Abstract
Background
To investigate the association between social capital and quality of life among type 2 diabetes patients in Anhui province, China.
Methods
In a cross-sectional study, 436 adults with type 2 diabetes were interviewed. The two domains of Quality of life, physical component summary (PCS) and mental component summary (MCS), were measured using the Short-Form Health Survey (SF-36). A modified instrument scale was used to measure cognitive and structural social capital. Multiple logistic regression models were used to assess the associations between social capital and quality of life, adjusting for social economic status and risk factors for health.
Results
24.3 % of participants (106) were in poor PCS and 25.0 % (109) in poor MCS. The proportions of participants who had low cognitive and structural social capital were 47.0 % (205) and 64.4 % (281), respectively. Results of logistic regression models showed that cognitive social capital was positively associated with PCS (OR = 1.84; 95 % CI: 1.12, 3.02) and MCS (OR = 1.65; 95 % CI: 1.03, 2.66). However, the associations between structural social capital and PCS (OR = 0.80, 95 % CI: 0.48, 1.34) and MCS (OR = 0.62; 95 % CI: 0.38, 1.01) were not statistically significant.
Conclusions
It is the first study in China to investigate associations between quality of life and social capital in type 2 diabetes. Findings document that cognitive social capital is associated with the quality of life of type 2 diabetes patients. Our study suggests that the social capital theory may provide a new approach to increase physical resources in diabetes prevention and control, especially in Low and Middle Income countries (LMICs).
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Background
China in the recent years has the largest number of persons suffering from type 2 diabetes (diagnosed or undiagnosed) in the world. Type 2 diabetes patients are widely distributed in China, and the diabetes national prevalence is estimated at as of 9.32 % in 2014 [1]. Diabetes patients suffer from many complications (heart, brain, kidney, peripheral nerves, eye and foot injury induced by marcovascular and microvascular damage) that reduce the quality of their life [2, 3]. Given that diabetes is a chronic disease and cannot be cured, improvement or maintenance of adequate quality of life is one of the most important public health challenges to both develo** and developed nations [4, 5]. Previous studies have documented that it’s multi-faced and not multi-faced factors influence quality of life, including the stage of the disease [6], life style [7], access to medical services [8], and social economic status [9]. However, few studies have investigated the determinants of quality of life among Chinese diabetes patients [43], patients with fibromyalgia [44], multiple sclerosis patients [45], women [46, 47], and AIDS patients [33]. In this cross-sectional study, we found some consistent evidence to support the hypothesis that higher cognitive social capital was associated with higher PCS and MCS, the two domains of quality of life, after adjustment for SES and risk factors. Cognitive social capital indicates ability that individual can use to acquire social resources from family, community, medical services, and society. Patients with high cognitive social capital may actively seek for information, material, and emotional support networks, comply with social norms and peer control, trust and work closely with others in their daily activities, all of which could lead to receive adequate medical services and psychological support to buffer sufferings caused by diabetes [13].
The crude analysis indicated the association between quality of life and structural social capital not significant. In this study, structural social capital was mainly composed of social participation. According to our study, the majority of respondents were rarely participating in formal organizations, such as politic parties, sports associations, religious and professional originations. The low level of participation in such organized activities may lead to low or non-association between this type of social capital and quality of life.
Limitation
This study was subject to several limitations. First, the study population in this survey was a convenient sample, with low representativeness that may deviate from overall Chinese population. Second, because of the nature of the cross-sectional study, the relationship is just a pure association, and need more information to support the possible causal relationship. Third, because social capital used in this study was measured at the individual level, the impact of ecological level and the entire social capital or six different dimensions on Quality of life were not considered. Finally, other risk factors such as blood sugar control and diet habit were not included in the study, which may undermine the main findings.
Conclusions
This study suggests that cognitive social capital may have an important protective role in improving the Quality of life of type 2 diabetes patients in Anhui province, China. This initial finding suggests that the social capital theory may provide a new idea to solve the shortage problem of physical resources in diabetes prevention and control, especially in Low and Middle Income countries (LMICs).
Abbreviations
- PCS:
-
Physical component summary
- MCS:
-
Mental component summary
- SF-36:
-
The Short-Form Health Survey
- CDC:
-
Centers for Disease Control and Prevention
- SES:
-
Socio-economic status
- SD:
-
Standard deviation
- ORs:
-
Odds ratios
- CI:
-
Confidence intervals
- SPSS:
-
Statistical package for the social sciences
- LMICs:
-
Low and Middle Income countries
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Acknowledgement
This project was supported by the National Natural Science Foundation of China (Grant No. 71273011).
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The authors declare that they have no competing interests.
Authors’ contributions
Fuyong Hu and Li Niu carried out the study, participated in the survey and drafted the manuscript. Ren Chen and Ying Ma participated in the design of the study and performed the statistical analysis. Zhi Hu and **a Qin conceived of the study, and participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.
Fuyong Hu and Li Niu contributed equally to this work.
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Social Capital Assessment Tool. (DOC 30 kb)
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Hu, F., Niu, L., Chen, R. et al. The association between social capital and quality of life among type 2 diabetes patients in Anhui province, China: a cross-sectional study. BMC Public Health 15, 786 (2015). https://doi.org/10.1186/s12889-015-2138-y
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DOI: https://doi.org/10.1186/s12889-015-2138-y