Assessment of Self-Care Practices among Type 2 Diabetic Patients in a Secondary Care Teaching Hospital
Background: Diabetes is one of the major health problems worldwide that can be effectively managed by good self-care activities like medication adherence, exercise, monitoring of blood glucose, foot care and diet. Objectives: The study assessed the self-care activities of diabetic patients using summary of diabetes self-care activities scale (SDSCA) and the variables (Age, gender, educational level, socioeconomic status (SES)) associated with it. Methods: A cross-sectional descriptive study was undertaken in 400 Type 2 diabetic patients. Self-care practices of the patients were evaluated by using SDSCA and correlation with variables were determined statistically. Results: Among 400 diabetic patients about 215 (53.75%) had an average score of self-care. Self-care was poor in 184 (46%) subjects, and only 1 subject (0.25%) scored good. Blood sugar monitoring was the highest (100%) followed by medication adherence (92.75%) whereas inadequate levels of self-care were reported in foot care (1.5%), and physical activity (31.5%) domains. A significant positive correlation was found between self-care practices and socio-demographic variables such as age (r=0.298, p=0.000), income (r=0.490, p=0.000) occupation (r=0.433, p=0.000), education (r=0.582, p=0.000), and Socio-Economic status (r=0.599, p=0.000). Conclusion: The study revealed higher level of adherence to self-care activities in terms of blood sugar monitoring and medication taking behaviour in the current setting, but self-care in other domains such as foot care is critically low. Age, education and Socio-Economic status seems to affect the self-care practice by the patients.
Keywords: Diabetes, Diabetes self- care, Diabetic foot care, Summary of diabetes self-care activities (SDSCA) score.
2. Organization (WHO) WH. Definition, diagnosis and classification of diabetes mellitus and its complications: World Health Organization (WHO)2007.
3. Selvaraj K, Ramaswamy G, Radhakrishnan S, Thekkur P, Chinnakali P, Roy G. Self-care practises among diabetes patients registered in a chronic disease clinic in Puducherry, South India. J of social health and diabetes 2016; 4(1):25-29.
4. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Kaeinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M., N . Engl. J. Med., 2001; 344:1343.
5. American Diabetes Association. Lifestyle management. Sec. 4. In Standards of Medical Care in Diabetes-2017. Diabetes Care 2017; 40(Suppl. 1):S33-S43
6. Understanding Diabetes & Self Care guideline. Understanding Diabetes Mellitus: https://www.worlddiabetesfoundation.org
7. Front . Endocrinol., 09 June 2017https://www.frontiersin.org
8. Wangoo SK, Maji D, Das AK, Rao PV, Moses A, Sethi B, et al. Barriers and solutions to diabetes management: An Indian perspective. Indian J Endocrinol Metab 2013; 17:594-601.
9. Improving the sustainability of healthcare systems through better adherence to therapies: a multi-stakeholder approach: background briefing. http://www.eu-patient.eu/globalassests/policy/adherence-compliance-concordance/adherence---joint-briefing-paper.pdf
10. DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care 2004. March; 42(3):200-209.
11. William SA. Making diabetes Education Accessible for people with Visual impairment. Diabetes edu. 2009; 35(4):612-21.
12. Veerakumar A M, Shanmugapriya D, Shanmugapriya J, Soorya Narayanan B, Subashini S. Self-care Activities among Diabetic patients in rural areas of Trichy District, Tamil Nadu. NJRCM. 2017; 6(2):120-123.
13. AADE. AADE7 self-care behaviours. Diabetes Educ 2008; 34:445-9.
14. Jackson IL, Adibe MO, Okanta MJ, Ukwe CV. Knowledge of self-care among type 2 diabetes patients in two states of Nigeria. Pharmacy Practice 2014 Jul-Sep; 12(3):404.
15. Reyes J, Tripp-Reimer T, Parker E, Muller B, Laroche H. Factors Influencing Diabetes Self-Management Among Medically Underserved Patients With Type II Diabetes. May 2017; 4:1-13
16. Toobert DJ, Hampson SE, Glasgow RE: The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care 2000; 23:943-950.
17. Nejaddadgar N, Solhi M, Jegarghosheh S, Abolfathi M, Ashtarian H. Self-Care and Related Factors in Patients with Type 2 Diabetes. Asian J Biomed Pharmaceut Sci. 2017; 7(61):6-9.
18. Sekhar STVD, Kodali M, Burra CK, Muppala SB, Gutta P et al. Self-care activities, Diabetes distress and other factors which affected the glycemic control in a tertiary care teaching Hospital in South India. J of clinical and diagnostic research 2013; 7(5):857-60.
19. Predicting dietary practice behaviour among type 2 diabetics using the theory of planned behaviour and mixed methods design. Int J Biol LifeSci. 2012; 11-25.
20. Zoellner J, Estabrooks PA, Davy BM, Chen YC, You W. Exploring the Theory of Planned Behaviour to Explain Sugar-sweetened Beverage Consumption. J Nutri Edu Behav. 2012; 44:172-7.
21. M.I. Harris, "Frequency of Blood Glucose Monitoring in Relation to Glycemic Control in Patients with Type II diabetes," Diabetes Care,Vol.24, no.6, pp.979-982,2001.
22. Suguna A, Magal SA, Stany A, Sulekha T, Prethesh K. Evaluation of self-care practices among diabetic patients in a rural area of Bangalore district, India.Int.J.Curr.Res.Aca.Rev 2015; 3(6):415-422.
23. Tewahido D, Berhane Y. Self-Care Practices among Diabetes Patients in Addis Ababa. J PLoS One 2017; 12(1):1-10.
24. Prabhu SS, Ramya N. Non-adherence to diabetic treatment and its effect on glycaemic control, study at a rural hospital of Tiruchirappalli, Tamilnadu, India. The Internet Journal of Health. 2011; 2(2).
25. Lakshmi N, Ptel N, Parmar P, Garasiya K, Chaudhary M. Study the foot care practice among diabtetes patients in Ahmedabad city, Gujarat. Int J of med science and public health 2018; 7(5):333-37.
26. Viji P T, Singh M. A Study to Assess the Practice of Diabetic Patient towards Self Care Activities for Longevity of Life. Sch. J. App. Med. Sci.2014; 2(1A):57-60.
27. Zanetti M, Baquedano I, Martins T,santos M. Self-Care of patients with Diabetes Mellitus Cared for at an Emergency Service in Mexico. Rev Latino-Am, Enfermagem 2010; 18(6):1195-202.
28. Xu Y & Pan W. Self-management practices of Chines Americans with type 2 diabetes. Nursing and Health Sciences 2010; 12:228-34.
29. Raithatha JS, Shankar US, Dinesh K. Self-Care Practices among Diabetic Patients in Anand District of Gujarat. ISRN Fam Med. 2014. http://dx.doi.org/10.1155/2014/743791.
30. Nejaddadgar N, Solhi M, Jegarghosheh S, Abolfathi M, Ashtarian H. Self-Care and Related Factors in Patients with Type 2 Diabetes. Asian J Biomed Pharmaceut Sci. 2017;7(61):6-9.
31. Karter AJ, Ferrara A, Darbinian JA, Ackerson LM, Selby JV. Self-monitoring of blood glucose: Language aid financial barriers in a managed care population with diabetes. Diabetes Care.2000; 23:47-483.
32. Connell M, Michael C, Nancy S, AnitaS, Erika F. Self-care behaviours in indigent patients with heart failure. Eur J Cardiovasc Nurs. 2008; 23:223-30.
33. Vosoghi Karkazloo N, Abootalebi Daryasari Gh. The study of self-care agency in patients with diabetes. Quarterly J Berjand. 2009;8:197-204.
34. Jackson IL, Adibe MO, Okanta MJ, Ukwe CV. Knowledge of self-care among type 2 diabetes patients in two states of Nigeria. Pharmacy Practice 2014 Jul-Sep; 12(3):404.
35. Kassahun T, Gesesew H, Mwanri L, Eshetie T. Diabetes related knowledge, self-care behaviours and adherence to medications among diabetic patients in Southwest Ethiopia: a cross- sectional study. BMC Endocrine Disorders. 2016; 16(28):1-11.
36. Chiou C, Bai Y, Chang Y. Self-care behaviour and related factors in older people with type 2 diabetes. J of Clinical Bursing 2009; 18:3308-15.
37. Veerakumar A M, Shanmugapriya D, Shanmugapriya J, Soorya Narayanan B, Subashini S. Self-care Activities among Diabetic patients in rural areas of Trichy District, Tamil Nadu. NJRCM. 2017; 6(2):120-123.
38. Patel M, Patel MI, Patel MY, Rathi KS. A Hospital-based observational study of Type 2 Diabetic subjects from Gujarat India. Health popul NUTR. 2011; 29(3):265-72.
39. Hasnain S, Sheikh NH. Knowledge and practices regarding foot care in diabetic patients visiting diabetic clinic in Jinnah Hospital, Lahore. J Pak Med Assoc. 2009; 59(10):687-90.
40. Desalus OO, Salawu FK, Jimoh AK, Adekoya AO, Busari OA, Olokoba AB. Diabetic foot care: Self-reported knowledge and practice among patients attending three tertiary hospitals in Nigeria. Ghana Med J. 2011; 45(2):60-65.
41. Chellan G, Srikumar S, Varma AK, Mangalanandan TS, Sundram KR, Jayakumar RV, Bal A, Kumar H. Foot care practice- The key to prevent diabetic foot ulcers in India. Foot(Edin). 2012; 22(4):298-302.
42. Lamchahab FZ, El Kihal N, Khoudri I, Chraibi A, Hassam B, Ait Ourhroui M. Factors influencing the awareness of diabetic foot risks. Ann Phys Rehabil Med. 2011; 54(6):359-65.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).