Self-care knowledge and practices among persons living with Type 2 Diabetes Mellitus attending an outpatient diabetes clinic at Thika level 5 hospital, Kenya

Abstract

Diabetes is a chronic condition associated with many complications, and its management needs sufficient levels of self-care knowledge, self-care practices, and adherence to medications. The main objective of the study was to determine the level of self-care knowledge and practices among persons living with diabetes at Thika Level 5 Hospital. A cross-sectional study design was used in this study. A sample size of 190 respondents was selected using a systematic random sampling method. A researcher-administered semi-structured questionnaire was used to collect data. The indicators that were assessed to indicate the knowledge level of the respondents included knowledge of the diabetes diet plan, hyperglycemia signs and symptoms such as increased thirst, increased urination, increased hunger, tiredness, blurred vision, unintentional weight loss, recurrent infections, such as thrush, bladder infections, and skin infections. Symptoms such as fast heartbeat, shaking, sweating, nervousness or anxiety, irritability or confusion, dizziness, and hunger were used to indicate the knowledge of hypoglycemia signs and symptoms. Knowledge of the management of hypoglycemia, diabetes complications, foot care, exercises, blood sugar monitoring, and eye care was also assessed. Adherence to diabetes self-care practices was assessed using indicators such as adherence to a diabetes diet plan, thirty minutes of daily exercise, frequency of blood sugar testing, foot care, eye care, and smoking score. Descriptive statistical analysis was used to analyze the frequencies, mean, and standard deviation of self-care knowledge and adherence to self-care practices scores, Regression analysis was used to test for the relationship between age, duration since diagnosis with Type 2 Diabetes Mellitus, and the knowledge of self-care and practice scores. The Chi-square test was used to test for the association between personal characteristics and self-care knowledge and self-care practices scores. Pearson correlation was used to assess the strength of the association between self-care knowledge and adherence to self-care practices. The strength of association between the variables was done at p< 0.05 significance levels. The females were the majority preponderance at 69.5% and a majority of the study participants were above 50 years old (60.5%). The mean diabetes knowledge score was 7.7 ± 3.4 and the mean adherence to recommended self-care activities score was 7.6 ± 4.0, indicating a deficit in several key areas in the self-care knowledge and self-care practices. Regression analysis test indicated that age and duration since diagnosis with T2DM significantly predicted knowledge level of self-care practices F (1,189) =6.279.p=0.013, F (1, 189) =4.943. p=0.027 respectively. The chi-square test indicated a statistically significant relationship between the patient’s level of knowledge of diabetes self-care practices and education level, (p = 0.01), and employment status, (p = 0.01). The regression analysis test also indicated age significantly predicted adherence score to self-care practices f (1,189) =4.963, p=0.027. Moreover, the chi-square test indicated that there was a statistically significant relationship between adherence to recommended diabetes self-care practices and age, (p = 0.03), education level, (p = 0.01), and employment status, (p = 0.005). Pearson correlation showed that there was a weak correlation between knowledge of diabetes self-care practices and adherence to diabetes self-care practices which was statistically significant, (p=0.0001). The research demonstrated gaps in self-care knowledge and adherence to self-care practices. Age, education level, duration since diagnosis, and employment status influenced the level of self-care knowledge while age, education level, and employment status influenced self-care practices score. The relationship between self-care knowledge and adherence to diabetes self-care practices was weak. Based on the findings, we would recommend that the patients equip themselves with adequate knowledge and skills that would help them make informed choices while practicing self-care. The patients should also make an effort to understand their individual unique needs to be able to prioritize the areas that they need improvement as far as diabetes self-care is concerned. It is also recommended that the patients own up self-care which would help apply the knowledge acquired into practice.