Studies with the use of Subjective Happiness Scale done on a large populations indicate that the average score runs from about 4.5 to 5.5, depending on the analysed group. College students tend to score lower (averaging a bit below 5) than working adults and older, retired people (who average 5.6) [10, 11].
In our study, both women and men achieved lower results than the average for population, with the results for women being similar to men (F=4.18, M=4.64, p=0.1418, Tab. 4). When analyzing the results according to the age categories, (<18, 18-26, 27-50), the average result of the subjective feeling of happiness turned out to be lower than in the general population, with similar fluctuation (the lowest in the young adulthood). In T1DM patients older than 50 the result was significantly higher, reaching similar value as in the general population.
This results may confirm observations form other studies that living with chronic illness is a complex, dynamic, cyclic and multidimensional process, and involves the development of special attributes: Acceptance, Coping, Self-management, Integration and Adjustment [12]. If those aspects of functioning with chronic illness are not fully developed, the level of subjective happiness may be lower, overvalued by frustration or anxiety. Proper education, adequate T1DM treatment with access to highly qualified specialists and new technologies as well as psychological support could be helpful in this respect [5].
On the other hand, high level of happiness in the group of T1DM patients older that 50 is an optimistic indicator that the acceptance of illness and feeling of fulfillment may come with age, as the patients confront their life expectations, possibilities and their fears with real life challenges, gaining the ability to overcome obstacles regardless of the chronic illness or even being motivated by it [13]
Results analyzed with respect to gender show that the general level of hope for success as well as its two components: finding solutions and willpower, reached the average results, with a bit higher result for men in all three categories. This shows that the general level of hope for success as well as the subjective feeling that one can find solution to difficult problems and has a strong will power to pursuit one’s goals do not vary the group of T1DM from general population
However when comparing the results for age groups, we observed that in the young adulthood (18-26 [years]) the hope for success in life and the feeling that one can cope with his/her problems significantly decreases. This may suggest that young adults with T1DM being in the process of making important life decisions, undertaking essential challenges connected with studies, choosing job, developing family may be confronted with fears and obstacles connected with their diabetes [14]. This group of T1DM patients requires special attention and support of diabetologists and health care professionals and educators, as positive motivation, proper education and psychological support may be beneficial of young adults, helping them to change their attitude and overcome anxiety, and thus create a solid background for happy and successful life with diabetes.
In contrast, we observed that patients above 50 years of age have significantly higher results in terms of hope for success that the average for general population. This shows that they belief in having a strong will, awareness of one's own effectiveness revealed achieving their goals and a belief in the ability to find solutions in difficult situations.
This result may be connected with the fact that those T1DM patients already achieved many of their life goals, managed to cope with many life challenges in spite of having T1DM, learned that T1DM did not stop them from fulfilling their dreams or even motivated them to do so. They base their future plans on their previous positive experiences.
One of the study limitations is the fact that since the questionnaire was anonymous and we did to have access to the clinical data, we were unable to correlate parameters assessed during the study with disease-related variables like diabetes duration, mode of diabetes management (multiple daily injections vs insulin), usage of continuous monitoring system, BMI, presence of diabetes-related complications and others. On the other hand, the fact that we analyzed “random sample” of patients being followed in different medical centers may be considered as the advantage of the study Another limitation may be the unequal size of the groups. However, the statistically used analyzes allow us to draw the presented conclusions.
According to our best knowledge, this study examining the level of happiness and hope for success in the population of T1DM patients is first one in Poland, we also have not found similar analyses in the international literature. This makes it pioneering and inspiring for further research. The limitation of the study is lack of more specific data concerning the duration of diabetes in particular patients, type of treatment applied, level of education etc. In the condition of a workshop we did not have the possibility to collect more information in this respect - it would be worth to broaden the analyzes in the future.