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

Self-care practice and associated factors among patients with diabetes on follow-up at Yirgalem General Hospital, Sidama, Ethiopia: a cross-sectional study

BACKGROUND

Self-care practice is an integral and efficient part of comprehensive diabetes management, which could be influenced by various socio-demographic, clinical, and lifestyle factors.

OBJECTIVE

The study aimed to assess the level of diabetes self-care practice and its associated factors among patients with diabetes on follow-up at Yirgalem General Hospital, Yirgalem, Sidama, Ethiopia.

METHODOLOGY

An Institution-based cross-sectional study was conducted from February 15 to May 10, 2022, involving 298 patients with diabetes on follow-up at Yirgalem General Hospital. A pre-tested interviewer-administered questionnaire was utilized to collect data from patients. A descriptive analysis was conducted to determine the level of good self-care practice. Bivariate and multivariable binary logistics regression were performed to determine factors associated with good diabetic self-care practice. Associations with a p-value < 0.05 were considered statistically significant.

RESULT

The overall good diabetic self-care practice among patients was 59.4%. Regarding the specific domains of care, 15 (5%) participants had good self-glucose monitoring care, 228 (76.5%) had good exercise self-care, 268 (89.9%) had good dietary self-care, 228 (76.5%) had good foot self-care, and 260 (87.2%) had good diabetic medication adherence. Single marital status (AOR = 5.7, 95% CI: (1.418, 22.915), urban residence (AOR = 2.992, 95% CI: (1.251, 7.153)), and having a glucometer (AOR = 2.273, 95% CI: (1.083, 4.772)) were factors that were significantly associated with good diabetic self-care practice.

CONCLUSION

Good diabetic self-care practices among participants was low. Marital status, place of residence, and having a glucometer were statistically significant predictors of good diabetic self-care practices. Targeted intervention addressing those patients from rural areas to increase awareness and practice of self-care, as well as the promotion of having a glucometer at home for self-glucose monitoring is recommended.

Poor self-care practices and contributing factors among adults with type 2 diabetes in Adama, Ethiopia

Diabetes mellitus (DM) is a prominent global health challenge, characterized by a rising prevalence and substantial morbidity and mortality, especially evident in developing nations. Although DM can be managed with self-care practices despite its complexity and chronic nature, the persistence of poor self-care exacerbates the disease burden. There is a dearth of evidence on the level of poor self-care practices and contributing factors among patients with DM in the study area. Thus, this study assessed the proportion of poor self-care practices and contributing factors among adults with type 2 DM in Adama, Ethiopia. An institution-based cross-sectional study was conducted among 404 patients. Self-care practice was assessed by the summary of diabetes self-care activities questionnaires. Binary logistic regression was used to identify factors associated with poor self-care practices. An adjusted odds ratio with a 95% confidence interval was used to assess the strength of associations. The statistical significance was declared for a p-value < 0.05. The proportion of poor self-care practices was 54% [95% CI 49.1, 58.6]. Being divorced (AOR = 3.5; 95% CI 1.0, 12.2), having a lower level of knowledge (AOR = 1.70; 95% CI 1.0, 2.8), being on insulin (AOR = 6.3; 95% CI 1.9, 20.6), taking oral medication (AOR = 8.6; 95% CI 3.0, 24.5), being unaware of fasting blood sugar (AOR = 2.9; 95% CI 1.6, 5.2), not a member of a diabetic association (AOR = 3.6; 95% CI 1.7, 7.5), a lack of social support (AOR = 2.9; 95% CI 1.7, 4.9), and having a poor perceived benefit of self-care practices (AOR = 1.84; 95% CI 1.0, 3.2) were associated with poor self-care practices. Overall, this finding demonstrated that a significant percentage of participants (54%) had poor self-care practices. Being divorced, having a low level of knowledge about diabetes and fasting blood sugar, lacking social support, relying on oral medication, perceiving limited benefits from self-care practices, and not being a member of diabetic associations were identified as independent factors of poor self-care.

Adherence to Self - Care Practice Among Type 2 Diabetes Mellitus Patients Using the Theory of Planned Behavior and Health Belief Model at Comprehensive Specialized Hospitals of Amhara Region, Ethiopia: Mixed Method

Background

Diabetes mellitus is one of the major public health problems that requires appropriate self-care practices to reduce complications. The current study assessed adherence to self-care practices and associated factors using the theory of planned behavior and the health belief model among type 2 diabetes mellitus patients.

Methods

A facility-based, sequential explanatory mixed-method was undertaken at comprehensive specialized hospitals in the Amhara region of Ethiopia. A single population proportion formula was used to calculate sample size. Proportional allocation to the three study settings and systematic random sampling techniques were used to select 846 study participants. Logistic regression analysis was used to identify associated factors. Variables with a P-value less than 0.05 were declared statistically significant. For the qualitative study, purposive sampling was used to select sixteen key informants, and thematic analysis was performed.

Results

About 42.4% of the study participants had good adherence to self-care practices. Being a member of a diabetes association (AOR = 2.57, 95% CI: 1.51, 4.38), having a home glucometer (AOR = 2.52, 95% CI: 1.59, 4.02), having good glycemic control (AOR = 4.07, 95% CI: 2.53, 6.53), having low perceived barriers (AOR = 8.65, 95% CI: 4.65, 16.07), and having middle perceived barriers (AOR = 3.26, 95% CI: 1.88, 5.66) were significantly associated with good adherence to self-care practice. On the other hand, poor wealth index (AOR = 0.27, 95% CI: 0.16, 0.46), poor behavioral control (AOR = 0.59, 95% CI: 0.36, 0.97), poor behavioral intention (AOR = 0.36, 95% CI: 0.21, 0.64), low perceived benefits (AOR = 0.20, 95% CI: 0.08, 0.51), and middle perceived benefits (AOR = 0.57, 95% CI: 0.31, 0.83) were significantly associated with poor adherence to self-care practice. The key informants explored the influence of patients' beliefs, self-efficacy, social support, and barriers on their self-care practices.

Conclusion

Less than half of type 2 diabetes mellitus patients had good adherence to self-care practices. This was more evident for patients who are members of a diabetes association, having a high wealth index, having a home glucometer, good behavioral control, good behavioral intentions, high perceived benefit, and poor perceived barriers. Appropriate intervention should be designed based on the aforementioned factors.

Self-care practice and its associated factors among diabetic patients attending public hospitals in Gurage zone southwest, Ethiopia

Background

Diabetes is a chronic disease that requires lifelong medical treatment and lifestyle modifications. Even though patients often neglect their own needs, self-care is an important factor in preventing and delaying complications related to diabetes. There are limited studies about self-care practice, and most of the studies conducted in Ethiopia focused on some parts of the recommended self-care practice. Therefore, this study aimed to assess the self-care practice and associated factors among diabetic patients in Gurage zone, south Ethiopia.

Methods

An institution-based cross-sectional study was conducted from February 6 to March 29, 2021. A systematic sampling method was employed to select 420 study participants. The data were collected using a pretested interviewer-administered questionnaire. All variables with P < 0.25 in the bi-variable logistic regression analysis were entered into multivariable logistic regression analysis. The statistical significance was declared at a p-value < 0.05.

Results

A total of 384 diabetes patients participated with a response rate of 91.4%. This study showed that more than half (60.4%) of the study participants had poor self-care practices. Being female (AOR: 2.40; 95% CI:1.31–4.40), rural residence (AOR:7.16;95% CI: 3.31–15.46), duration of diabetes treatment 5–10 years (AOR: 0.03; 95% CI: 0.1–0.11), duration of diabetes treatment ≥ 10 years (AOR:0.8; 95% CI: 0.03–0.21), haven’t social support (AOR: 0.10; 95% CI: 0.05–0.23), haven’t got health education (AOR: 0.17,95%CI 0.09–0.32) were factors significantly associated with self-care practice.

Conclusions

Despite, the importance of diabetes self-care practice for the management of diabetes and preventing its complications, a high number of diabetes patients had poor self-care practices. Female, rural residence, duration of diabetes mellitus, lack of social support, and not get of health education were significantly associated with poor self-care practice. Therefore, health care providers should give attention to diabetic patients with the aforementioned factors that affect diabetic patients’ self-care practices.