Profile of disabilities and their associated factors in patients with type 2 diabetes evaluated by the Canadian occupational performance measure: the Rio De Janeiro type 2 diabetes cohort study

Abstract

Purpose: To investigate the profile of disability in patients with type 2 diabetes and to evaluate its associated variables.

Method: The Canadian Occupational Performance Measure (COPM) assessed disabilities in 475 type 2 diabetic individuals. The activities were categorised by the International Classification of Functioning, Disability and Health. The Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) was used to evaluate pain, emotional and physical functioning domains of life-quality. Multivariable logistic regression assessed the independent correlates of better/worse performance.

Results:: Median COPM score was 4.5 (interquartile range 3–6). Problems in mobility (53.6%), self-care (21.1%) and daily-life (13.0%) were most frequently self-reported. Presence of restriction/pain in the upper limbs (odds ratio [OR]: 1.66; 95% CI: 1.11–2.47; p=0.013) and of peripheral neuropathy (OR: 1.64; 95% CI: 1.06–2.53; p=0.026) were associated with greater chance of worse performance. Higher values of SF-36 in pain and emotional domains (each 10 point increase; OR: 0.92 95% CI: 0.85–0.98; p=0.011; OR: 0.96; 95% CI: 0.92–1.00; p=0.063, respectively) and physical activity (OR: 0.63; 95% CI: 0.41–0.98; p=0.042) were associated with better performance.

Conclusions:: Type 2 diabetic patients frequently reported disabilities in mobility, self-care and daily-life domains; and its associated factors were the presence of depression, upper limb pain and diabetic peripheral neuropathy.

Implications for Rehabilitation

• The Canadian Occupational Performance Measure (COPM) instrument can be applied to patients with diabetes, as it identifies several disabilities, mostly in mobility, self-care and domestic life areas.

• Rehabilitation directed to upper limb pain/limitation and to lower limb peripheral neuropathy shall be implemented and may improve diabetic patients’ performance and quality of life.

• A patient-centered rehabilitation strategy, guided by the COPM, may enable greater independence and autonomy, but this should be confirmed in future intervention studies.

Keywords:

• Canadian Occupational Performance Measure
• disabilities
• type 2 diabetes

Declaration of interest

This study was partially supported by research grants from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and from the Fundação Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ).

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.