Knowledge and Practice of Self Care Management Among Patients With Diabetes Mellitus in Auchi
CHAPTER ONE
Objectives of the Study
Main Objective
The aim of this study was to assess the knowledge on diabetes and the effectiveness of self-management practices among diabetes patients at the Auchi Teaching Hospital.
Specific Objectives
Specifically, the study sought to:
- To access the knowledge of diabetic patients on diabetes at the ATH
- To ascertain the effectiveness of diabetes self-management practices among diabetic patients at the ATH
- Identify the factors that influence diabetes self-management among diabetics at the ATH
CHAPTER TWO
LITERATURE REVIEW
Introduction
In order to understand the background of this study, the chapter commences by providing an overview of diabetes, types of diabetes and classification of diabetes. A brief overview of the diagnosis criteria for diabetes, risks factors of diabetes, complications associated with diabetes and self-management of diabetes are also considered in this chapter. The chapter further considers the actual status of self-management of diabetes and the guidelines required to self-manage diabetes. The chapter concludes by looking at the factors that inhibit self-management of diabetes.
Overview of Diabetes
The prevalence of diabetes is on the ascendency and increasingly becoming a global health concern. Diabetes is a metabolic disorder which is characterized by high blood glucose levels (hyperglycemia). Diabetes occurs due to lack of insulin secretion, reduced insulin production or reduced insulin action (WHO, 2007). This anomaly interferes with carbohydrate, protein and fat metabolism.
Persistent high blood sugar level is a common outcome of uncontrolled diabetes and over time damages a lot of systems in the body including that of the cardiovascular and nervous system. Notable symptoms associated with diabetes include extreme hunger, increased urge to urinate, excessive thirst, weight loss, blurred vision and excessive fatigue. An individual is diagnosed with diabetes if the person persistently experiences hyperglycemia.
Earlier Classifications of Diabetes
The first widely accepted classification of diabetes was published in 1980 by the World Health Organization. This classification was subsequently revised in 1985. The 1980 Expert Committee proposed two classes of diabetes mellitus namely non-insulin dependent diabetes mellitus (NIDDM) and insulin dependent diabetes mellitus (IDDM). The 1985 classification required staging of diabetes based on a clinical descriptive criteria and a supplementary etiological classification. The 1980 classification represents a compromise between etiological and clinical classification as diabetes patients were classified based on clinical diagnosis even when the specific cause or etiology of the diabetes condition was unknown.
The 1980 and 1985 reports also considered other minor classes of diabetes such as gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT). The 1980 and 1985 classifications of diabetes and the other related categories of glucose intolerance comprised both statistical risk classifications and clinical classification. The 1985 classification is widely accepted and recognized internationally. It was officially recognized during the International Nomenclature of Diseases in 1991.
CHAPTER THREE
METHODOLOGY
Introduction
Chapter three gives an overview of the methodology that was employed during the study. The chapter commences by looking at the study area, the type of sampling technique that was used, the research design that was employed and the data collection process. The chapter further looks at quality control, the data analysis process and ethical consideration.
Research Design
A cross-sectional design (survey method) was used in gathering the requisite data for this research work. During the survey, a semi structured questionnaire was used as the main data collection instrument. The rationale for using the cross-sectional survey method was to enable the researcher to assess the knowledge on diabetes and the effectiveness of self- management practices among diabetes patients at the Auchi Teaching Hospital at the same point in time.
The researcher used the survey method because it was cost effective as it enabled the researcher to generate findings that was representative of the entire population without collecting data from the entire population. Secondly, it also enabled the researcher to collect a broad range of data from the respondents. Finally, the survey method was relatively easy to undertake.
CHAPTER FOUR
PRESENTATION OF RESULTS
Introduction
This chapter presents the results of the study. The analyzed results are presented in a form of tables. The chapter is made up of two major sections. The first section considers the socio-demographic characteristics of respondents who participated in the study whiles the second section presents findings of the study from the respondents.
CHAPTER FIVE
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
Introduction
The chapter presents the summary of key findings as well as the conclusions and recommendations of this study.
Summary of Key Findings
The key findings of this study are summarized as follows; Majority of respondents were females (61.7%)
Majority of the respondents were illiterates (56.4%)
Age of respondents had a significant positive relationship on their level of knowledge on diabetes (P-value=0.007)
Marital status of respondents had a statistically significant positive relationship on their level of knowledge on diabetes (P-value=0.005)
Educational background of the study participants had a significant positive relationship on their level of knowledge on diabetes (P-value=0.002)
Monthly household income levels of the respondents had a significant positive relationship on their level of knowledge on diabetes (P-value=0.007)
Ethnic background of respondents had a statistically significant positive relationship on their level of knowledge on diabetes (P-value=0.003)
Out of the 94 respondents who were sampled, only 46% of them had adequate knowledge on diabetes
Social support had a significant relationship on respondents ability to self-manage their diabetes condition (P-value=0.047)
Diabetic education had a statistically significant relationship on respondents ability to self-manage their diabetes condition (P-value=0.001)
A significant proportion of the total respondents (54.6%) disclosed that they don’t adhere strictly to their diabetes medication
Most of the study participants (58.5%) indicated that they don’t monitor their blood sugar level on a regular basis
Majority of the respondents (68.1%) preferred tight footwear whereas 31.9% of them preferred loose footwear
A significant proportion of the respondents (82%) do not effectively self-manage their diabetes condition.
Conclusions
From the study results and discussion above, the following conclusions can be reached; Respondent’s knowledge on diabetes was generally average and this is evidenced by the fact that only 54.3% of the entire respondents were able to answer 50% of the diabetes related questions correctly
Most of the respondents who seek for medical care at the Auchi Teaching hospital (ATH) do not adhere to the recommended diabetes self-management practices such as compliance to medication, preference for loose footwear and attending their diabetes related checkups on a regular basis.
Diabetes education and social support were identified as the significant factors that influence respondents diabetes self-management practices
Recommendations
Based on the findings of the study, the following recommendations were proposed by the researcher;
Nigeria Health Service should intensify its public awareness and sensitization campaigns on diabetes so as to enable diabetes patients in particular to acquire more knowledge about their health condition
The Ministry of Health should collaborate with Nigeria Health Service (GHS) to create more public education on the benefits associated with self-management of diabetes. This recommendation will help people living with diabetes to make conscious effort to self-manage their diabetes condition more effectively.
Diabetes related training should be organized on a regular basis for health workers who provide diabetes care so as to enable them to provide adequate health care for people living with diabetes
The research community, Non-Governmental Organizations and other advocacy groups should advocate for more resources to be committed towards diabetes prevention and its management
REFERENCES
- Abioye Akanji, Oluseyi Grace (2013). “An Exploration of the Barriers to Diabetes Management Among West African Immigrants in the United States” Master of Science in Nursing. Paper 21. http://digitalcommons.ric.edu/school_of_nursing/21
- Abokyi S., Koffour G.A., Ovenseri-Ogbomo G.,and Abokyi E., (2013). Knowledge of Diabetes and its Associated Ocular Manifestations by Diabetic Patients: A Study at Korle-Bu Teahing Hospital, Nigeria. Nigerian Medical Journal. 2013 Jul-Aug; 54(4): 217–223.
- Adisa R, Alutundu MB and Fakeye TO (2009). Factors Contributing to Non-adherence to Oral Hypoglycaemic Medications Among Ambulatory Type 2 Diabetes Patients in Southwestern Nigeria. Pharmacy Practice. (internet) 7(3):163-169.
- Ahola AJ, Groop PH. Barriers to self-management of diabetes. Diabetes Med. 2013 Apr; 30(4):413–20.
- Al-Kaabi J, Al-Maskari F, Saadi H, Afandi B, Parkar H, Nagelkerke N (2009). Physical activity and reported barriers to activity among type 2 diabetic patients in the United Arab Emirates. Rev Diabet Stud. Winter;6(4):271-8.
- Al Sayah, F., Majumdar, S. R., Williams, B., Robertson, S., & Johnson, J. A. (2013).
- Health Literacy and Health Outcomes in Diabetes: A Systematic Review. Journal of General Internal Medicine, 28(3), 444-452. doi: 10.1007/s11606-012-2241-z
- American Diabetes Association [ADA] (2013). Standards of Medical Care in Diabetes.
- Diabetes Care. 36 (Suppl. 1):S11-S66.
- American Diabetes Association (2011). Standards of medical care in diabetes. Diabetes Care 2011, 34 (Suppl 1):S11-S61.
- American Association of Diabetes Educators (2011). The Art & Science of DSME Desk Reference. Chicago, Illinois: Ed: Carole Mensing
