Knowledge on Management of Diabetes Mellitus among Patients with type II Diabetes Mellitus in a Selected Community Health Centre of Dadra and Nagar Haveli Area

 

Sharma Priya¹, Malik Sujeeta²

¹Assistant Professor, Shri Vinoba Bhave College of Nursing, Silvassa.

²M.sc Nursing Student, Shri Vinoba Bhave College of Nursing, Silvassa.

 

ABSTRACT:

Background: Diabetes is one of the incurable but easily controllable diseases. It is a chronic disease due to impaired between glucose and insulin in the body. Methods: Descriptive study was conducted in Community Health Centre, Rakholi, Dadra and Nagar Haveli. Pre-tested structured Performa was used to collect information from 80 patients with Type II Diabetes Mellitus which were selected by using non- probability purposive sampling technique during study period by utilizing personal interview method. Statistical Analysis: Demographic variable frequency percentage distribution, knowledge scoring and statistical association was analysed by using chi-square test. An descriptive research method was selected. Results: Result showed that 100% of the samples had inadequate knowledge regarding management of Diabetes Mellitus. It Shows that people has inadequate knowledge regarding management of Diabetes Mellitus. Conclusion: The study concluded that the patients with Type II Diabetes mellitus had inadequate knowledge regarding management of Diabetes Mellitus. Hence the patients with diabetes should be encouraged to attend health education programme.

 

 

INTRODUCTION:

Type 2 diabetes mellitus is a serious, progressive condition presenting with chronic hyperglycaemia, and its prevalence is increasing globally. In the short term, type 2 diabetes may lead to symptoms and debility and in the long term to serious complications, including blindness, renal failure, and amputation.¹ Furthermore, three quarters of people with type 2 diabetes will die from cardiovascular disease.²

 

 

 

Traditionally, treatment for the condition has centre done drug interventions to stabilize hyperglycaemia and to manage cardiovascular risk factors, including blood pressure and lipids, to prevent associated symptoms and reduce the risk of vascular complications over time.³ Long term follow-up data from the United Kingdom Prospective Diabetes Study has shown that despite early successes, metabolic control progressively worsens with time, warranting exploration of alternative approaches for long term management of type 2 diabetes.⁴ Anyone with diabetes, including type 2 diabetes, has to make multiple daily choices about the management of their condition, such as appropriate dietary intake, physical activity, and adherence to drugs, often with minimal input from a healthcare professional.⁵ In recent years, programmes to educate people about self management have become the focus of attention among health care professionals and are advocated for people with type 2 diabetes as a means to acquire the skills necessary for active responsibility in the day to day self management of their condition.⁶ In addition, it has been suggested that education on self management may play a pivotal role in tackling beliefs about health and so improve metabolic control, concordance with drug decisions, risk factors, and quality of life.⁷ A descriptive study was conducted to assess the knowledge of Diabetic patients about blood glucose monitoring attending medical outpatient department in selected hospital in Punjab. The 100 diabetic patients attending medical OPD were used as samples in the study by using Convenient Non Probability sampling technique. Data was collected by using structured knowledge questionnaire. The study findings showed that 45% of the study subject had average knowledge, about 22% had good knowledge and 12 % with very good knowledge score & only 14% & 7% of them had poor knowledge respectively.⁸ Diabetes education, with consequent improvement in knowledge, leads to better control of the disease, and is widely accepted to be an integral part of comprehensive diabetes care.⁹

 

This research aimed to assess the effectiveness of structured teaching program on knowledge regarding management of Diabetes Mellitus among Patients with Type II DM in a selected community health centre of Dadra and Nagar Haveli.

 

MATERIAL AND METHODS:

Descriptive study was conducted in Community Health Centre of Dadra Nagar Haveli. Community Health Centre was previously served as Primary Health Centre. In 2016 it was upgraded as Community Health Centre. Approximately 100 patients with Type II Diabetes Mellitus are coming for follow up at the interval of 15 days. Samples were selected by purposive sampling during January, 2018 and patients with Type II Diabetes Mellitus attending OPD were included as study population. After written consent from each study respondents, data was collected from 80 study subjects who were participated in study. Structured interview schedule method was used to collect data from study respondents by utilizing structured questionnaire that includes demographic characteristics as well as knowledge variables related to management of Diabetes Mellitus. The response with right or correct answer was marked as knowledge score ‘1’and with don’t know or wrong scored as ‘0’ for variables under study.

 

The maximum and minimum knowledge score was obtained and respondents were categorized into inadequate, moderately adequate and adequate knowledge quality. Knowledge variable and demographic characteristics frequency percentage distribution of study subjects were done and Chi-square test was applied to find out statistical association between knowledge and demographic characteristics.

 

RESULTS:

Table no. I shows majority (33.75%) of the samples belong to the age group of 39-48 and 61.25% samples were male, 27.5% of the samples were studied up to Middle school certificate and 33.75% of samples were unemployed. Among 80 samples, 58.75% samples were Hindu, 80% were married and 62.5% were non- vegetarian.

 

Table I: Distribution of respondents according to Baseline Characteristics.   n =80

CHARACTERISTICS	CATEGORY	FREQUENCY	PERCENTAGE
Age (In years)	18 – 28 29 – 38 39 – 48 49 – 58 ≥ 59	0 10 27 19 24	0% 12.5% 33.75% 23.75% 30%
Gender	Male Female	49 31	61.25% 38.75%
Educational Qualification	Profession or Honors Graduate or Post Graduate Intermediate or post high school diploma High School Certificate Middle School Certificate Primary School Certificate Illiterate	2 0 1 11 22 21 23	2.5% 0% 1.25% 13.75% 27.5% 26.25% 28.75%
Occupation	Profession Semi-Profession Self Employed Skilled Worker Semi-skilled Worker Un-skilled Worker Unemployed	1 0 3 21 20 8 27	1.25% 0% 3.75% 26.25% 25% 10% 33.75%
Religion	Hindu Muslim Christian Others	47 11 20 2	58.75% 13.75% 25% 2.5%
Marital Status	Married Unmarried Divorced Widow / Widower Separated	64 1 5 10 0	80% 1.25% 6.25% 12.5% 0%
Food Habit	Vegetarian Lacto-ovo Vegetarian Non-Vegetarian	30 0 50	37.5% 0% 62.5%
Area of residence	Urban Rural Semi-urban	13 27 40	16.25% 33.75% 50%
Sub Grouping of Population	Tribal Non-tribal	49 31	61.25% 38.75%

 

Table II: Knowledge Category Distribution of Respondents.

n = 80

Question Score	Frequency	Percentage	Performance
0-19	80	100%	Inadequate
20-30	0	0%	Moderately Adequate
31-40	0	0%	Adequate

*Significant at 0.05 level of significance.

 

The Data presented in Table-II showed that 100% of the samples scored below 50% which indicates inadequate knowledge on management of diabetes and none of them scored above 50 % which indicates moderately adequate and adequate knowledge.

 

 

 

Figure 1: Level of Knowledge of Patients with Type II DM on Management of Diabetes Mellitus.        n = 80

 

 

Table III. Association between Pretest Knowledge Score Regarding Management of Diabetes Mellitus among Patients with Type II Diabetes Mellitus with the Selected Baseline Characteristics              n = 80

Baseline Characteristics	≤ 13	˃ 13	Calculated value	Table value	df	Significant
Age in years 18 – 28 29 – 38 39 – 48 49 – 58 ≥ 59	0 6 20 6 13	0 4 7 13 11	8.25*	7.82	3	S
Gender Male Female	28 17	21 14	0.04	3.84	1	NS
Food Habit Vegetarian Lacto-ovo Vegetarian Non-Vegetarian	11 0 34	19 0 16	7.48*	3.84	1	S

*Significant at 0.05 level.       

 

 

The data is presented in table 8 showed that there was significant association between Knowledge and baseline characteristics; Age (c²_(3,0.05) = 8.25>7.82), food habits (c²_(1,0.05) = 7.48>3.84). Thus it can be interpreted there was significant association between knowledge on Diabetes mellitus and selected baseline characteristics on relation to age and food habits. There was no significant association between knowledge and gender (c²_(1,0.05) = 0.4<3.84).

 

 

 

CONCLUSION:

The study can be concluded that structured teaching programme can be given to any patient irrespective of gender, education, occupation, marital status, area of residence. The effectiveness of structured teaching programme established could be used as illustrative informational mode to student nurses, staff nurses, relatives and Diabetic patients.¹⁰

 

 

 

 

ACKNOWLEDGEMENT:

The authors are grateful to the authorities of Shri Vinoba Bhave College of Nursing, Silvassa for the facilities.

 

CONFLICT OF INTEREST:

The authors declare no conflict of interest.

 

REFERENCES:

1.      Massi – Benedetti M. (2012). The cost of diabetes type II in Europe: the CODE-2 study. Diabetologia. 45:S1-4.

2.      Tapp R, Shaw J, Zimmet P, eds. (2013). Complications of diabetes. In: International diabetes federation, ed. Diabetes atlas. 2^nd ed. International Diabetes Federation.

3.      Norris S, Nichols P, Caspersen C, Glasgow R, Engelgau M, Jack L. (2012). Increasing diabetes self management education in community settings. A systematic review. Am J Prev Med.22:39-66.

4.      U K Prospective Diabetes Study Group (2010). Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS33). Lancet. 352:837-53.

5.      Jarvis J, Skinner T, Carey M, Davies M. (2010). How can structured self – management patient education improve outcomes in people with type 2 diabetes? Diabet Obes Metab.12:12-9.

6.      Rutten G. (2015). Diabetes patient education: time for a new era. Diabetes Med.22:671.

7.      National Institute for Health and Clinical Excellence (2010). Guidance on the use of patient education models for diabetes. NIHCE.

8.      Vijayakumar G, Arun R, Kutty V. R. (2009). Prevalence of Type II Diabetes Mellitus and Other Metabolic Disorders in Rural Central Kerala. JAPI. VOL. 57.

9.      Jerlin J.M. (2014). Effectiveness of structured teaching programme on knowledge regarding prevention of foot ulcer among patients with diabetes mellitus. Nightingale Nursing Times: A window for health in action. ISSN 0975-2188.vol.10, N07. 24-26.

10.   Denise F. Polit and Cheryl Tatano Beck (2015). Nursing Research- Generating and assessing Evidence for Nursing Practice. South Asian Edition. 10^th edition. Published by Wolters Kluwer. India. Pvt. Ltd. New Delhi. ISBN-13: 978-9351296072.

11.   Suresh K Sharma (2014). Nursing research & Statistics. 2^nd edition. Published by Elsevier, a division of Reed Elsevier India Private Limited. ISBN-13: 978-8131233085.                                                                                                                                                                                  

 

 

 

 

Received on 02.10.2018         Modified on 02.11.2018

Accepted on 03.12.2018      ©A&V Publications All right reserved