Abstract
Background:In Fiji, Type 2 diabetes mellitus (T2DM) and Chronic kidney disease (CKD) are amongst the top four causes of premature mortality, disability and death. This study aims to identify the determinants of knowledge, attitude and practice (KAP) in T2DM patients with CKD in Fiji in 2018.Methods:A cross-sectional study was conducted at Sigatoka Sub-divisional Hospital (SSH) in Fiji in July-August, 2018 using a self-structured questionnaire to test KAP of 225 patients. The inclusion criteria were confirmed T2DM patients (Fijian citizens) with CKD, aged 30 years or above and attending Special Out-Patient's Department (SOPD) at SSH. Independent t-test and ANOVA was used to test differences between demographic variable and practice score while non-parametric tests were used for knowledge and attitude. Spearman correlation and multiple linear regressions were also done. All the tests were set at 5% level of significance.Results:The mean KAP level was high: knowledge, 23.3 (SD±3.25); attitude, 23.1 (SD±2.73) and practice, 7.1 (SD±2.04). A high level of knowledge was seen in those with university-level education (p<0.001), unemployed (p=0.05) and high average monthly income (p=0.03). Those aged 61-70 years had a 0.53-point lower attitude score (p=0.05) than other age categories, while those >70 years had a 1.78-point lower attitude score (p=0.01) than other age categories. Fijians of Indian descent (FID) had lower attitude (p=0.002) and higher practice (p=0.001) scores.Conclusion:Patients with both T2DM and CKD at SSH have high levels of KAP. Those with higher levels of education, the unemployed and those with high monthly income had higher knowledge, FID had low attitude but high practice scores, and the higher age category had lower attitude scores. The study identified high-risk groups for low KAP, which can become the focus of future public health intervention.
Highlights
Type 2 diabetes mellitus (T2DM) is characterized by fasting blood glucose of more than 7 mmol/L or random blood sugar of more than 11 mmol/L in the presence of symptoms of increase thirst/hunger, frequent urination and weight loss (O’Neil et al, 2012)
Fiji’s STEP-wise Surveillance Report (STEPS) of 2011 showed that 15.6% of the population had raised fasting blood sugar (Snowdon & Tukana, 2011). This is quite worrying, since T2DM is the major cause of Chronic kidney disease (CKD), accounting for 44% of all cases and a rise in T2DM will lead to a greater burden of CKD in Fiji (Atkins & Zimmet, 2010)
There have been no studies on KAP of T2DM patients with CKD in Fiji, this study aimed to identify the determinants of KAP in T2DM patients with CKD in Fiji in 2018
Summary
Type 2 diabetes mellitus (T2DM) is characterized by fasting blood glucose of more than 7 mmol/L or random blood sugar of more than 11 mmol/L in the presence of symptoms of increase thirst/hunger, frequent urination and weight loss (O’Neil et al, 2012). In Fiji, Type 2 diabetes mellitus (T2DM) and Chronic kidney disease (CKD) are amongst the top four causes of premature mortality, disability and death. This study aims to identify the determinants of knowledge, attitude and practice (KAP) in T2DM patients with CKD in Fiji in 2018. A high level of knowledge was seen in those with university-level education (p70 years had a 1.78-point lower attitude score (p=0.01) than other age categories. Conclusion: Patients with both T2DM and CKD at SSH have high levels of KAP Those with higher levels of education, the unemployed and those with high monthly income had higher knowledge, FID had low attitude but high practice scores, and the higher age category had lower attitude scores. The study identified high-risk groups for low KAP, which can become the focus of future public health intervention
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