Self-care Activities Of Patients Research Articles

The Effect of Telemedicine on Self-Care Activities of Patients with Type 2 Diabetes Mellitus and Patient Satisfaction During the Coronavirus-19 (COVID-19) Pandemic: A Repeated Cross-Sectional Study

Introduction: Patients with diabetes require regular follow-ups to achieve optimal glycemic targets. The coronavirus- 19 (COVID-19) pandemic resulted in interruptions in healthcare delivery placing greater importance on patient’s self-management of their condition. Telemedicine bridged the gap between the physician and patient that was created by community quarantines. Objective: To determine if there is a difference in patient’s self-care activities before and after using telemedicine using the Diabetes Self-Management Questionnaire (DSMQ). Methodology: A descriptive repeated cross-sectional study of patients with type 2 diabetes mellitus at the University of Santo Tomas Hospital who consulted via telemedicine using different available platforms were included. Self-care was measured using the DSMQ. Patient satisfaction with telemedicine was also assessed using a patient satisfaction survey. Results: An improvement in self-care practices was seen as significantly higher mean DSMQ scores after telemedicine consultations (6.79 ± 1.33 to 7.32 ± 1.21, p = 0.0015), with the highest scores on dietary control and physical activity. There was a statistically significant reduction in HbA1c on follow up (8.37 ± 2.31 to 7.31 ± 1.36; p<0.00001). Those with well-controlled diabetes (n = 14) at baseline remained to have good control while the proportion of those with poorly controlled diabetes (n = 34) showed improved glycemic control on follow up (p = 0.0045). Most patients were highly satisfied with telemedicine. Conclusion: The use of telemedicine by patients with diabetes showed numerical improvement in both self-care practices and glycemic control. These findings imply that telemedicine may be mainstreamed as part of diabetes care among Filipinos. Keywords: COVID-19, telemedicine, diabetes, self-care activities

Self-Care Knowledge and Self-Care Activities of Patients with Type 2 Diabetes Mellitus in Thai Nguyen Province, Viet Nam

Purpose: The study was conducted to investigate the status self-care knowledge and self-care activities of patients with type 2 diabetes mellitus.
 Methodology: A cross-sectional descriptive study was conducted on 408 patients diagnosed with type 2 diabetes mellitus at Thai Nguyen National Hospital through a questionnaire to assess Self-care Knowledge (DSCK-30) and Self-care activities in people with diabetes mellitus (SDSCA).
 Findings: Patients with type 2 diabetes mellitus had good self-care knowledge; the mean total score of knowledge was 21.20 ± 5.25 out of 30 scores. Self-care knowledge scores ranged from 7 to 30. The percentage of patients with self-care knowledge was still low, accounting for 53.9%. The highest percentage of patients who performed good self-care behaviors (from 5 to 7 days) was physical activity (88.0%) and the lowest was blood glucose level testing (2.7%); the rates of patients who followed the diet well, took care of their feet, and adhered to medication was 62.3%, 17.6%; and 13.0%, respectively.
 Unique contribution to theory, practice and policy: This study has proven that people with diabetes mellitus had low self-care knowledge and self-care activities in many areas. Therefore, health workers need to personalize in counseling, health education, and provide knowledge and self-care activities of people with diabetes mellitus.

Effectiveness of Acceptance and Commitment Based Group Therapy with the Islamic Approach on Diabetes Control and Increasing Self-Care Behaviors in Patients with Type II Diabetes in Yazd province.

Objective: The purpose of this study was to investigate the effectiveness of acceptance and commitment based group therapy (ACT) with the Islamic approach to diabetes control, increasing self-care behaviors in patients with type II diabetes mellitus (T2DM) referent to the Yazd Diabetes Research Center.
 Materials and Methods: The study method was semi experimental with control group. For this purpose, 40 diabetic patients were randomly divided into two experimental and control groups. The study was in Yazd diabetes research center. The purposeful sampling method was done. So, all of the patients did the A1C hemoglobin test, and completed the self-care questionnaire for diabetic patients (SDSCA). Then, the experimental group received ACT with an Islamic approach during 16 weeks. The population of both groups performed the A1C Hemoglobin test and completed the self-care questionnaire again after performing the instructional plan. In this research, the covariance analysis test was done to analyze the results.
 Results: The findings of the research showed that ACT group therapy with an Islamic approach effects on HbA1c decreasing (P: 0.001) and self-care behaviors improvement (P: 0.001) in T2DM patients.
 Conclusion: This study showed that the treatment group based on commitment resulted in a significant reduction of HbA1 and a significant increase in self-care activities in patients with T2DM.

Determinants of diabetes self-care activities in patients with type 2 diabetes based on self-determination theory.

In type 2 diabetes control, self-management is an effective way to minimize the risk of developing complications and improve the quality of life. Self-determination theory (SDT) proposed a promising explanatory framework to predict self-regulated behavior which was particularly relevant for self-management. This study aimed to investigate whether SDT constructs can affect the self-management and controlling glycated hemoglobin A1c (HbA1c) levels in type 2 diabetic patients or not. This cross-sectional study was conducted from August to December 2022 at two diabetes clinics in Zahedan. The study included 300 patients with type 2 diabetes. Data collection was done using a researcher-administrated questionnaire that included demographic data, diabetes self-care activities, and self-determination constructs including autonomous support, autonomous motivation, and perceived competence. The mean of the overall score of self-care activities was 34.62 ± 11.86 out of a maximum of 70. Patients in the fourth quarter (wealthiest) of the socioeconomic status had the highest mean self-care score (P = 0.003). There was a significant relationship between diet score with perceived competence (P = 0.009). Perceived competence (P<0.001) and controlled self-regulation (P<0.001) were the predictors of exercise score in diabetes patients. Independent self-regulation (P<0.001, r = 0.21) and overall self-regulation (P = 0.001, r = 0.19) were significantly related to blood-glucose testing score. There was a significant relationship between foot care score with perceived competence (P = 0.048, r = 0.11) and autonomous support (P = 0.013, r = 0.14). Multiple regression showed that exercise was the predictor of HbA1c (P = 0.014). Exercise is crucial for achieving good individualized glycemic control and reducing the risk of diabetes complications. The findings provided valuable insights into the determinants of self-care activities in patients with type 2 diabetes and underscore the need for interventions that address socioeconomic disparities, enhance perceived competence, and provide autonomy support to improve diabetes self-care.

RF16 | PSUN234 The Effect of Telemedicine on the Self-Care Activities of Patients with Type 2 Diabetes Mellitus and Patient Satisfaction during the COVID-19 Pandemic at the University of Santo Tomas Hospital

Abstract Introduction Outpatient consultations comprise the majority of referrals in endocrinology. Patients with diabetes require constant follow-up and medication adjustments to achieve optimal glycemic targets. The COVID-19 pandemic made interruption and delays in healthcare delivery inevitable. This placed a great strain on monitoring patients with diabetes, placing greater importance on patient self-management. Telemedicine was introduced in our country to bridge the gap between physician and patient that was created by community quarantines and travel restrictions. However, our country was not ready for telemedicine as it has never been used in our healthcare system. This caused apprehension among doctors and patients as not everyone was technologically adept to understand the system. However, as months went by, telemedicine was eventually accepted as a "new normal" way of seeking medical care. Objective To determine if there is a difference in patient's self-care activities before and after using telemedicine using the Diabetes Self-Management Questionnaire (DSMQ) Methodology A descriptive cross-sectional study of patients with type 2 diabetes mellitus who consulted via telemedicine using different available platforms were included. Patients were asked to accomplish the Diabetes Self-Management Questionnaire (DSMQ) as a measure of self-care activities before and after the use of telemedicine. Clinical profile and glycemic control before and after telemedicine were secondary outcomes. With the goal of improving and tailoring telemedicine for our countrymen, patient satisfaction and opinions regarding telemedicine (i.e, accessibility, ease of use, areas to improve on) were also assessed using a patient satisfaction survey. Results Fifty-five patients were included in the study. An improvement in self-care practices was demonstrated by significantly higher mean DSMQ scores after telemedicine consultations (6.79 + 1.33 to 7.32 + 1.21, p = 0.0015), with dietary control and physical activity subscales obtaining the highest scores. There was a statistically significant reduction in HbA1c on follow up (8.37 + 2.31 to 7.31 + 1.36; p &amp;lt; 0.00001). In terms of clinical profile, majority of patients had poorly controlled diabetes at baseline. Those with well-controlled diabetes (n = 14) at baseline remained to have good control while the proportion of those with poorly controlled diabetes (n = 34) showed improvement on follow up (p = 0.0045). Most patients were highly satisfied with telemedicine experience and were likely to recommend it to others and avail of the service in the future. Conclusion As far as we know, there has been no previously published study in our country regarding telemedicine and its effect on diabetes management. This paper showed that the use of telemedicine by patients with type 2 diabetes mellitus significantly improved both self-care practices and glycemic control. These findings, together with the positive responses in patient satisfaction, may deem it necessary that telemedicine be mainstreamed as part of diabetes care in our country. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Sunday, June 12, 2022 12:42 p.m. - 12:47 p.m.

Social Media-Delivered Patient Education to Enhance Self-management and Attitudes of Patients with Type 2 Diabetes During the COVID-19 Pandemic: Randomized Controlled Trial.

BackgroundThe use of mobile health technologies has been necessary to deliver patient education to patients with diabetes during the COVID-19 pandemic.ObjectiveThis open-label randomized controlled trial evaluated the effects of a diabetes educational platform—Taipei Medical University–LINE Oriented Video Education—delivered through a social media app.MethodsPatients with type 2 diabetes were recruited from a clinic through physician referral. The social media–based program included 51 videos: 10 about understanding diabetes, 10 about daily care, 6 about nutrition care, 21 about diabetes drugs, and 4 containing quizzes. The intervention group received two or three videos every week and care messages every 2 weeks through the social media platform for 3 months, in addition to usual care. The control group only received usual care. Outcomes were measured at clinical visits through self-reported face-to-face questionnaires at baseline and at 3 months after the intervention, including the Simplified Diabetes Knowledge Scale (true/false version), the Diabetes Care Profile–Attitudes Toward Diabetes Scales, the Summary of Diabetes Self-Care Activities, and glycated hemoglobin (HbA1c) levels. Health literacy was measured at baseline using the Newest Vital Sign tool. Differences in HbA1c levels and questionnaire scores before and after the intervention were compared between groups. The associations of knowledge, attitudes, and self-care activities with health literacy were assessed.ResultsPatients with type 2 diabetes completed the 3-month study, with 91 out of 181 (50.3%) patients in the intervention group and 90 (49.7%) in the control group. The change in HbA1c did not significantly differ between groups (intervention group: mean 6.9%, SD 0.8% to mean 7.0%, SD 0.9%, P=.34; control group: mean 6.7%, SD 0.6% to mean 6.7%, SD 0.7%, P=.91). Both groups showed increased mean knowledge scores at 12 weeks, increasing from 68.3% (SD 16.4%) to 76.7% (SD 11.7%; P<.001) in the intervention group and from 64.8% (SD 18.2%) to 73.2% (SD 12.6%; P<.001) in the control group. Positive improvements in attitudes and self-care activities were only observed in the intervention group (attitudes: mean difference 0.2, SD 0.5, P=.001; self-care activities: mean difference 0.3, SD 1.2, P=.03). A 100% utility rate was achieved for 8 out of 21 (38%) medication-related videos. Low health literacy was a significant risk factor for baseline knowledge scores in the intervention group, with an odds ratio of 2.80 (95% CI 1.28-6.12; P=.01); this became insignificant after 3 months.ConclusionsThe social media–based program was effective at enhancing the knowledge, attitudes, and self-care activities of patients with diabetes. This intervention was also helpful for patients with low health literacy in diabetes knowledge. The program represents a potentially useful tool for delivering diabetes education to patients through social media, especially during the COVID-19 pandemic.Trial RegistrationClinicalTrials.gov NCT04876274; https://clinicaltrials.gov/ct2/show/results/NCT04876274

A Study to Evaluate the Effectiveness of Knowledge Regarding Self-Care in Patient of Janu-Sandhigata Vataw.s.r to Osteoarthrosis-Primary Care Base Structured Teaching Program

Background –Knowledge about any disease is the best way of prevention of any disease. Janu sandhigta vata is the disease that occurs in old age. If we have knowledge about Janu Sandhigata vata before ongoing through the disease we have prevent this disease. So a study to evaluate the effectiveness of knowledge of self care activities in patients of Janu Sandhigata vata on out patients of National institute of Ayurveda, Jaipur. Objectives – 1. To develop and administer structured teaching program and access the knowledge of selfcare in knee Osteoarthrosis.2. To evaluate the effectiveness of Structured Teaching Program regarding selfcare among janusandhigata vata w.s.r. to Osteoarthrosis patients by comparing pre and post test knowledge score Method – Sample size is 150 of Janu Sandhigata Vata who visit the OPD of NIA, Jaipur with random sampling technique. Tool comprised of knowledge questionnaire and 3point rating i.e., inadequate, moderate, adequate knowledge. Results- In pre test adequate knowledge is 0% moderate knowledge is 34% and adequate knowledge is 66% and on post testing adequate knowledge is 94% and moderate knowledge is 6% while inadequate knowledge is 0%. The mean value of pre score is 9.973 and post score is 22.159 with mean difference is 12. 186.In paired t-test, p value is &lt; 0.0001 suggest Extremely significant for Structured teaching programme for Janusandhigata Vata. Conclusion: - As Janu-sandhigata Vata is a Krichasadhya vyadhi, so the better option is to prevent the disease by selfcare management, Structured Teaching Program is a better approach towards the understanding of the disease and its management. Above results findings suggest that the after STP program knowledge of patient is significantly increases. Hence it suggests that, STP program is useful in increasing the knowledge of patient regarding disease

Association between family behaviors and self-care activities among type-II diabetes mellitus patients at a teaching hospital in Kathmandu, Nepal.

BACKGROUND:Self-care activities are associated with prognosis of type-II diabetes mellitus patients and include medication adherence, dietary adherence, physical activity, self-monitoring of blood glucose (SMBG), and appropriate foot care. The behaviors of a patient's family members can influence the patient's self-care activities, but little data exist on this association. The objective of this study was to assess the extent of the association between behaviors of family members of Type-II diabetes patients and the patients' self-care activities.MATERIALS AND METHODS:We conducted a cross-sectional study at a teaching hospital in Kathmandu, Nepal, and interviewed 411 outpatients with Type-2 diabetes mellitus. We used exploratory factor analysis to group family members' behaviors into 3 domains (”authoritarian,” “supportive,” and “planning” behaviors) and graded the level of the behavior into 3 categories (”high” vs. “medium” vs. “low”) according to its ranking distribution in each domain. We assessed the association between domains of family behavior and self-care activities using multivariate logistic regression with Bonferroni correction.RESULTS:High (vs. low) level of supportive behavior was associated with compliance to SMBG (58% vs. 11%; adjusted odds ratio [OR] =7.44; 95% confidence interval [CI] =2.41, 23.01). High (vs. low) level of planning behavior was associated with high level of foot care adherence (64% vs. 21%; adjusted OR = 6.03; 95% CI = 3.01, 12.11).CONCLUSIONS:We found associations between behaviors of diabetes patients' family members and the patients' own self-care behaviors. However, the incongruence between the family behavior measurement questions and the self-care of interest limited the implications of the findings.

Relationship between A Coping Style and Self-Care Activities of Patients with Type 2 Diabetes Mellitus (T2DM) at Endocrinology and Diabetes Center in Al-Basra City: a cross-sectional study

Background: Diabetes self-care is primarily the patient's responsibility. Adherence to diabetes self-care regimens can be challenging with a greater focus on complication avoidance. The patient has to make several changes in his diet and lifestyle by taking diabetes self-control. These improvements are called coping mechanisms. The coping ability affects glycemic control of the patient for the long term through possible risks, this affects self-management adherence.Aims of the study: To assess a coping style and self-care activities of patients with Type 2 Diabetes Mellitus at endocrinology and diabetes center in Al-Basra city and found relationship between them.Methodology: A cross-sectional descriptive purposive study is conducted through the period of 17th November, 2020 to 3rd April, 2021 in Al-Basra city/ Iraq. The study was purposive (non-probability) composed of (60) patients.Results: The study findings Shows that participant's age group at a level (46-65 years) were (62%). (51.7%) were males. The study shows a significant statistical correlation between coping and exercise on one hand and blood tests and medications on the other hand (p values &lt;0.05), the correlation coefficient was not large enough to consider strong correlations. All other parameters were not correlated.Conclusion: Findings of the study shows the association of diabetes self-care activities and socio-demographic characteristics of study participants. There is a significant correlation between self-care activities and coping style.Recommendations: Educating patients with Diabetes Mellitus Type 2 to maintain self-care activities to control, and prevent complications of diabetes.

Self-care activities among patients with type 2 diabetes mellitus: A cross-sectional study.

This study investigated self-care activities and identified their related factors in Chinese patients with type 2 diabetes mellitus. A cross-sectional study was conducted in Guangzhou, China, between September 2016 and February 2017, involving 202 Chinese patients with type 2 diabetes mellitus. Measures included the Summary of Diabetes Self-Care Activities Questionnaire and Revised Illness Perception Questionnaire. Self-care activities in Chinese patients with type 2 diabetes mellitus were suboptimal overall. Foot care and blood sugar testing were the self-care activities that were performed the least. One fifth of patients smoked. Some subscales of illness perceptions, receiving health education on diabetes, employment status, education level, body mass index, age and time since type 2 diabetes mellitus diagnosis, were related to self-care activities in patients with type 2 diabetes mellitus. Health-care providers and nurses should encourage greater engagement in self-care activities in patients with type 2 diabetes mellitus, especially foot care and blood sugar testing. Illness perceptions may be used as a framework to guide interventions.

Effectiveness of A Coping Style- related Instructional program on Self - Care of Patients with Diabetes Mellitus Type II at Endocrinology and Diabetes Center in Al-Basra City

Methodology: A descriptive analytic (quasi – experimental) design. Sample composed of (60) patients were divided into two groups study and control group, (30) patients in each one. Results: The study findings Shows that participants’ age group at a level (46-65 years) were (67.7%) of the study group, and (56.7%) of the control group. (56.7%) of the study group were male, while (53.3%) of the control groups were female. The study also confirms that the effectiveness of a Coping style related instructional program on Self - Care of Patients with Diabetes Mellitus Type II at Endocrinology and Diabetes Center in Al-Basra City, Iraq.Conclusion : The study concludes that A coping style-related instructional program is effective to enhance diabetes patients’ self-care activities, knowledge, and coping style among patients with T2DM. This conclusion is based on the result of our study that reveals significant differences between pre-intervention and post-intervention. Recommendations: Improve knowledge and self-care activities of patients with T2DM, by using our study guidelines.. Encourage the health care provider to improve diabetic patients’ self-care activities and focusing on all domain aspects of self-care.

Evaluation of Self-Care Practice and Its Associated Factors in Adult Diabetic Patients, Ayder Diabetic Clinic, Mekelle, Ethiopia.

BackgroundSelf-care activities in patients with diabetes mellitus are behaviors undertaken by people with or at risk of diabetes in order to successfully manage the disease on their own. Even though self-care practice plays a critical role in preventing as well as delaying diabetes-related complications, there is poor self-care practice by patients with diabetes mellitus. In Ethiopia, especially in Tigray, there are few studies assessing self-care practice of patients with diabetes mellitus and thus this study will have an input in this area.ObjectiveTo evaluate self-care practice and its associated factors in adult patients with diabetes mellitus having follow-up in Ayder Comprehensive Specialized Hospital, Diabetes Clinic.MethodsA hospital-based cross-sectional analysis was made from March to May, 2015. A total of 410 patients with diabetes mellitus were included. The study participants were selected by a systematic random sampling method. Characteristics of study participants were analyzed using descriptive statistics, while bivariate and multivariable logistic regression was used to identify the association between dependent and independent variables.ResultsTwo hundred and eighty-eight (70.2%) study participants were above 30 years of age and 254 (62.9%) study participants were males. More than half (52.9%) of the study participants were type-2 diabetes patients. This study showed 207 (50.5%) had poor diabetes self-care practice. In multivariate logistic regression, low income (AOR = 0.518, 95% CI: 0.288–0.929) and poor knowledge about diabetes (AOR = 5.026, 95% CI: 2.893–8.734) were found to be significantly associated with poor self-care practice.ConclusionThe proportion of poor self-care practice was high, implying the need for regular follow-up as an integral component of the long-term management of diabetes mellitus.

Evaluation of Self-Care Activities and Quality of Life in Patients With Type 2 Diabetes Mellitus Treated With Metformin Using the 2D Matrix Code of Outer Drug Packages as Patient Identifier: Protocol for the DePRO Proof-of-Concept Observational Study.

BackgroundDiabetes mellitus (DM) is one of the most common noncommunicable diseases. DM has a substantial negative impact on patients’ quality of life, which is measured using a variety of diabetes-specific measures covering multiple aspects of patients’ psychological state, behavior, and treatment satisfaction. A fully digital data collection system, including patient identification, would represent a substantial advance in how these patient-reported outcome (PRO) data are measured. Within the European Union, one way to identify patients without the involvement of health care professionals is to use the unique 2D matrix codes on the packaging of prescription medication—for example, metformin, the recommended initial treatment for patients with type 2 DM (T2DM).ObjectiveIn the DePRO study we aim to (1) describe the self-care activities of patients with T2DM using metformin-containing medication; (2) describe the self-reported health status (eg, presence of diabetes complications and quality of life) of these patients; (3) describe associations between self-care activities and demographics and disease characteristics; and (4) assess the usability of the my ePRO app.MethodsDePRO is an observational, multicenter, cross-sectional, digital, patient-driven study conducted in Germany. Patients with a prescription for a metformin-containing medication will be given a postcard by their pharmacist, which will include a download link for the my ePRO app. In total, 12 diabetes-focused pharmacies, selected to represent urban and rural areas, will be recruited. Participants will use their own mobile device (bring your own device) to download the my ePRO app and access the DePRO study, for which they can register using the 2D matrix code on their medication. An electronic informed consent form will be displayed to the patients and only after giving consent will patients be able to complete the study questionnaires. The PRO instruments used in the study are the Summary of Diabetes Self-Care Activities Scale, the Diabetes Treatment Satisfaction Questionnaire, and the 5 level, 5-dimension EuroQol Questionnaire. Patients will also be asked to complete a questionnaire with items addressing demographics, patient characteristics, disease history, complications, and concomitant medications. Data will be transferred to the study database by the app upon completion of each questionnaire. Statistical analyses of primary and secondary endpoints will be exploratory and descriptive.ResultsEnrollment began in June 2020. The estimated study completion date is December 31, 2020, and the planned sample size is 300 patients.ConclusionsThe DePRO study uses completely digital data collection, including authentication of eligible patients and completion of the study questionnaires. Therefore, the design of the DePRO study represents a substantial advance in the evaluation of the digital capturing of PRO data.Trial RegistrationClinicalTrials.gov NCT04383041; https://clinicaltrials.gov/ct2/show/NCT04383041International Registered Report Identifier (IRRID)PRR1-10.2196/21727

Impact of a Clinical Pharmacist Intervention Program on the Follow-up of Type-2 Diabetic Patients.

The primary aim of this current study was to investigate the impact of the clinical pharmacist interventions on glycemic control and other health-related clinical outcomes in patients with type 2 diabetes in Egypt. A prospective trial was conducted on 100 patients with uncontrolled type 2 diabetes admitted in the diabetes outpatient's clinics. Patients were randomly allocated into the clinical pharmacist intervention group and usual care group. In the intervention group, the clinical pharmacist, in collaboration with the physician had their patients receive pharmaceutical care interventions. In contrast, the usual care group patients received routine care without clinical pharmacist's interference. After 6-month of follow-up, of the average HbA1c and FBG values of the patients in the clinical pharmacist intervention group (HbA1c % from 8.6 to 7.0; FBG (mg/dL) from 167.5 to 121.5) decreased significantly compared to the usual care group patients (HbA1c % from 8.1 to 7.8; FBG (mg/dL) from 157.3 to 155.9) (P < .05). Additionally, the results indicated that mean scores of patients 'diabetes knowledge, medication adherence, and diabetes self-care activities of the patients in the clinical pharmacist group increased significantly compared to the control group (P < .05). The study demonstrated an improvement in HbA1c, FBG, and lipid profile, in addition to self-reported medication adherence, diabetes knowledge, and diabetes self-care activities in patients with type 2 diabetes who received pharmaceutical care interventions. The study outcomes support the benefits and the need to integrate clinical pharmacist interventions in the multidisciplinary healthcare team in Egypt.

Assessing and testing the reliability of mini self-care practices questionnaire among type 2 diabetic patients attending rural health training centre, Kanchipuram, Tamil Nadu

Background: India is the diabetic capital of the world with nearly 31.7 million people suffering from the disease in 2000 which is projected to become 79.4 million in the year 2030. The incidence of diabetes in India is around 8.8%. This study aims at developing a mini questionnaire to quickly assess the self-care practices among the diabetic patients attending rural health training centre and also to educate the diabetic patients about self-care practices and dietary pattern they need to follow.Methods: The study design is a community based cross-sectional study. All diabetic patients who visited rural health training centre attached to a private medical college aged 40 years and above in the period of June to July 2019 were included in our study. Institutional ethical clearance was taken before commencing the study. Construction of mini self-care practices questionnaire (MSCPQ) comprised of two phases. Trained medical students collected the data by interview method using semi-structured, pre-tested questionnaire.Results: The reliability of the MSCPQ using Cronbach’s alpha came to be 0.82 and the intra class correlation coefficient was 0.81; 95% CI (0.763-0.853) (p=&lt;0.001). Around sixty six percent are having their health check-up regularly. Most (43%) of the study participants check their blood sugars monthly.Conclusions: Even though there are various factors contributing in facilitating self-care activities in patients living with diabetes, the role of health care physicians in educating about self-care practices are indispensable.

Diabetic self care practices in rural Mysuru, Southern Karnataka, India — A need for Diabetes Self Management Educational (DSME) program

ContextDiabetes and its complications are the leading cause of morbidity and mortality in the world. Self care has emerged as a crucial element in the management of diabetes and a key factor associated with the quality of diabetic care. AimsThe purpose of the study was to assess the self care activities of patients with Type II diabetes mellitus in a rural area of Mysuru district. Settings and designA community based cross sectional descriptive study was carried out among 400 diabetic patients in rural Mysore. Methods and materialSelf care Activities (Diet, exercise, self blood glucose monitoring, medication, foot care, smoking) were assessed using a pre designed and tested questionnaire. Statistical analysis usedRelevant descriptive analysis like percentages is carried out using SPSS version 22.0. ResultsMost of the diabetic patients had good compliance for medication (92.5%), followed by 72% for diabetic diet. Only 27.75% of the diabetic patients participated in walking, 24.25% practised foot care, blood glucose monitoring by 24.75% and only 25.5% of them were current smokers. ConclusionsThe rural diabetic patients are more adherent and compliant to medication and diabetic diet and less compliant to physical activity, foot care and self glucose monitoring.

English

Diabetes is an endocrine chronic disease that causes high blood sugar level, produced by retardation in, or deficiency of, glucose metabolism in the body of the individual with the disease. Neuropathies and/or angiopathies are complications of diabetes that result in changes in the lower limbs which subsequently evolve for the diabetic foot. Diabetic foot represents one of the most devastating complications of diabetes and can lead to ulcerations, amputations and even death. Based on these, the aim of this work was to develop an Intelligent System for Monitoring the Prevention of Diabetic Foot (SIM2PeD), allowing personalized care from each individual routine. The work consists of a platform integrated with a mobile device to capture individuals’ data, entitled Mobile SIM2PeD, and a web device for monitoring the medical patient, titled Web SIM2PeD. Individuals receive alerts regarding care according to their location and activity directly from their smartphones. After capturing, the information is passed to the expert system (Intelligent module) that generates recommendations from the answers. The developed system presents a model of alerts as the best architecture, to the detriment of the pictogram model. The data captured show that slight displacements in frequency caused large variations of answers delivered to the application. The various experiments conducted made the system performed to be specified, and suitable for the remote monitoring of self-care activities in patients with diabetic foot.

Diabetes Education, Knowledge Improvement, Attitudes and Self-Care Activities Among Patients With Type 2 Diabetes in Bangladesh

Background: Diabetes education provided by physicians in Bangladesh has some limitations, and its impacts on self-management are unclear. These prompted the Diabetic Association of Bangladesh (BADAS) to train 100 diabetes educators to improve the diabetes self-care activities of patients and to pilot the effects of the education. Objectives: In this context, the current study aimed to assess the impact of diabetes education to improve knowledge on and attitudes towards diabetes and self-care activities in patients with type 2 diabetes mellitus (T2DM). Methods: The pretest-posttest study recruited 500 newly-diagnosed patients with T2DM by convenience method from 19 healthcare centers of BADAS. They received a one-hour diabetes education only once at the time of registration to the hospital. A four-part interviewer-administered questionnaire was used to assess the knowledge, attitudes, and self-care activities in the patients with diabetes. The observed changes were compared after 18 months of the intervention and psychological support, in knowledge, attitudes and self-care activities among 458 (91.6%) patients with the mean age of 52.3 ± 11.4 years. Results: After the intervention, the mean score of knowledge (8.5 ± 2.6 vs. 5.5 ± 2.9) and attitudes (85.7 ± 6.1 vs. 79.9 ± 6.5) of the patients improved significantly (P = 0.0001). About 67.7%, 85.2%, 82.8% and 92.1% of the patients were monitored for blood glucose, doing exercises, taking foot care and smoking withdrawal whereas the rates were 8.3%, 69.2%, 25.8% and 86.7%, respectively before the intervention; a significant difference was observed between the measures. Consumption of betel nuts increased at the posttest compared to that of the pretest (73.4% vs. 70.7%). About 25.5% followed the dietary advice given by dietitians whereas it was only 5.2% at the pretest; there were significant changes between the pretest and posttest measures in this regard (P = 0.0001). One-third of the subjects took meals at a certain time; the number slightly decreased compared to the pretest. Around 36% of the patients weighted food before eating compared to 37.6% at the pretest. There was a significant difference regarding the certain time and weighting food before eating between pretest and posttest measures (P = 0.001). Conclusions: Diabetes education enhances the knowledge of patients and changes their attitudes towards all aspects of DM. It also helps them to improve some aspects of diabetes self-care activities.

A Structural Equation Model Linking Health Literacy to Self-efficacy, Self-care Activities, and Health-related Quality of Life in Patients with Type 2 Diabetes

Health literacy has been attracting increasing attention because low health literacy is considered an important predictor of adverse health outcomes in many chronic conditions, including diabetes. However, it is unclear how health literacy is associated with health outcomes. The purpose of this study was to formulate a hypothetical structural equation model linking health literacy to self-efficacy, self-care activities, and health-related quality of life (HRQOL) in patients with type 2 diabetes. A cross-sectional survey design was employed, and 459 patients with type 2 diabetes were recruited from outpatient clinics in two university hospitals. The patients completed a pack of questionnaires. The hypothetical model was tested using structural equation modeling analysis. The values of multiple fit indices indicated that the proposed model provided a good fit to the data. Health literacy exerted not only a direct effect on self-care activities, but also an indirect effect on self-care activities via self-efficacy. However, health literacy exerted only an indirect effect on HRQOL. This structural model was invariant across hemoglobin-A1c-controlled and hemoglobin-A1c-uncontrolled groups. Based on R(2) values, the final model accounted for 20.0% of the variance in self-efficacy, 61.0% of the variance in self-care activities, and 16.0% of the variance in HRQOL. This study suggests that self-care activities are crucial to the link between health literacy and HRQOL. Both health literacy and self-efficacy need to be considered in clinical practice for enhancing self-care activities in patients with type 2 diabetes. This approach may ultimately improve HRQOL in these patients.

Re-designing Orem's Self-care Theory for Patients with Chronic Hepatitis.

Background:Hepatitis is an inflammatory disease which has many adverse effects on patients’ life because of its chronic nature. Since Orem's theory of self-care is a grounded theory, the concepts and applications of this theory in patients with chronic hepatitis who have special needs may lead to some challenges. The purpose of this study was to explore self-care in patients with chronic hepatitis.Methods/Design:A directed content analysis was used in this qualitative study. Participants were recruited from a metropolitan area. Data were collected through semi-structured interviews. The verbatim transcripts of the participants’ interviews were analyzed according to directed content analysis.Results:In this study, four themes, suggested by Orem, were drawn from the data according to directed content analysis. The codes generated from the data were classified into concepts and then the concepts were assigned into these four themes. These themes were needs in the matrix of time and place, self-care agency, need for change in self-care and consequences of hepatitis.Conclusion:The use of Orem's self-care theory cannot meet the need for self-care in hepatitis patients because these patients have vital sexual, respect and belonging, physical, economical, and psychological-behavioral needs, and lack adequate knowledge about self-care. Consequently, the specific self-care model developed in this study helps health professionals identify self-care activities in patients with chronic hepatitis.