RESUMO
OBJECTIVE: To examine the association between diabetes-related lower-extremity amputation (LEA) and ethnicity, age, source of payment, geographic location, diabetes severity, and health condition in adults with diabetes mellitus type 2 living in border and non-border counties in Texas, United States of America, and to assess intra-border region geographic differences in post-LEA treatment. METHODS: This correlational study was based on secondary data from the 2003 Texas Inpatient Hospital Discharge Data. The sample consisted of individuals 45 years of age and older with type 2 diabetes who had undergone a nontraumatic LEA (n = 5,865). Descriptive statistics and logistic regression analyses were applied. RESULTS: The following characteristics were predictors of LEA: being Hispanic or African American, male, ≥ 55 years old, and a Medicare or Medicaid user, and living in a border county. Persons with moderate diabetes and those who suffered from cardiovascular disease or stroke also had higher odds of undergoing an LEA. Post-LEA occupational therapy was significantly less prevalent among border residents (9.5%) than non-border residents (15.3%) (P < 0.001). CONCLUSION: Understanding the factors that influence diabetes-related LEA may lead to early detection and effective treatment of this disabling consequence of diabetes along the U.S.-Mexico border.
Assuntos
Amputação Cirúrgica/estatística & dados numéricos , Diabetes Mellitus Tipo 2/complicações , Pé Diabético/cirurgia , Etnicidade/estatística & dados numéricos , Isquemia/cirurgia , Perna (Membro)/irrigação sanguínea , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , Comorbidade , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etnologia , Pé Diabético/epidemiologia , Pé Diabético/etnologia , Feminino , Pé/irrigação sanguínea , Pé/cirurgia , Humanos , Isquemia/epidemiologia , Isquemia/etnologia , Perna (Membro)/cirurgia , Masculino , Americanos Mexicanos/estatística & dados numéricos , México/epidemiologia , México/etnologia , Pessoa de Meia-Idade , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etnologia , Texas/epidemiologia , População Branca/estatística & dados numéricosRESUMO
OBJECTIVE: To examine the association between diabetes-related lower-extremity amputation (LEA) and ethnicity, age, source of payment, geographic location, diabetes severity, and health condition in adults with diabetes mellitus type 2 living in border and non-border counties in Texas, United States of America, and to assess intra-border region geographic differences in post-LEA treatment. METHODS: This correlational study was based on secondary data from the 2003 Texas Inpatient Hospital Discharge Data. The sample consisted of individuals 45 years of age and older with type 2 diabetes who had undergone a nontraumatic LEA (n = 5 865). Descriptive statistics and logistic regression analyses were applied. RESULTS: The following characteristics were predictors of LEA: being Hispanic or African American, male, > 55 years old, and a Medicare or Medicaid user, and living in a border county. Persons with moderate diabetes and those who suffered from cardiovascular disease or stroke also had higher odds of undergoing an LEA. Post-LEA occupational therapy was significantly less prevalent among border residents (9.5 percent) than non-border residents (15.3 percent) (P < 0.001). CONCLUSION: Understanding the factors that influence diabetes-related LEA may lead to early detection and effective treatment of this disabling consequence of diabetes along the U.S.-Mexico border.
OBJETIVO: Analizar la asociación entre las amputaciones de extremidades inferiores (AEI) relacionadas con la diabetes y el grupo étnico, la edad, la procedencia del pago, la ubicación geográfica, la gravedad de la diabetes y el estado de salud de los adultos que padecen diabetes tipo 2 residentes en los condados fronterizos y no fronterizos de Texas (Estados Unidos de América), y evaluar la diferencias geográficas dentro de la zona fronteriza en cuanto al tratamiento posterior a la amputación. MÉTODOS: Este estudio correlacional se basó en datos secundarios procedentes de la información de egreso de pacientes hospitalizados en Texas durante el año 2003. La muestra estuvo integrada por personas de 45 años o mayores con diabetes tipo 2, que habían sido sometidas a la amputación no traumática de una extremidad inferior (n = 5 865). Se aplicaron estadística descriptiva y análisis de regresión logística. RESULTADOS: Las siguientes características constituyeron factores predictivos de AEI: ser hispano o afroestadounidense, hombre, de 55 años o mayor, beneficiario de Medicare o Medicaid, y residente en un condado fronterizo. Las personas con diabetes moderada que padecían enfermedades cardiovasculares o habían sufrido un accidente cerebrovascular también tenían una mayor probabilidad de ser sometidas a una AEI. La terapia ocupacional posterior a la amputación fue significativamente menos prevalente entre los residentes fronterizos (9,5 por ciento) que entre los no fronterizos (15,3 por ciento) (P < 0,001). CONCLUSIONES: La comprensión de los factores que influyen en las AEI relacionadas con la diabetes puede conducir a la detección temprana y el tratamiento eficaz de esta secuela discapacitante en la zona fronteriza entre los Estados Unidos y México.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Amputação Cirúrgica/estatística & dados numéricos , /complicações , Pé Diabético/cirurgia , Etnicidade/estatística & dados numéricos , Isquemia/cirurgia , Perna (Membro)/irrigação sanguínea , Negro ou Afro-Americano/estatística & dados numéricos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , Comorbidade , /epidemiologia , /etnologia , Pé Diabético/epidemiologia , Pé Diabético/etnologia , População Branca/estatística & dados numéricos , Pé/irrigação sanguínea , Pé/cirurgia , Isquemia/epidemiologia , Isquemia/etnologia , Perna (Membro)/cirurgia , Americanos Mexicanos/estatística & dados numéricos , México/epidemiologia , México/etnologia , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etnologia , Texas/epidemiologiaAssuntos
Amputação Cirúrgica , Saúde na Fronteira , Diabetes Mellitus Tipo 2 , Saúde das Minorias , México , Texas , Estados Unidos , Amputação Cirúrgica , Saúde na Fronteira , Diabetes Mellitus Tipo 2 , Saúde das Minorias , Estados Unidos , Pé Diabético , Etnicidade , Isquemia , Perna (Organismo) , Negro ou Afro-Americano , Comorbidade , Pé , Americanos Mexicanos , Acidente Vascular Cerebral , Amputação Cirúrgica , Doenças Cardiovasculares , População Branca , Fatores de RiscoRESUMO
BACKGROUND: Depression affects more Hispanics with type 2 diabetes than other ethnic groups. This exploratory, binational study examined the prevalence and correlates of clinical depressive symptoms in Hispanics of Mexican origin with type 2 diabetes living on both sides of the Texas Mexico border. METHODS: Two binational samples, consisting of 172 adult patients of Mexican origin with type 2 diabetes in South Texas and 200 from the Northeastern region of Mexico, were compared. Logistic regression analyses were used to test personal and social correlates to clinical depressive symptoms. RESULTS: The rate of clinical depressive symptoms was similar in both South Texas and Northeastern Mexico patients (39% and 40.5%, respectively). Gender, education, emergency department visits, and burden of diabetes symptoms were predictors of clinical depressive symptoms in the South Texas sample. Among respondents in the Northeastern Mexico sample, the only statistically significant correlate to clinical depressive symptoms was the burden of diabetes symptoms. CONCLUSIONS: Diabetes and depression must be addressed as priorities in diabetes initiatives at the US Mexico border region. Further research is warranted to examine the extent and impact of involving family practice physicians from both sides of the border in depression screenings among patients with type 2 diabetes.
Assuntos
Depressão/etnologia , Diabetes Mellitus Tipo 2/etnologia , Comorbidade , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Americanos Mexicanos/estatística & dados numéricos , México/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Texas/epidemiologiaRESUMO
OBJECTIVES: To examine physical and mental health domains of health-related quality of life (HRQL) in a binational adult population with type 2 diabetes at the Texas-Mexico border, and to explore individual and social correlates to physical and mental health status. METHODS: Adults 18 years and older with type 2 diabetes residing in the South Texas Lower Rio Grande Valley and in Reynosa, Tamaulipas, Mexico, were recruited using a convenience sampling technique and interviewed face-to-face with a structured survey. HRQL was measured using physical and mental health summary components of the Medical Outcomes Study Short Form. HRQL correlates included demographic characteristics, health factors, access to healthcare, and family support. Samples characteristics were compared using the Student's t-test or Mann-Whitney U test. Associations between dependent and independent variables were examined using unadjusted and adjusted (multiple variable) logistic regression models. RESULTS: There were no significant differences between Valley and Reynosa respondents in physical or mental health status scores. Valley participants with lower socioeconomic status and those perceiving their supportive relative's level of diabetes-related knowledge as "low" were more likely to report worse physical health than those lacking those characteristics. In the Reynosa group, lower physical health status was associated with duration of diabetes and insulin use. Both sample populations with clinical depressive symptoms were more likely to have worse physical and mental health than those without such symptoms. CONCLUSIONS: HRQL is an important outcome in monitoring health status. Understanding the levels and influences of HRQL in U.S.-Mexico border residents with diabetes may help improve diabetes management programs.
Assuntos
Diabetes Mellitus Tipo 2 , Nível de Saúde , Qualidade de Vida , Adolescente , Adulto , Idoso , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/psicologia , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Entrevistas como Assunto , Modelos Logísticos , Masculino , Americanos Mexicanos , México , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Qualidade de Vida/psicologia , Fatores de Risco , Fatores Socioeconômicos , Estatísticas não Paramétricas , TexasRESUMO
OBJECTIVES: To examine physical and mental health domains of health-related quality of life (HRQL) in a binational adult population with type 2 diabetes at the Texas-Mexico border, and to explore individual and social correlates to physical and mental health status. METHODS: Adults 18 years and older with type 2 diabetes residing in the South Texas Lower Rio Grande Valley and in Reynosa, Tamaulipas, Mexico, were recruited using a convenience sampling technique and interviewed face-to-face with a structured survey. HRQL was measured using physical and mental health summary components of the Medical Outcomes Study Short Form. HRQL correlates included demographic characteristics, health factors, access to healthcare, and family support. Samples characteristics were compared using the Students t-test or Mann-Whitney U test. Associations between dependent and independent variables were examined using unadjusted and adjusted (multiple variable) logistic regression models. RESULTS: There were no significant differences between Valley and Reynosa respondents in physical or mental health status scores. Valley participants with lower socioeconomic status and those perceiving their supportive relatives level of diabetes-related knowledge as "low" were more likely to report worse physical health than those lacking those characteristics. In the Reynosa group, lower physical health status was associated with duration of diabetes and insulin use. Both sample populations with clinical depressive symptoms were more likely to have worse physical and mental health than those without such symptoms. CONCLUSIONS: HRQL is an important outcome in monitoring health status. Understanding the levels and influences of HRQL in U.S.-Mexico border residents with diabetes may help improve diabetes management programs.
OBJETIVOS: Analizar los dominios de salud física y mental de la calidad de vida relacionada con la salud (CVRS) en una población binacional de adultos con diabetes tipo 2 en la frontera Texas-México y explorar los factores individuales y sociales relacionados con el estado de la salud física y mental. MÉTODOS: Se realizó un muestreo de conveniencia de personas de 18 años de edad o más con diabetes tipo 2 que vivían en Lower Rio Grande Valley, al sur de Texas, y en Reynosa, Tamaulipas, México, y se les realizó una entrevista estructurada presencial. La CVRS se midió mediante los componentes abreviados de salud física y mental del MOS-SF8 (Medical Outcomes Study Short Form 8). Entre los factores relacionados con la CVRS estaban las características demográficas, los factores de salud, el acceso a la atención sanitaria y el apoyo familiar. Se compararon las características de las muestras mediante la prueba de la t de Student o la prueba de la U de Mann-Whitney. Las asociaciones entre las variables independientes y la dependiente se analizaron mediante modelos de regresión logística múltiple, ajustados y sin ajustar. RESULTADOS: No se encontraron diferencias significativas entre los entrevistados de Valley y de Reynosa en cuanto a la puntuación del estado de salud física y mental. Los participantes de Valley con menor estatus socioeconómico y los que consideraban que los parientes que los apoyaban tenían un "bajo" nivel de conocimiento sobre la diabetes presentaron una mayor probabilidad de informar un peor estado de salud física que los que no tenían esas características. En el grupo de Reynosa, el peor estado de salud física se asoció con la duración de la diabetes y el uso de insulina. En ambos grupos, las personas con síntomas clínicos de depresión tuvieron una mayor probabilidad de informar una peor salud física y mental que los que no presentaban esos síntomas. CONCLUSIONES: La CVRS es un importante criterio en el análisis del estado de salud. La comprensión de los niveles de CVRS de los diabéticos que viven en la frontera entre los EE.UU. y México y de los factores que influyen en su CVRS puede contribuir a mejorar los programas de control de la diabetes.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Nível de Saúde , Qualidade de Vida , /tratamento farmacológico , /psicologia , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Entrevistas como Assunto , Modelos Logísticos , Americanos Mexicanos , México , Educação de Pacientes como Assunto , Qualidade de Vida/psicologia , Fatores de Risco , Fatores Socioeconômicos , Estatísticas não Paramétricas , TexasRESUMO
Understanding influences on health-related quality of life (HRQL) is critical in order to track and improve the health of poor, vulnerable populations and reduce health disparities. However, studies assessing HRQL of minorities are relatively scarce. The purpose of this study was to document personal and socioenvironmental correlates to HRQL. The study population is Mexican Americans in the Texas-Mexico border region living in colonias - unincorporated, impoverished settlements with substandard living conditions along the U.S.-Mexico border. Mexican Americans living in colonias are one of the most disadvantaged, hard-to-reach minority groups in the United States. We used data from the Integrated Health Outreach System Project collected in 2002 and 2003. Our sample included 386 participants randomly selected and interviewed face-to-face with a structured survey. We measured HRQL and examined personal and socioenvironmental correlates. Unadjusted and adjusted (multivariate) logistic regression models were used for data analyses. We found that border Mexican Americans living in colonias were of similar mental health status compared to the general population of the United States, but worse off in terms of physical health. Poor education and long-term residency in colonias were predictors of lower physical health. Women reported worse mental health than men. Length of time living in a colonia, co-morbidity status, and perceived problems with access to healthcare was associated with poorer mental health status. This study provides information for health professionals and policymakers and underscores the need to provide better preventive and medical services for underserved populations. Major findings indicate the need for additional research centered on further exploration of the impact of economic, cultural, and social influences on HRQL among severely disadvantaged populations.
Assuntos
Doença Crônica/etnologia , Doença Crônica/epidemiologia , Nível de Saúde , Americanos Mexicanos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Comorbidade , Estudos Transversais , Feminino , Acessibilidade aos Serviços de Saúde , Disparidades nos Níveis de Saúde , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/etnologia , México/etnologia , Pessoa de Meia-Idade , Áreas de Pobreza , Fatores Sexuais , Perfil de Impacto da Doença , Fatores Socioeconômicos , Texas/epidemiologiaAssuntos
Qualidade de Vida , Diabetes Mellitus Tipo 2 , Fatores de Risco , Saúde na Fronteira , Americanos Mexicanos , Texas , México , Estados Unidos , Qualidade de Vida , Diabetes Mellitus Tipo 2 , Fatores de Risco , Saúde na Fronteira , Americanos Mexicanos , Estados Unidos , Hipoglicemiantes , Insulina , Entrevistas como Assunto , Modelos Logísticos , Estatísticas não Paramétricas , Nível de Saúde , Qualidade de Vida , Educação de Pacientes como Assunto , Fatores de Risco , Fatores SocioeconômicosRESUMO
OBJECTIVE: To examine personal and environmental correlates of exercise among Mexican Americans living in the Texas-Mexico border region. METHODS: The study was based on data from a community health assessment conducted in 2 counties at the Texas-Mexico border region. A random-digit-dialed community survey was used in this cross-sectional study (n=933). RESULTS: A majority of border Mexican Americans (52%) did not exercise at all. Gender, age, and self-rated health were statistically significant correlates to exercise. CONCLUSIONS: Understanding personal and environmental factors that influence physical activity and exercise in this minority population is critical for the development of culturally sensitive health interventions.