Self-care practice and associated factors among patients with diabetes mellitus on follow up at University of Gondar Referral Hospital, Gondar, Northwest Ethiopia

Family Support and Type 2 Diabetes Self-management Behaviors in Underserved Latino/a/x Patients

BACKGROUND

Latino/a/x families experience persistent Type 2 diabetes mellitus (T2DM) disparities, including higher rates of diagnosis and mortality due to disease complications than their non-Hispanic White counterparts. Though greater social support is associated with improved disease outcomes for Latino/a/x patients with diabetes, research has yet to identify the specific pathways through which social support, and specifically family support, influences self-management.

PURPOSE

This study tested a theoretical model highlighting the mechanisms and pathways linking social support and physical health. Specifically, self-efficacy and depression were tested as psychological pathways connecting family support to diabetes self-management behaviors and diabetes morbidity in Latino/a/x patients with T2DM.

METHODS

Data from 177 patients were analyzed using structural equation modeling. Measures included diabetes-specific family support needed and received, depressive symptoms, self-efficacy in diabetes management, diabetes self-management behaviors, health appraisal, and hemoglobin A1c.

RESULTS

Greater diabetes-specific family support was significantly associated with more frequent engagement in diabetes self-management behaviors, both directly (p < .001) and through diabetes self-efficacy's partial mediation of this relationship (p = .013). Depression was not significantly associated with either family support (support received, p = .281; support needed, p = .428) or self-management behaviors (p = .349).

CONCLUSIONS

Family support and diabetes self-efficacy may be important modifiable psychosocial factors to target via integrated care interventions aimed at supporting Latino/a/x patients with T2DM. Future research is needed to test empirically based, culturally adapted interventions to reduce T2DM-related health disparities in this population.

Relationship Between Patient Activation and Type 2 Diabetes Mellitus Self-management and Clinical Outcomes in Saudi Arabian Primary Care Setting

PURPOSE

Type 2 diabetes mellitus (T2DM) self-management is a comprehensive approach that individuals with T2DM employ to manage and control their condition. Patients' activation, "an individual's knowledge, skill, and confidence for managing their health and health care", has been used as a major driver of self-management. This study aimed to assess the relationship of patient activation with T2DM self-management and clinical outcomes.

DESIGN

A cross-sectional study.

SUBJECTS

Patients with type T2DM who age 18-years and older.

SETTING

The primary care centers in Saudi Arabia.

MEASURES

Patient activation measure (PAM) and the Summary of Diabetes Self-Care Activities (SDSCA).

ANALYSIS

Descriptive statistic, T-test, One-way ANOVA test, Chi-square test, and linear and logistic regressions were performed.

RESULTS

A total of 398 patients, mostly male (54.9%) with a mean age of 53.2 (±10.7) years old participated in the study. The participants' mean of Hemoglobin A1c (HbA1c) was 8.4% (±1.7%) and most of them (74.5%) had an uncontrolled HbA1c level (>7% %). The mean patient activation score was 55.9 (±13.5). 24.4% were at [PA1], 26.7% at [PA2], 37.4% at [PA3], and 11.5% at [PA4]. Patient activation level was positively associated with better glycemic control and self-management behaviors including diet, physical activity, blood glucose self-testing, foot care, and smoking (P < .05) but not with adherence to medication.

CONCLUSIONS

Our findings reveal a positive association between patient activation level and enhanced glycemic control and self-management behaviors and suggest that patient activation-informed self-management interventions are more likely to yield promising health outcomes.

Diabetes knowledge and foot care practices among type 2 diabetes patients attending the chronic ambulatory care unit of a public health hospital in eastern Ethiopia: a cross-sectional study

OBJECTIVE

To assess diabetes knowledge and foot care practices among type 2 diabetes patients.

DESIGN

An institution-based cross-sectional study was undertaken from 1 January to 31 January 2021.

SETTING

Eastern Ethiopia.

PARTICIPANTS

Randomly selected type 2 diabetes patients who were available during the data collection period were included.

OUTCOMES

Patients' diabetes knowledge was assessed with the revised diabetes knowledge test questionnaire. Five items were used to evaluate foot self-care practices.

RESULTS

The study population comprised of 549 patients. About 52.5% of the patients had adequate diabetes knowledge (95% CI: 48.2% to 56.7%). Patients with an educational level of secondary school and above (adjusted OR (AOR): 2.04, 95% CI: 1.13 to 3.71), (AOR: 5.28, 95% CI: 2.28 to 12.22), and those with medium and above wealth status (AOR: 3.81, 95% CI: 2.24 to 6.47), (AOR: 3.46, 95% CI: 1.98 to 6.04), were found to have better odds of having adequate diabetes knowledge. However, those aged >55 years (AOR: 0.47, 95% CI: 0.22 to 0.99) were found to have lower odds of adequate diabetes knowledge.Of the total included patients, 20.2% (95% CI: 16.9% to 23.8%) had good foot care practices. Knowledge of the target fasting plasma glucose (AOR: 3.18, 95% CI: 1.94 to 5.22) and adequate diabetes knowledge (AOR: 3.40, 95% CI: 1.95 to 5.91) were significantly associated with good foot care practices.

CONCLUSION

According to this study, about half of individuals with type 2 diabetes have adequate levels of knowledge about the disease. In addition, only one out of every five patients has good foot care habits. Diabetes education should emphasise the significance of rigorous adherence to daily foot care practices.

Prevalence of Self-care Practices among Type 2 Diabetes Mellitus Patients and its Effect on Glycemic Control: A Cross-sectional Study in Secondary and Tertiary Health-care Centers in Lucknow

Background

Globally, prevalence of diabetes is 10.5%, and in 2019, approximately 463 million adults were living with diabetes by 2045; this will increase to 700 million (10.9%). India is a diabetic capital of world, prevalence of diabetes in India is 8.3%.

Aim

This study aimed to assess self-care practices (SCPs) among type 2 diabetes mellitus (T2DM) patients, its predictors, and effect of SCP on glycemic control.

Materials and Methods

A cross-sectional hospital-based study was conducted among 300 known T2DM patients in the age group of 18-60 years attending noncommunicable diseases clinic at Secondary and Tertiary Care Hospitals of Lucknow, Uttar Pradesh, selected using two-stage purposive sampling method. Data were collected using a predesigned and pretested semi-structured questionnaire. Data were collected from consenting respondents on the sociodemographic profile (about their residence, gender, marital status, type of family, educational status, family income, employment status, etc.). SCP was assessed using Summary of Diabetes Self-Care Activities. Data were analyzed using SPSS.

Results

Among 300 patients with a mean age 50 ± 8.9 years, the prevalence of good SCPs was 37%. Out of 189 T2DM patients with poor SCPs, 66.4% had uncontrolled blood sugar level (285.4 ± 67 mg/dL). Out of 73 T2DM patients with poor SCPs, 65.7% had uncontrolled glycated hemoglobin level (8.4% ± 2%), and this was statistically significant.

Conclusion

The practice of self-care was found to be suboptimal among patients with T2DM in the study.

The role of structural racism and geographical inequity in diabetes outcomes

Diabetes is pervasive, exponentially growing in prevalence, and outpacing most diseases globally. In this Series paper, we use new theoretical frameworks and a narrative review of existing literature to show how structural inequity (structural racism and geographical inequity) has accelerated rates of diabetes disease, morbidity, and mortality globally. We discuss how structural inequity leads to large, fixed differences in key, upstream social determinants of health, which influence downstream social determinants of health and resultant diabetes outcomes in a cascade of widening inequity. We review categories of social determinants of health with known effects on diabetes outcomes, including public awareness and policy, economic development, access to high-quality care, innovations in diabetes management, and sociocultural norms. We also provide regional perspectives, grounded in our theoretical framework, to highlight prominent, real-world challenges.

Assessment of self-care practice amongst patients with type II diabetes attending Adama Hospital Medical College, Ethiopia

INTRODUCTION

There is almost no published data on the assessment of self-management practice among adult type II diabetes patients in Ethiopia. Hence, we aim to assess the level of self-management practice for people with type II diabetes patients attending Adama Hospital Medical College, Ethiopia.

METHOD

The study was conducted from April 1 to August 30, 2021 in type II diabetes mellitus patients at Adama Hospital Medical College. The survey was performed using the diabetes mellitus self-Management questionnaire, which consists of four domains Physical activity, Physician contact, Medication adherence, glucose management and dietary management of the patients. The data was analyzed using Statistical Package for Social Science (SPSS) version 20.0. Descriptive statistics was performed. Fisher's Exact Test was used to determine the presence of association between adherence to self-care behavior and other variables. P-value less than 0.05 determines statistical significance.

RESULT

Majority (63.4%) of respondents do not perform self-monitoring of blood glucose (SMBG). Out of a total of 93 participants, 48 (51.6%) respondents adhered to insulin therapy. Sixty-two (66.7%) adhered to recommended diet management practice, 57 (61.3%) did not adhere to physical activity recommendations and 59 (63.5%) participants adhered to overall self-care practice (DMSQ).

CONCLUSION

Although the importance of self-care practices in the management of diabetes were recognized to be useful and effective for achieving glycemic control and preventing serious diabetes complications, our study found that most patients had not adhered to self-care practice especially in terms of SMBG and physical activity. Overall (DSMQ) adherence to self-care practice was optimal amongst type II diabetes patients in AHMC Chronic care unit.

Feasibility of Virtual Simulation-Based Diabetes Foot Care Education in Patients with Diabetes in Ethiopia: Protocol for a Randomized Controlled Trial

INTRODUCTION

Diabetes mellitus is a rapidly growing global public health problem; the number of adults with diabetes is expected to increase from 424.9 million in 2017 to 628.6 million in 2045. Approximately 80% of diabetic patients live in low- and middle-income countries where access to care may be limited. For example, in Ethiopia, diabetes care is often rudimentary, and formal, structured diabetes education is almost non-existent. One potential solution to the lack of diabetes management education for patients could be virtual simulation-based diabetes education incorporating the contextual realities of patients in Ethiopia. Despite its great potential to improve glycemic control, delay diabetes-related complications and reduce mortality associated with diabetes, the feasibility of virtual simulation-based diabetes self-management education has not been studied in low- and middle-income settings.

OBJECTIVE

The purpose of the current study is to evaluate the feasibility of a virtual simulation-based Diabetes Foot Care Education (DFCE) program among adult patients with diabetes in Ethiopia.

METHODS

A randomized controlled feasibility study including participants from University of Gondar Referral Hospital (UoGRH) will be conducted. A sample of 40 participants will be recruited, of which 20 participants will receive the virtual simulation-based education program, and the other 20 participants will continue with their usual diabetes care. After the education program, a questionnaire and structured interview will be used to explore the feasibility (acceptability, practicality) and the potential impact of virtual simulation-based DFCE intervention in patients with diabetes. Data will be analyzed using SPSS version 25 using descriptive statistics, independent t-tests, paired sample t-test, and factorial ANOVA at significance levels of less than 0.05.

DISCUSSION

Our study seeks to understand the perceived usefullness and usability of virtual simulation-based diabetes foot care education on behavioural (diabetes foot-care knowledge, foot self-care practices, and foot self-care efficacy). Furthermore, the study will provide insight to assist in the development of technologically assisted and contextually designed DFCE programs.

TRIAL REGISTRATION NUMBER

NCT04841291 (ClinicalTrials.gov Identifier).

Response to self-care practice messages among patients with diabetes mellitus visiting Jimma University medical center facility based cross sectional design application of extended parallel process model

Objective

To determine response to self-care practice message among patients with diabetes in Jimma University Medical center based on the Extended Parallel Process Model.

Design

A facility-based cross-sectional study was conducted.

Setting

Jimma University Medical Center is found in Jimma town.

Participants

A total of 343 patients with diabetes participated in the study; making a response rate of 93.9%. All patients with diabetes who were 18 years and above and who were on follow up and registered were included in the study and those with Gestational DM were excluded.

Data analysis

Multivariable logistic regression analysis.

Result

Responsive respondents scored high in self-care practice score as compared to other respondents. educational status, information sources, knowledge, and preferred message appeals were independent predictors of controlling the danger of diabetes.

Conclusion

There is a significant gap in controlling the danger of diabetes. Variables like the level of education, knowledge of diabetes mellitus, information sources, and message appeals were independent predictors of controlling the danger of diabetes. Designing message having higher efficacy while maintaining the level of threat is the best that fits the existing audience’s message processing to bring about desired diabetic self-care Practice.

Social support as a mediator between depressive symptoms and self-care activities in adults patient with type 2 diabetes mellitus

BACKGROUND

People with type 2 DM are at risk of experiencing depression, which in turn can affect their self-care activities. Recent evidence has shown that social support is beneficial in reducing the risk of depression and positively affecting increases in self-care activities. However, the role of social support in the relationship between depressive symptoms and self-care activities has not been studied. This study aims to determine the mediating effects of social support on the relationship between depressive symptoms and self-care activities of people with type 2 DM.

DESIGN AND METHODS

A cross-sectional consecutive sampling approach was used with 94 respondents with type 2 diabetes in East Jakarta, Indonesia, who were undergoing diabetes treatments during May-June 2020. The instruments used were the Centre for Epidemiologic Studies-Depression Scale (CES-D), Summary of Diabetes Self Care Activities (SDSCA), and Duke-UNC Functional Social Support Questionnaire (DUFSSQ). All three questionnaires have been tested for validity and reliability. Data analysis was carried out using multiple linear regression, path analysis, and the Sobel test.

RESULTS

The results of multiple linear regression analysis on the variables age, sex, education level, socioeconomic status, duration of type 2 DM, and complications of type 2 DM showed that only complications of type 2 diabetes affected self-care activities (p = 0,000; R2 = 0.515). The results of the path analysis and Sobel test showed that social support significantly mediated the effects of the relationship between depressive symptoms and self-care activities (z = -0,162 > table 1.96; direct effect = -0,499; indirect effect = -0,0789; total effect = 40, 3%).

CONCLUSIONS

Screening for depressive symptoms and interventions involving social support are strongly suggested for patients with type 2 DM who are suspected of showing a decline in self-care activities.

Do adult patients with diabetes mellitus living in rural part of Ethiopia and having poor social support have disproportionately poor self-care practice? A systematic review and meta-analysis

OBJECTIVE

This systematic review and meta-analysis is aimed at determining the pooled national percentage of diabetic self-care practice and its determinants among adult diabetic patients in Ethiopian.

METHODS

Different electronic databases including PubMed/Medline and search engines such as Google scholar were used to retrieve published studies. The Joanna Briggs Institute quality appraisal checklists were used to appraise the quality of studies. Data were extracted using excel spreadsheets and analyses were done by STATA 14. Heterogeneity among studies was diagnosed using the I² test. The DerSimonian and Laird random-effects model was employed for substantial heterogeneity (I2 > 50%). The pooled estimate of diabetic self-care and odds ratio was reported based on the 95% CI.

RESULTS

A total of 3861 studies were identified, of which only 19 studies have reached the final qualitative synthesis and quantitative analysis. Well over half of the Ethiopian diabetic patients have good self-care 54.04% (47.07-61.01, I² = 97.3, P < 0.001). Subgroup analysis by region showed that the highest pooled estimate was observed in Southern Nations Nationalities and Peoples 81.96% (71.85-92.04), I² = 89.1, p < 0.002), whereas the lowest was from the Harari region 44.53% (32.16-56.89%) I² = 94%, p < 0.001). Being knowledgeable about diabetes Mellitus 2.69 (1.62, 4.46; I2 = 99%, p < 0.001), having good social support 2.25 (1.49-3.39; I² = 99%, p = 0.00), owning private glucometer 3.04(1.64, 5.65; I² = 97.4, P < 0.001), and being urban residents 3.26 (2.24, 4.74; I² = 96.3%, P < 0.001) promote diabetic victims to apply self-care practice.

CONCLUSIONS

Despite the life-threatening complications of diabetes Mellitus, the percentage of patients applying self-care has remained low in Ethiopia, depicting the high proportion of diabetic patients are prone to develop long and short-term sequelae of diabetes Mellitus. Therefore, improving the client's awareness about the disease and counseling clients about the significance of social support are believed to be possible strategies to improve self-care practice and policymakers are strongly recommended to combat complications to attain sustainable development goal 3.4 Aims to reduce premature death.

REGISTRATION

The protocol has been registered under the prospective Register of Systematic Review and Meta-analysis (PROSPERO) and received a unique registration number CRD42020151014.

Prevalence of Poor Diabetes Self-Management Behaviors among Ethiopian Diabetes Mellitus Patients: A Systematic Review and Meta-Analysis

Background

Diabetes has no cure so far, but appropriate self-management contributes to delay or control its progression. However, poor self-management by diabetic patients adds to disease burden. The pooled prevalence of overall, and its main components of poor self-management among Ethiopian diabetic patients remain elusive. Hence, this study aimed to determine the prevalence of poor diabetes self-management behaviors among diabetic patients in Ethiopia.

Method

by using different combinations of search terms, we accessed articles done until February 15, 2020 through Pubmed, Scopus, Web of Science and Embase databases. Newcastle-Ottawa quality assessment scale was used for quality assessment, and STATA version 14 software along with the random-effects model was employed for statistical analyses. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA.) guideline was followed to report the results.

Result

Twenty-one studies with 7,168 participants were included in this meta-analysis. The overall pooled prevalence of poor self-management behavior among diabetic patients in Ethiopia was 49.79% (95% CI: 43.58%, 56.01%). Based on subgroup analysis, the estimated magnitudes of poor self-management by regions were 68.58% in Tigray, 55.46% in Harari, 54.74%, in Amhara, 40.90%, in SNNPRS and 37.06% in Addis Ababa. The worst (80.91%) and relatively better (24.65%) self-management components were observed on self-blood glucose monitoring and medication adherence, respectively.

Conclusion

One in two diabetic patients in Ethiopia had poor self-management. Thus, we strongly recommend to the ministry of health and universities to train diabetes health educators, and the health facilities to deliver tailored diabetes health education.

Diabetes self-care practice and associated factors among type 2 diabetic patients in public hospitals of Tigray regional state, Ethiopia: A multicenter study

Background

The prevalence of type 2 diabetes is increasing steadily at an alarming rate. Ethiopia is placed fourth among the top five countries of the African region members of the international diabetes federation. This study aimed to determine the level of diabetes self-care practice and associated factors among patients with type 2 diabetes mellitus attending public hospitals of the Tigray region.

Methods

An institution-based, cross-sectional study was conducted in six selected hospitals of Tigray region from January to February 2020. Study participants were recruited using a systematic random sampling method. Diabetes self-care practice was assessed using Summary Diabetes Self-Care Activities (SDSCA) assessment tool. The data were collected by trained nurses via face-to-face interview. Binary and multivariable logistic regression analyses were used to identify factors associated with self-care practices. Statistical significance was declared at p-value < 0.05.

Results

A total of 570 patients with type 2 diabetes were included in this study. The mean (SD) age of the participant was 46 (±14.6) years. Less than half (46.7%) of the participants had good diabetes self-care practices. Surprisingly, only 68 (11.9%) of the participants had access to a personal glucometer. Urban residency (AOR = 1.9, 95% CI = 1.20–2.94), age group 48–63 years (AOR = 2.1, 95% CI = 1.19–3.98), not having a formal education (AOR = 2.6, 95% CI = 1.32–5.25), having family support (AOR = 1.9, 95% CI = 1.24–2.85), and having a personal glucometer at home (AOR = 6.1, 95% CI = 2.83–13.0) were the factors associated with good diabetes self-care practices.

Conclusion

The diabetes self-care practice in the region was found to be poor. Where factors like, being an urban resident, age group between 49–63 years, not having a formal education, and having a personal glucometer at home were associated with good self-care practices. Health care providers might have to consider actions to act on the identified factors and improve the level of self-care practices of the patients.

Self-care practice and its predictors among adults with diabetes mellitus on follow up at public hospitals of Arsi zone, southeast Ethiopia

Objective

Diabetes mellitus is a chronic illness that requires ongoing patient self-management and support to prevent acute complications and to reduce the risk of long- term complications. The objective of the study was to assess diabetic self-care practice and its predictors among adults with diabetes mellitus on follow up at hospitals of Arsi zone, southeast Ethiopia.

Results

Above half (53.3%) of diabetic patients had good self-care practice. Younger age (AOR: 8.95, 95% CI 1.89,42.48), earning a high income (AOR: 2.495, 95% CI 1.0,5.85), having a family history of diabetes (AOR: 4.5, 95% CI 1.3, 15.5), long duration since the diagnosis of diabetes (AOR: 2.14,95% CI 1.127,4.05), not having diabetic complications (AOR: 3.87, 95% CI 2, 7.48), and having glucometer (AOR: 4.08, 95% CI 1.78 l, 9.33) were significantly associated factors with good diabetic self care practice. Efforts should be made to prevent complications of diabetes mellitus, to support patients who are aged and who have no glucometer at their home to promote good self-care practice. Particularly, health care providers should give special attention to newly diagnosed patients.

Non-adherence to self-care and associated factors among diabetes adult population in Ethiopian: A systemic review with meta-analysis

BACKGROUND

Self-care practice among people with diabetes is not well-implemented in Ethiopia. So far, in Ethiopia, several observational studies have been done on self-care practice and its determinants in people with diabetes. However, a comprehensive review that would have a lot of strong evidence for designing intervention is lacking. So, this review with a meta-analysis was conducted to bridge this gap.

METHODS

A systematic review of an observational study is conducted following the PRISMA checklist. Three reviewers have been searched and extracted from the World Health Organization's Hinari portal (SCOPUS, African Index Medicus, and African Journals Online databases), PubMed, Google Scholar and EMBASE. Articles' quality was assessed using the Newcastle-Ottawa Scale by two independent reviewers, and only studies with low and moderate risk were included in the final analysis. The review presented the pooled proportion of non-adherence to self-care practice in people with diabetes and the odds ratios of risk factors hindering to self-care practice after checking for heterogeneity and publication bias. The review has been registered in PROSPERO with protocol number CRD 42020149478.

RESULTS

We included 21 primary studies (with 7,134 participants) in this meta-analysis. The pooled proportion of non-adherence to self-care in the diabetes population was 49.91 (95% CI: 44.73-55.08, I2 = 89.8%). Male (Pooled Odds Ratio (POR): 1.84 95%CI; 1.04-2.64, I2 = 15.0%), having private glucometer (POR: 2.71; 95%CI: 1.46-3.95, I2 = 0.0%), short-term Diabetes Mellitus (DM) duration (POR: 3.69; 95%CI: 1.86-5.52, I2 = 0.0%), DM complication (POR: 2.22; 95%CI: 1.48-2.95, I2 = 0.0%), treatment satisfaction (POR: 1.8; 95% CI: 1.15-2.44, I2 = 0.0%), received diabetes self-management education (POR: 2.71; 95% CI: 1.46-3.95, I2 = 0.0%) and poor self-efficacy (POR: 3.09; 95% CI: 1.70-4.48, I2 = 0.0%) were statistically significant factors of non-adherence to self-care practice.

CONCLUSIONS

The overall pooled proportion of non-adherence to self-care among adult diabetes in Ethiopia was high. Further works would be needed to improve self-care practice in the diabetes population. So, factors that were identified might help to revise the plan set by the country, and further research might be required to health facility fidelity and each domain of self-care practice according to diabetes self-management guideline.

Self-care Related Knowledge, Attitude, and Practice and Associated Factors Among Patients with Type 2 Diabetes in JMC, Ethiopia

BACKGROUND

A patient's knowledge, attitude and practice toward diabetes self-care is found to be imperative for them to attain the desired treatment targets and contribute meaningfully in the management of their disease.

OBJECTIVE

To assess the knowledge, attitude and practice towards diabetes self-care with the associated factors among patients with type 2 diabetes mellitus (T2DM) in Jimma Medical Center, Ethiopia.

METHODS

A cross-sectional study was conducted to determine knowledge, attitude, and practice toward diabetes self-care. Three hundred and seventy-one T2DM patients attending Jimma Medical Center from March 30 to June 1, 2019 were included in this study and an interviewer-administered questionnaire was used to collect the data. SPSS version 20 was used for descriptive and logistic regression analysis. Odds ratios and their 95% confidence intervals together with p-value <0.05 were used to declare statistical significance.

RESULTS

Out of 371 patients, 201 (54.2%) were male. Of the total, 235 (63.3%) had good knowledge, 221 (59.6%) had positive attitude, and 201 (54.2%) had good self-care practice toward diabetes. Primary educational level (AOR=1.895) was associated with poor knowledge of diabetes, while urban living (AOR=0.570) was protective for low knowledge of diabetes. Monthly income <1000 Ethiopian birr (ETB); (AOR=2.723) and 1000-3000 ETB; (AOR=1.126), illiterate (AOR=2.3), and duration of diabetes mellitus (DM) <5 years (AOR=2.242) were significantly associated with negative attitude. Having other comorbidities (AOR=0.602) was less likely to have negative attitude towards diabetes. Patients age, 41-50 years (AOR=2.256), and 51-60 years (AOR=2.677), education: being illiterate (AOR=4.372), primary level (AOR=4.514), and earning monthly income <1000 ETB (AOR=4.229) were significantly associated with poor self-care practice. On the contrary, being male (AOR=0.198) was less likely to have a poor self-care practice.

CONCLUSION

The knowledge level, attitude status and self-care practice among T2DM patients were found to be optimal.

The Magnitude, Types, and Roles of Social Support in Diabetes Management among Diabetics' in Southern Ethiopia: a Multilevel, Multicenter Cross-Sectional Study

INTRODUCTION

Lifelong medical management is the main intervention to reduce diabetes-related morbidities and premature deaths; yet, social support can be a vital intervention to improve diabetics' health. Therefore, this study aimed to determine the magnitude, types, and role of social support in diabetes management in southern Ethiopia.

METHODS

A multi-stage systematic sampling was applied to recruit 634 adult diabetics from the three-tiered healthcare system in the region. We proportionally distributed the sample size between randomly selected ten health-care facilities across the hierarchy. Pretested questionnaires and checklist; Epi-Info, and SPSS software used for data collection; entry, and analyses, respectively, and the statistical significance was determined at a P-value ≤0.05.

RESULTS

A total of 240 females and 356 males completed the study, and the overall magnitude of the social support was 50.20% [95% CI: 46.19%, 54.21%], and it was categorized into non-material and material with 44.13% [95% CI: 40.14%, 48.12%] and 34.23% [95% CI: 30.42%, 38.04%] magnitudes, respectively, and social support was left to the patients' families and friends whereas formal institutions and the public sectors were rarely offering when the patients needed it. Though sex, educational level, and health-care hierarchy were not significantly associated with the social support, residence, some occupations, presence of diabetic family members, acute medical conditions, blood glucose level, compliance to medical follow-ups, treatment adherence, and taking anti-diabetic drugs a day before the current visit to health-care facility were all statistically significantly associated with social support.

CONCLUSION

One of every two adult diabetic patients in southern Ethiopia was receiving any social support, and social support for diabetic people reduces medical follow-ups absenteeism, improves treatment adherence, glycemic level controlling, and helps lifestyle modifications. Therefore, to keep diabetic people healthy and achieve diabetes management goals, the Ethiopian healthcare system, institutions, and concerned stakeholders should strengthen the social support for diabetic patients.

Does Patients' Perception Affect Self-Care Practices? The Perspective of Health Belief Model

BACKGROUND

Poor lifestyle choices contribute to the continued growth of chronic illness and disability. Patients with diabetes require continuous self-care choices and management to minimize the short- and long-term impact of the disease. This study aimed at assessing the use of the health belief model to describe self-care practices among patients with diabetes.

METHODS

An institutional-based cross-sectional study was conducted from February to March 2019 in Gondar City, Northwest Ethiopia. A total of 396 diabetics patients were selected using a systematic random sampling technique. Pretested, structured, and interview administered questionnaire was used for data collection. The collected data were analyzed using STATA 14. Bivariate and multivariate logistic regression models were fitted to identify the factors associated with self-care behavior. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-values <0.05 were used to declare statistical association.

RESULTS

Health belief model described 48% of the variance in self-care practices of patients with diabetes. More than half (55.6%) of diabetic patients had good self-care practice. Of the participants, 45.8% and 49.9% had low perceived susceptibility and perceived severity, respectively. The strongest correlation was found between cues to action and perceived severity of health belief model constructs (P<0.001). Formal education, longer duration of diabetes, high social support, high perceived severity, and high self-efficacy contributed to good self-care practices, whereas comorbidities, high perceived benefit, and high perceived barrier were associated with poor self-care practices.

CONCLUSION

Self-care practice of diabetes patients in Gondar City was considerably low. Health professionals need to strengthen delivering tailored health messages on the benefit self-care practices and means of overcoming the potential barriers. Health communication programs are also better to consider for individuals with comorbidities, lack of social support, and lower education.

Self-Care Practice and Associated Factors Among People Living with Type 2 Diabetes in Addis Ababa, Ethiopia: A Facility-Based Cross-Sectional Study

INTRODUCTION

Diabetes is a global public health threat with a considerably high burden in low- and middle-income countries. The application of self-care practice by people living with diabetes helps to manage diabetes and its complications, and to lengthen their life. However, the level of diabetes self-care practice in Ethiopia is very low.

METHODS

A cross-sectional study was conducted among people living with type 2 diabetes who were on follow-up from January 01 to 31, 2019 at Yekatit 12 Hospital. A systematic sampling technique was employed to recruit 354 study participants. A face-to-face interview was administered by trained data collectors using a structured questionnaire. Diabetes self-care practice was assessed by using Summary of Diabetes Self-Care Activities (SDSCA) scale. Multi-variable binary logistic regression analysis was carried out to identify factors associated with diabetes self-care practice.

RESULTS

More than half (52.0%, 95% CI: 49.9% - 57.1%) of the people living with diabetes had poor diabetes self-care practice. Poor self-care practice was associated with being unemployed and retired (AOR= 3.57, 95% CI 1.65-7.72), having diabetes for ≥10 years (AOR= 1.78, 95% CI 1.07-2.95), having comorbidity (AOR= 2.15, 95% CI 1.35-3.43), not owning glucometer (AOR= 1.81, 95% CI 1.16-2.83), not receiving diabetes education (AOR= 1.95, 95% CI 1.20-3.18) and dissatisfaction with social support (AOR= 4.24, 95% CI 1.25-14.40).

CONCLUSION

Poor self-care practice was found to be substantial among people living with diabetes in Addis Ababa, with self-monitoring of blood glucose and regular exercise being the least performed. It is beneficial to focus more on lifestyle modifications and educating about the severity of the disease for better management of blood sugar levels and hindrance of complications.

Predictors of Diabetes Self-Care Practice Among Patients with Type 2 Diabetes in Public Hospitals in Northeastern Ethiopia: A Facility-Based Cross-Sectional Study

OBJECTIVE

Even though life-threatening complications in type 2 diabetes mellitus (T2DM) minimize through self-care practice, extensive studies in northeast Ethiopia have been scarce about self-care practice and predictors. This study aimed to assess diabetes self-care predictors among patients with T2DM patients at Dubti and Assaita hospitals in northeastern Ethiopia.

METHODS

A facility-based cross-sectional study was conducted among 403 patients with T2DM who followed-up in northeastern Ethiopia's Dubti and Assaita hospitals. Data were analyzed using SPSS version-22.0 after the data were entered, sorted and cleaned. Multiple stepwise backward logistic regression analysis was done for a P value of <0.25 to identify the independent predictors of self-care practice.

RESULTS

In the present study, males comprised 62% of the sex category. Overall, 63.8% of the study participants had adequate self-care practice, while 36.2% had inadequate self-care practice. Being younger age (AOR 2.27, 95% CI 1.27-4.07, P= 0.005), monthly income status with low (AOR 3.08, 95% CI 1.08-8.78, P= 0.04), average (AOR 2.43, 95% CI 1.15-5.09, P= 0.02) and high (AOR 2.68, 95% CI 1.03-6.99, P= 0.04), treated with oral hypoglycemic agents (OHA) (AOR 0.22, 95% CI 0.05-0.95, P = 0.04) and insulin (AOR 0.18, 95% CI 0.04-0.75, P= 0.01), having social support (AOR 3.09, 95% CI 1.76-5.4, P ≤ 0.01) and diabetic education from health professionals (AOR 5.53, 95% CI 1.92-15.93, P= 0.001) and media (AOR 2.63, 95% CI 1.47-4.7, P = 0.001) were the independent predictors of self-care practice.

CONCLUSION

In this study, the practice of self-care found to be sub-optimal among patients with T2DM. Independent predictors of self-care practice were age, monthly income, treatment regimen, social support, and diabetic education. Therefore, a suitable approach should be built to improve self-care practice with diabetes.