, 68 %; mean age, 62 years) were interviewed using four components of the ICF-CS for DM including "Body functions", "Body structures", "Activities and participation", and "Environmental factors".
  
  
  RESULTS
  The mean number of categories in which difficulty was experienced in the four components was significantly greater in DMN patients with HD followed by DMN patients without HD, and diabetes patients without nephropathy (23.9 vs. 18.0 vs. 13.1, respectively). Multivariate logistic regression models revealed that, compared with diabetes patients without nephropathy, diabetes patients with nephropathy were more likely to have difficulty with physical problems and social activities and participation. Among DMN patients, dialysis patients were found to have larger numbers of problems, and face difficulty with employment status after adjusting for sex, age, type, and duration of diabetes.
  
  
  CONCLUSIONS
  The results of this study using the ICF-CS for DM identified the areas for improvement among physical and psychosocial problems in DMN patients with and without HD in contrast to diabetes patients without nephropathy.
authors.affiliation: Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. htsutsui@med.teikyo-u.ac.jp.|General Medical Education and Research Center, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. htsutsui@med.teikyo-u.ac.jp.|Research Center of Health, Physical Fitness, and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan. htsutsui@med.teikyo-u.ac.jp.
authors.forename: Hideyo
authors.initials: H
authors.lastname: Tsutsui
authors.affiliation: Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Nomura
authors.affiliation: Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.affiliation: Department of Endocrinology, Japanese Red Cross Nagoya Daiichi Hospital, 3-35, Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Ozaki
authors.affiliation: Research Center of Health, Physical Fitness, and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Kusunoki
authors.affiliation: Research Center of Health, Physical Fitness, and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan.|Ishiguro Internal Medical Clinic, 1-11-1 Asamiya-cho, Kasugai, 486-0846, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ishiguro
authors.affiliation: Research Center of Health, Physical Fitness, and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Oshida
mesh_terms: D000368:Aged; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000523:psychology*
keywords: Diabetic nephropathy; Hemodialysis; International Classification of Functioning, Disability and Health Core set for Diabetes Mellitus; Physical and psychosocial problems