A cross-sectional study of the differences in diabetes knowledge, attitudes, perceptions and self-care practices as related to assessment of chronic illness care among people with diabetes consulting in a family physician-led hospital-based first line health service and local government health unit-based health centers in the Philippines

Grace Marie V Ku,Guy Kegels

doi:10.1186/s12930-014-0014-z

Abstract

BackgroundThe purpose of this study was to investigate differences in diabetes knowledge, attitudes and perceptions (KAP), self-care practices as related to assessment of chronic illness care among people with diabetes consulting in a family physician-led tertiary hospital-based out-patient clinic versus local government health unit-based health centers in the Philippines.MethodsPeople with diabetes consulting in the said primary care services were interviewed making use of questionnaires adapted from previously tested and validated KAP questionnaires and the patients’ assessment of chronic illness care (PACIC) questionnaire. Adherence to medications, diabetes diet, and exercise and the number of diabetes consultations were asked. Analysis of variance was used to determine differences in KAP, self-care practices, and PACIC and regression analysis was used to determine any associations of the abovementioned variables to the PACIC ratings.ResultsA total of 549 respondents were included in the study. Differences in knowledge, attitudes, perceptions, PACIC, utilization of health services, and adherence to medications and exercise were all statistically significant. Ratings for diabetes knowledge, positive attitudes, and the perceptions of support attitudes and the abilities to perform self care, and the proportions of those properly utilizing health services and adhering to medications and exercise were higher while ratings for negative attitudes, perceived support needs, perceived support received and PACIC were lower among those consulting in the family physician-led health service.ConclusionsCombining family medicine-based approaches with culturally competent diabetes care may improve knowledge, attitudes, perceptions and self-care practices of and collaborative care with people with diabetes.

Highlights

People with chronic conditions encounter many dayto-day situations where they have to make decisions on their own [1]; self-care plays an important role and collaboration rather than a health provider-directed care may be a more effective care model [2]
Studies have demonstrated that culturally competent self-management education improved diabetes care, self-awareness and understanding of diabetes [7] while patient-centered, biopsychosocial approaches as practiced in the family medicine paradigm address personal barriers [8] and improved diabetes knowledge, patient perceived selfefficacy and glycemia [9,10,11]
First line health services are offered at the Department of Family Medicine and Out-Patient Services where primary care is delivered by family physicians organized as in a group practice; different clinical specialty services may be availed of

Summary

Introduction

People with chronic conditions encounter many dayto-day situations where they have to make decisions on their own [1]; self-care plays an important role and collaboration rather than a health provider-directed care may be a more effective care model [2]. Collaborative care between people with chronic conditions and their health care providers is better achieved if the people having these chronic conditions are informed and activated [3] Such may involve self-management education and skills development. The provision of self-management education and support is not simple It does involve the development of selfmanagement skills but barriers should be addressed [4]. Personal barriers include disease-related beliefs, emotions, knowledge and experiences [5]; sociocultural barriers take account of the differences in language, and in cultural and ethnic beliefs and perceptions of health and illness [6] between the providers and the recipients of self-management development; and environmental barriers refer to the immediate environment of family and friends and the wider environment of the health care system and the community in supporting adoption of proper self-care behavior. Family medicine-based first line and ambulatory care services can be delivered

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