Development and testing of Diabetes Complications Risk Educational Tool (DiREcT) for improving risk perception among patients with diabetes mellitus: a mixed method study

Abstract

The problem of type 2 diabetes mellitus and its complications are threateningly increasing in the existing health scenario. The awareness and perception about risk of developing complications and role of self-care practices for glycemic control are very important. This study aimed to develop and validate an educational tool for improving perception about risk of getting complications among patients with diabetes mellitus. This mixed method study was conducted in a tertiary hospital. Known risk factors of diabetic complications were identified from literature and drafted based on their strength of association. A panel of eight experts from different departments was constituted to evaluate the risk factors, and the tool was finalised after three rounds using Delphi technique. Content and construct validity of the developed tool were also assessed by the panel. A pilot study among 50 patients with diabetes mellitus was done to assess the effectiveness of the tool. The DiREcT tool developed had 11 risk factors of diabetic complications, each categorised into low, moderate and high risk. On baseline risk assessment, 60% of the participants were in high-risk category for glycemic control. Patient’s perception about risk of developing complications increased from 26 to 60% by using the tool. More than 80% of the participants reported that the tool is simple and easy to understand. The DiREcT tool was effective in changing perception of developing complications among patients with diabetes mellitus. It can be used by the healthcare provider at the primary healthcare level for both educating and monitoring of patients with high risk.