A quality improvement project to improve diabetes self-management and patient satisfaction in a low-resourced central Kenyan hospital.

Tsitsi Muhoma,Linda D Knecht,Margaret W Waruiru,Olayemi Sanni,Marilyn Mcfarland

doi:10.4314/ahs.v20i3.38

Abstract

There is limited evidence about effective strategies for promoting culturally congruent diabetes education in low-resourced primary-care settings. This project, conducted in Central Kenya, examined the effect of an intervention on provider practices and patients' knowledge of diabetes self-care management. The intervention consisted of short (30-minute) sessions that offered providers evidenced-based, culturally congruent diabetes education and teaching materials to use with patients. A checklist was used to assess providers' diabetes care practices at baseline and post intervention. Data from semi-structured patient interviews assessed patients' diabetes knowledge at baseline and post intervention. Providers and patients also completed post-intervention satisfaction surveys. Six providers and 74 patients participated in the project. Statistical analysis was completed using SPSS. Significant increases were noted in patients' post-intervention overall diabetes knowledge score (p=.05) and the foot care knowledge subscale (p=.02). No significant differences were noted between patients' baseline and post-intervention scores in the general diabetes (p=.86) or nutrition knowledge (p=.32) subscales. These findings suggest supporting providers with culturally congruent tools and resources about diabetes care guidelines can improve knowledge of self-care practices in patients with diabetes.

Highlights

Diabetes, once considered a disease of affluent societies, is a growing problem in middle and low-income countries, largely due to obesity.[1]
While culturally appropriate education on diabetes self-care can help increase positive patient outcomes,[10] there is limited evidence about effective strategies for promoting culturally congruent diabetes education in low-resourced primary care settings. This quality improvement project was designed to promote the integration of upto-date, evidence-based diabetes education guidelines through culturally congruent provider education sessions and teaching materials that acknowledge patients’ cultural, socioeconomic, education, technological, and psychosocial factors
All six healthcare providers participated in the education sessions

Summary

Introduction

Once considered a disease of affluent societies, is a growing problem in middle and low-income countries, largely due to obesity.[1]. While culturally appropriate education on diabetes self-care can help increase positive patient outcomes,[10] there is limited evidence about effective strategies for promoting culturally congruent diabetes education in low-resourced primary care settings. This quality improvement project was designed to promote the integration of upto-date, evidence-based diabetes education guidelines through culturally congruent provider education sessions and teaching materials that acknowledge patients’ cultural, socioeconomic, education, technological, and psychosocial factors. Objectives: This project, conducted in Central Kenya, examined the effect of an intervention on provider practices and patients’ knowledge of diabetes self-care management.

Objectives

Methods

Results

Discussion

Conclusion