Electronic physician

In summary, our study permitted identification of hospitals patient safety climate dimensions. In particular, it allowed us to have a clear understanding of different dimensions of the current climate. Our data demonstrated the urgent need of hospitals for formulating safety-oriented strategies and acquiring senior management support for safety actions in order to strengthen positive culture across hospitals. A culture of safety, in which everyone accepts responsibility for patient safety is necessary before other patient safety practices are introduced, otherwise individuals expected to implement the safety initiatives are unable to effectively communicate or work together. Lack of an established mechanism to report the event inhibits the hospitals from reviewing events systematically; this finding highlights the importance of developing a reporting system as a priority for these hospitals. This study highlighted the importance of cultural change prior to any safety initiative.

This study was sponsored by Kerman University of Medical Sciences with grant number “1387.23”.

Mohammadreza Amiresmaili

Health services administration department,

Kerman University of Medical Sciences, Kerman, Iran

Tel: +98.91269365404

E-mail: amiresmaili@kmu.ac.ir and mohammadreza.amiresmaili@gmail.com

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[Praveen Govinda Gowda, Vittal Balakrishna Ganjigatte. A study of knowledge and self care practices in patients of type 2 diabetes mellitus. Electronic Physician, 2012;4(2):551-554. Available at: http://www.ephysician.ir/2012/551-554.pdf ]. (ISSN: 2008-5842). http://www.ephysician.ir

Diabetes is a complex disease characterised by a state of chronic hyperglycaemia requiring the adoption of numerous skills and behaviour changes in order for the disease to be managed successfully. Prevalence of type 2 diabetes is increasing globally (1). India leads the world with the largest number of diabetic subjects and is termed as diabetes capital of the world (2). Diabetes affects 10-16% of urban population and this is projected to double by 2030 (3). There is an increasing amount of evidence that the patient education is the most effective way to lessen the complications of diabetes and aid its management (4). Diabetic education helps to equip patients with self care knowledge and if integrated into the diabetic care in the primary care settings, results in improved disease knowledge and self care behaviour (5). Unfortunately there is still inadequate awareness about existing interventions for prevention and control of diabetes and its complications.

Self care is a critical element of diabetes management. ‘Self care’ are the activities which are undertaken by the individual itself in order to promote, maintain or restore health. Though self care constitutes 95% of diabetes management it is not given due emphasis (6). The objective of this study is to assess the knowledge and self care practices in type 2 diabetes mellitus patients.

2. Materials and Methods

This study is a cross-sectional, hospital based, descriptive study conducted in Hassan Institute of Medical Sciences, Medical College Hospital, Hassan. Type 2 diabetes mellitus patients aged ≥ 40 years who attended out-patient department (OPD) of the hospital from Feb-March 2011 were included in the study. Two hundred patients, after getting their written informed consent were given pre-designed and pre-tested questionnaire. The ‘structured patient profile form’ included parameters like age, gender, education, body mass index (BMI) and responses to knowledge and practices regarding self care in type 2 diabetes mellitus. The questionnaire had eight questions for knowledge and nineteen questions for practices regarding self care in type 2 diabetes mellitus. Each correct answer was given a score one and each wrong answer a score of zero. The maximum possible score for knowledge and practices was eight and nineteen respectively. The data was analyzed using SPSS Ver 11.0. Chi-square test was applied to test for association.

Among the 200 study subjects 134 (67%) were males, 140 (70%) were literate and 106 (53%) were obese (Table 1).

type 2 diabetes mellitus*

Mean age of subjects was 54.15±10.05 years and mean duration of diabetes was 6.63±5.54 years. Out of 200 respondents 24 (12%) had poor knowledge, 144 (72%) had average knowledge and 32 (16%) had good knowledge regarding self care in type 2 diabetes mellitus (Table 2). Knowledge of self care in type 2 diabetes mellitus increased with increasing duration of diabetes (Table 3). Chi-square test showed a significant association (p< 0.001) between duration of diabetes and level of knowledge regarding self care in type 2 diabetes mellitus. Of the respondents, 118 (59%) had irregular Random Blood Sugar (RBS) check up and 152 (76%) were not getting regular eye check up. However 150 (75%) of the respondents were strict about their diet and were consuming sugarless beverages. Regular physical exercise was practiced by 114 (57%). Only 46 (23%) were taking precautions while travelling and 48 (24%) practiced foot care (Table 4). Mean knowledge and practice score regarding self care in type 2 diabetes mellitus of the respondents according to their body mass index (BMI) were evaluated and the details are mentioned in Table 5.

The mean age of the respondents was comparable with mean age in similar studies (6, 7). It was encouraging to note that majority of the respondents in our study had average to good knowledge regarding self care in type 2 diabetes mellitus and findings are comparable to other studies. With increasing duration of diabetes there was stepwise and statistically significant increase in knowledge about self care. This could be due to increased informative interaction with health care providers (8). It is well understood that diabetes management requires patient involvement for better complication prevention (9, 10). Even though 88% of the respondents had average to good knowledge regarding self care, the same was not practiced. With regard to practice it was unfortunate to note that majority of respondents were not getting their regular eyes checkup. It was also noted that majority of the respondents were not involved in any regular physical activity or exercise as noted by Badruddin et al and Priyankraj et al (11). Majority of the respondents were not taking any precaution while travelling and same was observed with the foot care practices. Notably, majority of the respondents were consuming sugarless beverages. It may be due to their perception that avoiding sugar beverages alone can prevent the complications. Although mean knowledge of respondents was similar, corresponding BMI and practices were not observed, as knowledge was not put into practice and BMI levels corresponded to practice levels but not to knowledge levels (Table-5).

Knowledge regarding self care practices in type 2 diabetes mellitus is high but it is not put into practice. Since there is a gap between knowledge and practices among diabetics regarding self care, it is important to formulate strategies that convert knowledge into beneficial practices. This suggests the need for awareness programme for the patients to improve their self care practices. Limitation of the study was that it was conducted only among the outpatients and hence may not be generalizable to the overall diabetic population.

The authors would like to acknowledge and thank the undergraduate students Asharani J, Bhargavi D, Bhavya C, Deepa GS, Deepthi Verma, Ekatha CN, Gaurav Singh, Kishan N, Mallana Gowda and Megha Jain for the help rendered.

Dr Praveen G,

Department of Community Medicine,

Hassan Institute of Medical Sciences,

Hassan, Karnataka state, India

Mobile: +91.9986957773

Landline: +91.8172261068

Email: drgpraveen@gmail.com

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