Self-Care Practices and Associated Determinants among Adult Clients with Type 2 Diabetes Mellitus in selected Health Care Facilities in Kibwezi East Sub-County, Makueni County

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder which is characterized by raised level of sugar in the blood. Diabetes self-care practices are important to prevent diabetes related complications. This study aimed to assess self-care practices and associated determinants among adult clients with T2DM in Kibwezi East sub-county, Makueni County. An analytical cross-sectional design was conducted at Kibwezi East sub-county, Makueni County. Stratified random sampling technique was used to select health facilities. A total of 110 adults with T2DM were recruited through a census method. Researcher administered questionnaires were used to collect data. The tool had four sections comprising of socio-demographic characteristics, level of knowledge assessed using Diabetic knowledge test, socio-economic factors and summary of diabetic self-care activities (SDSCA). Statistical package for social sciences (SPSS) version 27 was used to analyze quantitative data. Descriptive statistics used included percentages and frequencies to calculate the of the socio-demographic characteristics of study participants, their level of knowledge and self-care practices Chi-square/fisher exact test and binary logistic regression and Multivariate logistic regression were used to establish association between level of knowledge and self-care practice of the study participants and also the relationship between socio-economic factors associated with self-care practices at 95% CI and p value ≤0.05. Data was presented in pie charts, bar graphs and frequency tables. Majority of the study participants were female (62.7%, n=69), with 46.4% aged above 51 years with 32% having attained post diploma as the highest level of education. The level of self-care practices was found to be poor among majority (n=86, 78.2%) of the study participants The level of knowledge concerning self care practices was based on Revised Brief Diabetes Knowledge Test (DKT2). Those who scored <10, 11-16 and 17 items and above were classified as having poor, moderate and good level of knowledge respectively and60% were rated to have poor level of knowledge on selfcare practice. However, on bivariate analysis there was no significant relationship on between level of knowledge and self-care practices (X2 value2= 1.27, df= 1, p value = 0.258). Significant association on bivariate analysis for socio economic factors; psychological support, source of spiritual support, net income of the participant and mode of paying for services was observed. The level of self-care practices was found to be poor among the study participants. Being knowledgeable about self-care practices does not translate to practice of the same. Health care providers to emphasise on the on practical rather than the theorical aspect of all self care practises among T2DM patients. In conclusion, provision of psychological and spiritual support from family and church and use of social health insurance increases the likely hood of better selfcare practice.