Evaluation of a quality-of-life tool for cats with diabetes mellitus

• Published in: Journal of veterinary internal medicine 2010-09, Vol.24 (5), p.1098-1105
• Main Authors: Niessen, S.J.M, Powney, S, Guitian, J, Niessen, A.P.M, Pion, P.D, Shaw, J.A.M, Church, D.B
• Format: Article
• Language: English
• Subjects: Animals; Behavior; blood glucose; Bonding, Human-Pet; Cat Diseases - drug therapy; Cats; diabetes mellitus; Diabetes Mellitus - drug therapy; Diabetes Mellitus - veterinary; Endocrinology; Feline; Health Status Indicators; Humans; Hypoglycemic Agents - therapeutic use; Insulin - therapeutic use; medicine; Owner; pets; principal component analysis; psychological stress; Psychometry; quality of life; Quality of Life - psychology; social impact; surveys; Surveys and Questionnaires
• ISSN: 0891-6640; 1939-1676
• DOI: 10.1111/j.1939-1676.2010.0579.x

Background: Success in management of diabetes mellitus (DM) is defined as improvement of blood glucose concentrations and clinical signs. However, the psychological and social impact of DM and its daily treatment regimen on quality of life (QoL) of both animal and owner is uncertain. Hypothesis/Objectives: To design, validate, and apply a diabetic pet and owner-centered, individualized measure of impact of DM (DIAQoL-pet). Animals/Subjects: Two hundred and twenty-one owners of insulin-treated diabetic cats were recruited to complete the DIAQoL-pet. Methods: Discussions and pilot surveys with clinicians and owners of diabetic cats led to the design of 29 specific DM-associated QoL questions. Owners of diabetic cats completed the finalized survey. Each item was scored according to impact frequency and perceived importance. An item-weighted impact score (IWIS) for each item was calculated, as was an average-weighted impact score (AWIS) by averaging all IWISs. Principal component analysis and Cronbach's α calculation assessed the measure's reliability. Two overview questions measured overall QoL and diabetes-dependent QoL. Results: The DIAQoL-pet showed high reliability (Cronbach α 0.83). The AWIS was -1.76 +/- 2.4 (mean +/- SD). Areas reported as most negatively impacting QoL included: "boarding difficulties" (IWIS ± SD: -4.67 +/- 5.3), "owner wanting more control" (-4.34 +/- 4.7), "difficulties leaving cat with friends or family" (-4.21 +/- 4.7), "worry" (-4.10 +/- 3.9), "worry hypo" (-3.67 +/- 3.5), "social life" (-3.48 +/- 3.9), "costs" (-3.04 +/- 3.8), and "work life" (-3.03 +/- 3.7). Forty-one percent of owners believed their cat's life would be "a little better" without DM. Conclusions and Clinical Importance: The DIAQoL-pet proved robust and identified specific areas most negatively impacting on diabetic cats and their owners' QoL. This tool warrants further investigation for use in clinical or research settings.