Family Support, Malnutrition and Barriers to Optimal Dietary Intake among Elderly Diabetic Patients in Benghazi, Libya

Abstract

Background: Higher levels of social and family support especially regimen-specific are associated with better diabetes self management and less perceived barriers to diet. Objectives: To determine the level of perceived family support for diet and barriers to diet self care and their relation to malnutrition among elderly Libyan patients with type 2 diabetes. Methods: A cross-sectional study carried out on 312 elderly diabetic patients attending outpatient clinics of Benghazi diabetes Centre from end of February to the 1st of May 2013. Data was collected through personal interview. Perceived family support for diet was assessed with Diabetes Family Behavior Checklist II diet subscale. Barriers to diet were measured with diet subscale of Barriers to Self-care Scale. Participants screened for nutritional risk according to MNA (Mini Nutritional Assessment) tool. Results: Low level of family support was perceived by most of the studied elderly diabetic patients. Family support for diet was significantly correlated to perceived barriers to diet self-care and MNA score (p<0.01). According to diet barrier scale being “around people who are eating and drinking things patient shouldn’t” was the most frequent barrier perceived. Perceived barriers to diet self-care were significantly higher in male patients while their nutritional status found to be better than that of females. Gender, family size, satisfaction with prescribed diet, total MNA score and number of learning barriers were found as significant predictors of diet self-care barriers (Adjusted R2 was 0.357). Conclusion: Healthcare providers, dietitians and health educators should consider involvement of entire family as well as elderly diabetic patients in self management training and education programs with dietary counseling sessions that can enhance adherence to dietary regimen, decrease diet self-care barriers and consequently improve nutritional status of this vulnerable group.