Diabetes Attitudes, Wishes and Needs in the Dominican Republic (DR-DAWN2).

Abstract

Purpose: The purpose of this study was to assess the psychosocial status of people with diabetes and their perceived quality of received health care services in a local outpatient center in Santo Domingo, Dominican Republic.

Methods: Cross-sectional study that included 385 Dominican adults with diabetes. Demographic and clinical information was collected. Key psychometric indicators were collected by using the WHO-5 Well-Being Index, EuroQol-5D Visual Analogue Scale (EQ-VAS), Problem Areas in Diabetes Scale, Summary of Diabetes Self-Care Activities, and Patient Assessment of Chronic Illness Care.

Results: The mean EQ-VAS score was 77.6 (SD 18). Of all the participants, 18.7% exhibited symptoms of depression, with higher rates among women and younger age groups. Diabetes-related distress was present in 22.6% of participants, particularly among younger individuals and those employed. Physical activity was the self-care activity with the lowest reported adherence. Perceptions of received health care services aligned moderately with the chronic care model (CCM), with a higher perceived alignment in patients that were enrolled in a chronic disease management program.

Conclusions: Patients with diabetes report having a reduced quality of life and significant psychological burdens, with a high rate of depressive symptoms and diabetes-related distress and a low adherence to self-care behaviors. The enrollment in chronic disease management programs improved patients' perception of received health care services, reporting a more coordinated care and experiencing more patient activation, which could improve health outcomes. These findings underline the need for psychological screening, patient-centered care, and broader implementation of the CCM to improve health outcomes in this population.