Quality of life of Turkish type 2 diabetics in Germany and Turkey – a comparison between Hamburg and Istanbul

Abstract

Objectives. The analyses address the following research questions: (1) Do Turkish diabetics in Germany and Turkey differ in terms of quality of life? (2) If yes, can these differences (in part) be explained by social factors (age, gender, education, household size), functional limitations and availability of support? (3) Are social factors, functional limitations and availability of support differently associated with quality of life among Turkish diabetics in Germany and Turkey?

Design. For this comparative cross-sectional study, 111 patients with type 2 diabetes were personally interviewed in Istanbul (Turkey) and 294 Turkish patients in Hamburg (Germany). For quality of life measurement we have used the Turkish version of the WHOQOL-Bref-26. Sociodemographics included age, sex, education and household-size. Health related functional limitations were assessed on the basis of an index of (instrumental) activities of daily living including the availability of help. Statistical analyses were conducted on group comparisons with Chi-square- and T-tests as well as linear regressions.

Results. There are no significant differences between Turkish diabetics in Germany and Turkey in the physical and the psychological dimensions of the WHOQOL-Bref. However, in the WHOQOL-domains ‘social QoL’ and ‘environmental QoL’ Turkish diabetics living in Hamburg have a significantly better quality of life than their counterparts in Istanbul. These differences cannot be explained by individual sociodemographic factors, functional limitations and availability of support. Furthermore, we found much stronger positive associations between education and quality of life in Istanbul than in Hamburg.

Conclusion. Beyond strong similarities between the two samples in sociodemographics, physical and mental health the social and environmental quality of life was significantly assessed better by the Turkish diabetics living in Hamburg. This is most likely an effect of public investment in social security, infrastructure and health care which is also influencing the decision as to where to spend life in retirement.

Keywords:

• quality of life
• WHOQOL
• migrants
• diabetes
• Turkey
• Germany
• SES
• education
• environment
• IADL
• functional limitations
• social support
• cross-sectional comparative study

Acknowledgements

The study in Hamburg was undertaken as part of the project ‘Health literacy of Turkish immigrants with diabetes 2 related to course of disease, health care, socioeconomic status and integration’ (02/2008–09/2011). The project was funded by the German Federal Ministry of Education and Research [01GX0749]. We also like to thank the two anonymous reviewers for their engaged comments and helpful advice in the progress of this paper.

Key messages

1. Quality of life in terms of physical health and psychological well-being is very similar in two comparable groups of Turkish diabetics living in Hamburg respectively in Istanbul.

2. Perceived social and environmental quality of life is significantly assessed better by those living in Hamburg compared to their counterparts in Istanbul.

3. Social and environmental quality of life may be considered as relevant factors for the decision in which country to stay for good.