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Modeling the factors affecting the quality of life in diabetic patients in India using total interpretive structural modeling

Puneeta Ajmera (Department of Hospital Administration, Amity University Haryana, Gurugram, India)
Vineet Jain (Department of Mechanical Engineering, Amity University Haryana, Gurugram, India)

Benchmarking: An International Journal

ISSN: 1463-5771

Article publication date: 23 January 2019

Issue publication date: 28 March 2019



Diabetes mellitus has become a major world health problem that has unenviable impacts on health of the people including quality of life (QOL) also and in which person’s physical and psychological state, social commitments and relationships and his interaction with the environment is affected. This shows that there is an urgent need for behavior change and considerable educational strategies for proper management and rehabilitation (Reddy, 2000). This research has identified and ranked the significant factors which affect the QOL in diabetic patients in India. The paper aims to discuss these issues.


In this paper, nine factors which affect the QOL in diabetic patients in India have been identified through review of the literature and evaluated by total interpretive structural modeling (TISM) approach, i.e. an extended version of ISM. In this approach, interpretations of the interrelationship among factors have been discussed. Therefore, TISM approach has been used to develop the model and the mutual interactions among these factors.


The results of the model and MICMAC analysis indicate that diet restriction, body pain and satisfaction with treatment are the top-level factors.

Practical implications

Identification of the factors that have a remarkable effect on the QOL in diabetic patients is very important so that the doctors and other healthcare professionals may handle these factors efficiently and proper rehabilitation can be provided to such patients.


This paper has used an application of the TISM approach to interpret the mutual relationship by using the tool of interpretive matrix and has developed a framework to calculate the drive and the dependence power of factors using MICMAC analysis. The issues related to QOL are extremely important, as they can strongly anticipate a person’s capability to govern his lifestyle with disease like diabetes mellitus and maintain good health in the long run. This shows the urgent requirement of an optimized model which can predict and interpret the relationships among these factors. In this research, the interrelationships among these factors have been developed and interpretations of these interactions have been given to develop a comprehensive model so that QOL of diabetic patients may be improved.



Ajmera, P. and Jain, V. (2019), "Modeling the factors affecting the quality of life in diabetic patients in India using total interpretive structural modeling", Benchmarking: An International Journal, Vol. 26 No. 3, pp. 951-970.



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