A survey on patients' characteristics, perception of family support and diabetes self-management among type 2 diabetes patients in South-West Nigeria

Social support from family, associated factors and relationship with glycemic control among diabetic patients in Uganda: a cross-sectional study

Introduction

social support from family members in diabetes management is a predictor of optimal glucose control. There is limited evidence of the relationship in Uganda. The objective was to determine association of social support from family and glycemic control, and association of social demographic and clinical characteristics with family support among diabetic patients in eastern Uganda.

Methods

this was a cross-sectional study involving 405 adult patients attending diabetic clinics between May 2021 and June 2021. Socio-demographics, clinical characteristics, social support from family, and glycemic control data were collected. Descriptive statistics were done and associations were determined using Pearson chi-square and Fisher´s exact tests. Generalized linear model was used to determine independent association with social support from family.

Results

the mean age was 52 years, (60%) were female, majority (49.4%) were 45-64 years old. Perceived social support from family (PSS-fa) and good glucose control were found in; (95.3%) and (20.99%) respectively. PSS-fa was associated with good glucose control. Financial contribution from family members to cost of care, cohesion among family members in support of care, being (married/cohabiting) and monthly income ≥28 USD were associated with PSS-fa. Factors independently associated with PSS-fa were; female gender, financial contribution to cost of care and cohesion among family in support of care.

Conclusion

social support from family was associated with good glycemic control. Factors associated with PSS-fa were; female gender, financial contribution from family to cost of care and cohesion among family in support of care.

Family-integrated diabetes education for individuals with diabetes in South-west Nigeria

Objectives

This study aimed to determine the effects of family-integrated diabetes education on diabetes knowthe ledge of patients and family members, as well as its impact on patients' glycosylated haemoglobin (A1C).

Design

The design was a two-group Pretest Posttest quasi-experimental.

Setting

The study took place at the diabetes clinics of two tertiary hospitals in southwestern Nigeria.

Participants

People Living with Diabetes (PLWD) and family members aged 18 years and over and without cognitive impairment were placed, as clusters, into either a control group (CG) or an intervention group (IG) The CG comprised 88 patients and 88 family members while IG comprised 82 patients and 82 family members. Of these, 78 and 74 patients completed the study in CG and IG, respectively.

Interventions

PLWD in IG along with their family members were given an educational intervention on diabetes management and collaborative support with an information booklet provided. This was followed by three (3) complimentary Short Messaging Service (SMS).

Main outcome measures

A1C and diabetes knowledge.

Results

Over half (52.4%) and about a fifth (18.2%) of family members and patients, respectively, had never had diabetes education. There was a statistically significant increase in the knowledge of patients and family members in IG. Unlike CG, the A1C of patients in IG improved significantly at three and six-month post-intervention, (p<0.01). Regression showed an independent effect of family members' knowledge on IG's A1C.

Conclusions

Improved family members' diabetes knowledge positively impacted patients' glucose level. There is a need to integrate family members into diabetes care better.

Funding

African Doctoral Dissertation Research Fellowship (ADDRF) award offered by the Africa Population and Health Research Center (APHRC) in partnership with the International Development Research Centre.

Evaluating nursing opinion and perception of maggot therapy for hard-to-heal wound management

OBJECTIVE

Maggot therapy (MT) or larval debridement therapy is a recognised, effective but underutilised treatment for the management of hard-to-heal wounds and infected ulcers. It is available on NHS prescription in the UK, where wound management is predominantly nurse-led. Anecdotal reports and published literature suggest that nurses may be reluctant to utilise the therapy. The aim of this study was to evaluate the feelings and opinions of nurses regarding the use of MT.

METHOD

The first stage of this mixed-methods study was a focus group held to discuss MT and opinions of specialist nurse clinicians. Next, an anonymised web-based online survey was launched through the Nursing Times journal and distributed through social media targeting all nurses. Finally, in-depth interviews were held with specialist and generalist nurses.

RESULTS

Awareness of MT among all nurses was extremely high. A breakdown of results showed that MT was much more highly regarded by wound specialist nurses than non-wound specialist nurses. The latter exhibited a greater level of reluctance to administer the therapy, with almost one-third of these nurses surveyed saying they found maggots disgusting and that the idea of MT made their skin crawl. In-depth interviews revealed that a lack of knowledge about MT was a prime concern.

CONCLUSION

Wound specialist nurses are more likely to embrace MT than non-wound nurse specialists, who report a varying degree of wariness to MT. Our study highlights a need for better education and training in MT for all nurses, to address issues with acceptance and willingness to treat or help treat patients with hard-to-heal wounds which are suitable for MT.

Treatment burden and perceptions of glucose-lowering therapy among people living with diabetes

AIMS

Address treatment burden and general perceptions of pharmacological treatment in patients with diabetes.

METHODS

We surveyed adult patients with diabetes cared for in a tertiary academic medical center about: i) knowledge about the impact of glucose-lowering medication use on diabetes control and complications, ii) common beliefs about natural medicine and insulin use, iii) attitudes towards glucose-lowering medications, iv) burden of treatment, v) general knowledge of diabetes pharmacological treatment, and vi) perceptions of shared decision-making.

RESULTS

Two hundred-four participants completed the survey. While most (90%) agreed that adherence to medication would control diabetes and improve quality of life, 30-40% were not certain that it would translate to fewer disease complications. About one of three thought medications could be harmful (29.4%). Over 50% agreed or was unsure that natural remedies were as good/better than prescribed medications. About 30% acknowledged difficulties taking their diabetes medications and monitoring blood glucose, and over 50% were concerned about treatment costs. Nearly 30% denied receiving a detailed explanation from their clinician regarding their disease and is treatment.

CONCLUSIONS

Our results highlight the importance of patient education regarding pharmacological treatment for diabetes, and eliciting sources of distress and treatment burden among patients with diabetes.

Illness Representation and Associated Factors among Hypertensive Patients in Central Ethiopia

Background

Illness representation is an implicit belief system about an illness constructed by an individual to give meaning to their illness. An individual's belief about his/her illness, treatment, and own control are known to influence an individual's ability to cope with the illness and sustain the health-related quality of life. However, how Ethiopians perceive hypertension has not been studied well. This study aimed to assess illness representation and associated factors among hypertensive patients in Central Ethiopia.

Method

A facility-based cross-sectional study was conducted in four public hospitals in Central Ethiopia. A total of 989 patients participated in the study. The revised Illness Representation Questionnaire was used to collect relevant data. Data were analyzed using the Generalized Estimating Equation with an ordinal logistic regression model and exchangeable working correlation matrix. A P-Value of less than 0.05 was indicated statistical significance.

Results

Overall, 64.3% (95% CI: 61.3, 67.4) of the respondents reported low to moderate Illness representation about their hypertension. Respondents who were housewife [AOR: 1.48, 95% CI= 1.05, 2.08], in older age category 50-64 years [AOR: 1.92, 95% CI= 1.19, 3.09] and ≥ 65 years [AOR: 2.38, 95% CI= 1.43, 3.96], and had no family support [AOR: 1.98, 95% CI= 1.44, 2.73] showed a significant association with Illness Representation.

Conclusion

This study revealed that about two-thirds of hypertensive patients in Central Ethiopia perceived hypertension as a low to moderately threatening illness. Such low illness representation undermines initiation of treatment and effective control of blood pressure. Health care providers need to strengthen strategies that increase their patient's illness representation.

An Interpretive Description of Sociocultural Influences on Diabetes Self-Management Support in Nigeria

The purpose of this study is to explore how Nigeria’s social and cultural environment influences professional diabetes self-management support practices. This interpretive descriptive study is based on two diabetes clinics in southeastern Nigeria. Nineteen healthcare providers, including nurses, were purposely selected and engaged in participant observation and interviews. Concurrent data generation and analysis facilitated iterative constant comparative analysis. Findings show significant factors influencing diabetes self-management support include belief in the supernatural origin of diabetes, individual–family interdependence, myths and limited understanding of diabetes, lack of health insurance, poverty, and the rigidity of a hierarchical acute care model of diabetes services. Thus, there is an urgent need to adapt diabetes self-management support strategies to fit people’s contexts. By doing so, specific challenges in the healthcare system can directly be addressed while capitalizing on identified strengths and adapting select strategies that constructively foster person-centered and culturally appropriate care.

Translation of the Chinese version of the Self-Care for Aspiration Pneumonia Prevention Scale and its validation among Chinese community dwelling elderly with risk of dysphasia

Aim

To translate the Self‐Care for Aspiration Pneumonia Prevention Scale into the Chinese and validate its reliability and validity among community dwelling elderly with risk of dysphasia.

Design

A cross‐sectional survey.

Methods

A total of 430 elderly with risk of dysphasia were recruited. The reliability was measured by internal consistency, split half reliability, and test–retest reliability. The validity was evaluated by expert consultation and factor analysis.

Results

The translated scale had ideal reliability. The content validity index (S‐CVI) was 0.952. The 3‐factor structure, supported by the eigenvalues, total variance explained, and scree plot, was obtained by using exploratory factor analysis. And as a result of a confirmatory factor analysis, the model fitting indexes were all in the acceptable range. The Chinese version of the Self‐Care for Aspiration Pneumonia Prevention scale can contribute to clinical practice and education to improve self‐care for aspiration pneumonia prevention among elderly at risk of dysphasia.

Family Support in Caring for Diabetes Mellitus Patient: Patient’s Perspective

BACKGROUND: Perspectives of diabetes mellitus patients on family support received during the treatment of their disease at home has high complexity. The family’s intention to help patients to take care of themselves at home can lead to misperceptions or is not well accepted by diabetes mellitus patients. AIM: The aim of the study was to explore the support provided by families in the care of diabetes mellitus patients at home based on the patient’s perspective. METHODS: A phenomenological study using semi-structured questions was chosen as a design in this study. A total of 19 participants were recruited using criteria including being diagnosed with diabetes mellitus for at least 1 year, outpatient, and willing to participate in the study. Data analysis used seven steps of descriptive phenomenological analysis from Colaizzi including data recognition, identification of significant statements, formulating meanings, grouping themes, developing complete descriptions, producing fundamental structures, and seeking verification of fundamental structures. RESULTS: This research shows that the support needed by participants comes from the nuclear family. The first theme identified is the family function as participants’ perceived support. The second theme identified is the family role as participants’ perceived support. The fourth third theme identified is perceptions of family support received. Moreover, the final theme found in this study is perception of spiritual support by the family. CONCLUSION: This research implies that diabetes mellitus patients need support from their families to accept the disease and eventually volunteer to carry out their disease care at home.