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 conducted. All tests were set at 5% level of significance. Results:From 249 questionnaires distributed, 225 responded thus response rate was 95%. The mean KAP level was high: knowledge, 23.3/30 (SD±3.25); attitude, 23.1/30 (SD±2.73) and practice, 7.1/10 (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. The determinants of KAP have been shown and thus, this 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)
This research was able to identify high-risk groups with low levels of knowledge, attitude and practice, towards whom targeted public health interventions can be targeted in future
Health promotion activities are vital in improving knowledge, attitude and practice, and it is recommended that health promotion and interventional studies to be conducted using the results of this study among patients targeted toward at-risk groups identified in this study to potentiate the greatest improvements in health outcomes and to measure the effectiveness of health promotion intervention
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. Methods: A cross-sectional study was conducted at Sigatoka Subdivisional Hospital (SSH) in Fiji in July-August, 2018 using a selfstructured questionnaire to test KAP of 225 patients. A high level of knowledge was seen in those with universitylevel 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. The determinants of KAP have been shown and this study identified high-risk groups for low KAP, which can become the focus of future public health intervention
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