Knowledge and Practice of Self Care Management Among Patients With Diabetes Mellitus in Auchi
CHAPTER ONE
Objectivesย ofย theย Study
Mainย Objective
The aim of this study was to assess the knowledge on diabetes and the effectiveness ofย self-managementย practicesย amongย diabetesย patientsย atย theย Auchiย Teachingย Hospital.
Specificย Objectives
Specifically,ย theย studyย soughtย 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 TWOย
LITERATUREย REVIEW
Introductionย
In order to understand the background of this study, the chapter commences by providingย an overview of diabetes, types of diabetes and classification of diabetes. A brief overviewย of the diagnosis criteria for diabetes, risks factors of diabetes, complications associatedย with diabetes and self-management of diabetes are also considered in this chapter. Theย chapterย furtherย considersย theย actualย statusย ofย self-managementย ofย diabetesย andย theย guidelinesย required to self-manage diabetes. The chapter concludes by looking at theย factors that inhibitย self-managementย ofย diabetes.
Overviewย ofย Diabetes
The prevalence of diabetes is on the ascendency andย increasingly becoming aย globalย health concern. Diabetes is a metabolic disorder which is characterized by high bloodย glucose levels (hyperglycemia). Diabetes occurs due to lack of insulin secretion, reducedย insulin production or reduced insulin action (WHO, 2007). This anomaly interferes withย carbohydrate,ย proteinย andย fatย 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.
Earlierย Classificationsย ofย Diabetesย
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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.
CHAPTERย THREEย ย
METHODOLOGY
Introductionย
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.
Researchย Design
A cross-sectional design (survey method) was used in gathering the requisite data for thisย research work. During the survey, a semi structured questionnaire was used as the mainย data collection instrument.ย The rationale for using the cross-sectional survey method wasย to enable the researcher to assess the knowledge on diabetes and the effectiveness of self-ย management practices among diabetes patients at the Auchi Teaching Hospital at theย sameย pointย 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 FOURย
PRESENTATIONย OFย 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.
CHAPTERย FIVE
ย SUMMARY,ย CONCLUSIONSย ANDย RECOMMENDATIONS
ย Introduction
Theย chapterย presentsย theย summaryย ofย keyย findingsย asย wellย asย theย conclusionsย andย recommendations ofย thisย study.
Summaryย ofย Keyย Findings
Theย keyย findingsย ofย thisย studyย areย summarizedย asย follows;ย Majorityย ofย respondentsย wereย femalesย (61.7%)
Majorityย ofย theย respondentsย wereย illiteratesย (56.4%)
Ageย ofย respondentsย hadย aย significantย positiveย relationshipย onย theirย levelย ofย knowledgeย on diabetes (P-value=0.007)
Maritalย statusย ofย respondentsย hadย aย statisticallyย significantย positiveย relationshipย onย theirย levelย ofย knowledgeย on diabetesย (P-value=0.005)
Educationalย backgroundย ofย theย studyย participantsย hadย aย significantย positiveย relationshipย onย theirย levelย ofย knowledgeย onย diabetesย (P-value=0.002)
Monthlyย householdย incomeย levelsย ofย theย respondentsย hadย aย significantย positiveย relationshipย onย theirย levelย ofย knowledgeย onย diabetesย (P-value=0.007)
Ethnicย backgroundย ofย respondentsย hadย aย statisticallyย significantย positiveย relationshipย onย theirย level ofย knowledge onย diabetesย (P-value=0.003)
Outย ofย theย 94ย respondentsย whoย wereย sampled,ย onlyย 46%ย ofย themย hadย adequateย knowledgeย on diabetes
Socialย supportย hadย aย significantย relationshipย onย respondentsย abilityย toย self-manageย theirย diabetes conditionย (P-value=0.047)
Diabeticย educationย hadย aย statisticallyย significantย relationshipย onย respondentsย abilityย to self-manage their diabetesย conditionย (P-value=0.001)
Aย significantย proportionย ofย theย totalย respondentsย (54.6%)ย disclosedย thatย theyย donโtย adhereย strictlyย to theirย diabetesย medication
Mostย ofย theย studyย participantsย (58.5%)ย indicatedย thatย theyย donโtย monitorย theirย bloodย sugarย levelย on aย regularย basis
Majorityย ofย theย respondentsย (68.1%)ย preferredย tightย footwearย whereasย 31.9%ย ofย themย preferred looseย footwear
Aย significantย proportionย ofย theย respondentsย (82%)ย doย notย effectivelyย self-manageย theirย diabetes condition.
Conclusions
Fromย theย studyย resultsย andย discussionย above,ย theย followingย conclusionsย canย beย reached;ย Respondentโsย knowledgeย onย diabetesย wasย generallyย averageย andย thisย isย evidencedย byย theย factย thatย onlyย 54.3%ย ofย theย entireย respondentsย wereย ableย toย answerย 50%ย ofย theย diabetesย related questionsย correctly
Most of the respondents who seek for medical care at the Auchi Teaching hospitalย (ATH) do not adhere to the recommended diabetes self-management practices such asย compliance to medication, preference for loose footwear and attending their diabetesย related checkupsย onย aย regularย basis.
Diabetes education and social support were identified as the significant factors that influence respondents diabetes self-management practices
Recommendationsย
Basedย onย theย findingsย ofย theย study,ย theย followingย recommendationsย wereย proposedย byย theย researcher;
Nigeriaย Healthย Serviceย shouldย intensifyย itsย publicย awarenessย andย sensitizationย campaigns on diabetes so as to enable diabetes patients in particular to acquire moreย knowledgeย aboutย theirย health condition
The Ministry of Health should collaborate with Nigeria Health Service (GHS) to createย more public education on the benefits associated with self-management of diabetes.ย This recommendation willย help peopleย living with diabetes toย makeย conscious effortย toย self-manageย their diabetesย conditionย more effectively.
Diabetesย relatedย trainingย shouldย beย organizedย onย aย regularย basisย forย healthย workersย who provide diabetes care so as to enable them to provide adequate health care forย peopleย livingย 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
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