INTRODUCTION:

Background of the study

Corona viruses disease 2019 {COVID-19} is a highly infectious disease. It is caused by a novel viruses belonging to a family known as corona viruses. This virus was first identified in the month of December 2019 in Wuhan, China Hubei province since it’s the first identification it has spread globally.

It was declared a public health emergency of international concern on January 30, 2020 by WHO. Despite all effort the virus continues to spread and WHO declared pandemic as on March 11, 2020.¹

The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over 134 million by 2045. Approximately 57% of these individuals remain undiagnosed. The high prevalence of diabetes globally makes it a frequent co-morbidity in patients with corona virus associated disease 2019 (COVID-19). Though diabetes increases the risk of infection in general, most studies have reported prevalence of diabetes almost similar to that in general population in patients with COVID-19².

A meta-analysis of eight trials in China showed that diabetes was present in 8% of 46,248 patientswith COVID19. Understandably, prevalence of diabetes in patients with COVID-19 varies by region, age and ethnicity. It was published in New England Journal of Medicine, explained that diabetes, is associated with increased risk of covid-19 severity and mortality with 20 to 30% of patients who died with the infectious disease reported to have diabetes^3.

The first case of COVID-19 in India, which originated from china on 30 January 2020. India currently had the largest number of confirmed covid positive cases in Asia. This study aims to assess the current level of knowledge regarding self management behavior in prevention of covid 19 among type 2 Diabetes Mellitus: a set of questionnaires is used as a tool to analysis the level of knowledge regarding self management behavior in prevention of COVID-19 among type2 DM patients. Findings from the study shows that knowledge regarding self management behavior in prevention of covid 19among type 2 diabetes mellitus is satisfactory. Yet a significant number of participants.

are lacking confidence. The increased rate of those suffering from diabetes combined with the prevalence of COVID-19 suggest that the care for diabetic patients must increased in order to reduce any further complication and risk of death.³

NEED AND SIGNIFICANCE:

COVID-19 is caused by the corona virus SARS-CoV-2, which has spread quickly more than 160 countries across the world. The spreading mechanism of the virus is primarily by transmission of respiratory droplets between people. The people with diabetes are more prone to COVID-19. Moreover, even in those with the infection such as COVID-19, which lead to pneumonia, the chances of a secondary bacterial infection complicating the viral pneumonia is there. Hence people with diabetes should take particular precautions with respect to COVID-19, as they have a slightly immune compromised state.⁴

Nurses can aware the challenges of delivering high quality care at a time of pandemics and have demonstrated how they can improve productivity with sustained high quality. for instance, COVID-19 continues overwhelm many health care System across the globe, large number of nonCOVID-19 patients are left without the necessary health care services they need due to their previous condition.⁵

Furthermore, many have been affected by the reduced physical activities caused by the lockdown introduced by most governments across the globe – which is of specific importance for those who suffer from diabetes. All of this Implications should be considered problematic has they by increase the risk of infections, hospitalization, amputations, and possibly death in diabetes patients⁶.

Persons with diabetes were among the most vulnerable groups affected by COVID-19. This population was at high risk of becoming seriously ill if infected and at risk of neglecting care due to social isolation and reduced availability of health services. Thus this study is found to be significant in nursing as nurses play an important role in managing diabetes treatment.

Due to a lack of study on the relationships between COVID-19 and diabetes, it is difficult to suggest how exactly to know about the effect of covid complications. Thus it is indeed tou assess the knowledge and provide prevention guidelines regarding COVID-19 for people who suffering from diabetes mellitus.⁷

OBJECTIVES:

1. To assess the knowledge regarding self management behaviour in prevention of the COVID19 among type2 diabetes patients at selected area, Alappuzha.

2. To find out the association between the knowledge regarding self management behaviour in prevention of the COVID19 among type2 diabetes patients with selected demographic variable.

HYPOTHESIS:

Hypotheses were tested at 0.05 level of significance.

There will be significant association between the level of knowledge regarding self management behaviour among type2 diabetes patients in prevention of COVID19 with selected demographic variables

MATERIALS AND METHODS:

Research Design:

Pre test research design

Setting of the Study:

The setting was selected areas at Alappuzha district

Research Approcah:

The quantitative research approach was used to assess the knowledge regarding self management behaviour among type 2 diabetes mellitus patients in selected areas at Alappuzha district.

Population and Sample:

The 50 Samples were selected according to the non-probability who met inclusion and exclusion criteria under this study.

Sampling Techniques:

The convenient sampling techniques.

Tools/Instruments:

A tool is a device used to measure the concept of interest in a research project that a researcher used to collect. The following tool was used for the present study.

Description of Tool:

Section A

The section A was developed after extensive review of literature and based on expert opinion. It include baseline performance is a structured knowledge questionnaire to collect information regarding the sample. It include data like age, sex, education, occupation, area of residence, marietal status, religion, type of family, income etc.

Data was collected using 3 tools.

Tool 1-(a) Demographic data

A questionnaire schedule on socio-demographic Performa which comprised of 9 items

Tool 1-(b) General information

A questionnaire schedule on general information

Tool 2- Questionnaire to assess the knowledge

Structured questionnaire to assess the knowledge regarding self management behaviour in prevention of COVID 19. It consists of 32 questions.

Section B:

The section B was developed after extensive review of literature and based on expert opinions. The researcher was prepared the knowledge questionnaire regarding immune boosting diet among housewives. It consist of 32 questions. each correct answer carries one mark and wrong answer carries zero marks.

Section-A: Sample characteristics:

This section deals with the frequency and distribution of sample characteristics.

Sl No

Variable S

Frequency

(%)

AGE

a)31-40

b)41-50

c)51-60

d)61 and above

SEX

a) Male

b) Female

Occupation

a) Employed

b) Unemployed

c)Homemakers

d)Retired

EDUCATION

a) Primary

b) Highschool level

c) Higher secondary

d) Graduation and above

Religion

a) Hindu

b) Christian

c) Muslim

Marietal Status

a) Married

b) Unmarried

c) Divorces

d) Widow/Widower

Type of family

a) Joint family

b) Nuclear Family

c) Extended family

Area of residence

a) Rural

b) Urban

Income

a) Below 5000

b) 5001-10000

c) 10001 and above

Section B: Distribution of subjects based on knowledge about prevention of COVID 19 among type2 diabetes mellitus patients.

Knowledge questionnaire on prevention of COVID 19 among type2 diabetes mellitus patients which contains 32questions.Each correct answer was given 1 mark and 0 mark for wrong answer. Total score for knowledge questionnaire is 32 marks.

Scoring Criteria for Knowledge Questionnaire

The scoring was done based on the maximum and minimal score gained by the sample. Max. Possible score= 32

Table – 2: Frequency, Percentage distribution of knowledge of prevention of COVID 19 among type2 diabetes mellitus patients.

Score	Inference
21-32	Good
11-20	Average
1-10	Poor

Figure (2): Diagramatic representation of frequency, percentage distribution of knowledge of prevention of COVID 19 among type

Table 3: Association of knowledge of prevention of COVID 19 among type2 diabetes mellitus patients.

Sl No	Sociodemographic variable	Scoring			X2	df	Level of significance
Sl No	Sociodemographic variable	Good	Average	Poor	X2	df	Level of significance
1	AGE				1.83	6	0.935
	30yrs – 40yrs	7	0	0
	41yrs – 50yrs	8	0	0
	51yrs – 60yr	12	3	0
	61yrs and above	15	5	0
2	Sex				1.39	2	0.5
	Male	20	2	0
	Female	22	6	0
3	Religion				1.82	6	0.935
	Hindu	14	1	0
	Christain	26	6	0
	Muslim	2	1	0
	Others	0	0	0
4	Marietal Status				0.28	6	1
	Married	26	6	0
	Unmarried	2	0	0
	Divorced	1	0	0
	Widow/Widower	13	2	0
5	Family				0.58	4	0.965
	Joint Family	6	1	0
	Nuclear Family	33	7	0
	Extended Family	0	0	0
6	Area of Residence				0.002	2	1
	Rural Area	37	7	0
	Urban Area	5	1	0
7	Education				1.87	6	0.931
	Primary School	16	3	0
	High School	14	5	0
	Higher Secondary	6	0	0
	Graduation and Above	6	0	0
8	Occupation				3.82	6	0.70
	Employed	16	1	0
	Unemployed	4	0	0
	Homemaker	17	5	0
	Retired	5	2	0
9	Income				0.22	4	1
	Below 5000	14	2	0
	5001-10000	15	3	0
	10000 And Above	13	3	0

The association of the knowledge score with the selected demographic variables was computed using chi-square. The chi square present in the table4 shows that there is no significant association between knowledge level among type II diabetes patients.

Fig (3): Frequency and percentage distribiution of samples based on their correct answers of selected questions regarding covid-19

Fig (4) shows frequency and percentage distribution of samples based on the level of knowledge regarding high risk group to get infected with covid-19

Fig(5) shows frequency distribution of samples based on their level of knowledge regarding warning signs of covid-19

Fig(6) shows frequency and percentage distribution of samples based on their correct answers of selected questions regarding home care management of diabetes mellitus

DISCUSSION:

In the present study 16% of diabetic patient have average knowledge and 84% of diabetic patients have good knowledge regarding self care management of prevention of COVID 19. The study aims to assess the knowledge regarding self care management behaviour in prevention of COVID 19 among type 2diabetic patients in selected area Alappuzha. The survey was conducted by using structured questionnaires involving convenient sampling techniques which obtained 50 responses in total. The descriptive analysis were performed on the socio demographic parameters by chi-square test. Initial studies found increased severity of coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in patients with diabetes mellitus. Furthermore, COVID-19 might also predispose infected individuals to hyperglycemia.

CONCLUSION:

The study pointed out some important concern about the understanding of COVID-19 pandemic among Indians. Diabetes and COVID-19 are health treated conditions that spread in whole of the world. Diabetes patients are more of other people in danger of severity of COVID-19 and mortality, and consisted of 14.5% of COVID-19 patients. Best function is prevention and then usage of evidence-based treatment. Creating awareness by innovative ways should be adopted as of the best practices to combat the spread of pandemic. This should improve the confidence of people to let them protect themselves and care COVID-19 patients.

RECOMMENDATIONS:

1. On the basis of research study conducted, certain suggestions are given for the future studies:

2. The study can be conducted on a wider range of population so that the study findings can be generalized.

3. The study can be conducted in a community setting.

REFERENCE:

1. https://www.who.int/laos/news/detail/24-03-2020-ministry-of-health-and-who-respondto-first-case-of-covid-19-inlaos#:~:text=Coronaviruses%20are%20a%20large%20family,China%20in%20December %202019.

2. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technicalguidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it.

3. https://nwhn.org/how-does-covid-19-affect-different-age-groups/

4. Anna Lucy Tavares de Oliveira, Luiz Felipe, Lage Souza Camilo, Ravena Rieelly Araújo Moura, Letícia Karoline Braga, Cassia Regina Gontijo Gomes; COVID-19 and diabetes: a review literature, Volume 5,2020.

5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144611/

6. International Diabetes Federation; COVID-19 and diabetes,2020 https://diabetesvoice.org/en/news/covid-19-and-diabetes/

7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215977/

Received on 01.08.2022 Modified on 29.08.2022

Asian J. Nursing Education and Research. 2022; 12(4):449-453.

DOI: 10.52711/2349-2996.2022.00097

Sl. No.	Level of Knowledge	Frequency	%
1	Good	42	84%
2	Average	8	16%
3	Poor	0	0