Knowledge, attitudes and adapted behaviours of adults with Type 2 Diabetes Mellitus, attending a private clinic in the Western Cape: A mixed-method study.

Winton, Loreen (2020-02-24)

Thesis (MHumanRehabSt)--Stellenbosch University, 2020.

Thesis

ENGLISH SUMMARY : Introduction: Diabetes is a worldwide epidemic. It is one of the top ten causes of death globally. Insulin resistance and deficiency are the main causes of type 2 Diabetes Mellitus (T2DM). Without proper control of blood glucose levels, tissue damage takes place within the body, causing diabetesrelated complications. These include possible loss of vision, renal failure, peripheral and autonomic neuropathy, sexual dysfunction, cardiovascular disease, and symptoms of hypertension and lipoprotein abnormalities. Studies done in South Africa have demonstrated relatively poor knowledge, attitudes and practices of individuals with T2DM. Most of these studies have been conducted in state hospitals or rural areas in Southern Africa. The current study aimed to describe the diabetes-related knowledge, attitudes and self-reported adapted behaviours of persons diagnosed for at least one year with T2DM, and attending a private clinic in Cape Town, South Africa. Methods: A mixed method design was applied using a phased approach; quantitative data were collected using a structured questionnaire, followed by qualitative interviews. Sixty-seven consecutively sampled participants, attending the Diabetes Life Clinic, formed the study population and completed the questionnaire. Six participants were interviewed via telephone for the qualitative phase. Descriptive statistics have been used for quantitative data, as well as basic inferential statistics, with P<0.05 considered statistically significant. Thematic analysis was applied to qualitative data. Results: A knowledge score of 60.6% was found. A significant correlation was found between less favourable attitude and behaviour. The behaviour scores of female participants was significantly lower than that of males (p=.16). There was a positive significant association between behaviour and higher levels of education (p=.049), and a significant association between depression (p=<.001) and stress/anxiety (p=.026) and quality of life. Qualitative data elicited three themes; 'Where it all started - How the diagnosis changed my life'; 'The diabetes journey – A daily choice'; 'It takes a village…support is key!’ Conclusion: Despite a reasonable knowledge score, this study sample demonstrated less than favourable behaviour and attitudes. The qualitative findings illustrated the stress and difficulty of managing diabetes daily. Recommendations were for healthcare professionals and their role in collaborating in empowering-partnerships with patients, NGO’s and their role in support groups and programmes, patients and their families, and the need to assume ownership of their DM.

AFRIKAANSE OPSOMMING : Inleiding: Diabetes is 'n wêreldwye epidemie. Dit is een van die top tien oorsake van dood wêreldwyd. Insulienweerstandigheid en tekort is die belangrikste oorsake van tipe 2 Diabetes Mellitus (T2DM). Sonder behoorlike beheer van bloedglukosevlakke vind weefselskade binne die liggaam plaas, wat diabetesverwante komplikasies veroorsaak. Dit sluit in moontlike verlies aan visie, nierversaking, perifere en outonome neuropatie, seksuele disfunksie, kardiovaskulêre siektes, en simptome van hipertensie en lipoproteïne abnormaliteite. Studies wat in Suid-Afrika gedoen is, het getoon relatief swak kennis, houdings en praktyke van individue met T2DM. Die meeste van hierdie studies is in staatshospitale of landelike gebiede in Suider-Afrika gedoen. Die huidige studie het ten doel gehad om die diabetes-verwante kennis, gesindhede en selfgerapporteerde gedrag van persone wat ten minste een jaar met T2DM gediagnoseer is, en 'n privaat kliniek in Kaapstad, Suid-Afrika bywoon, te beskryf. Metodes: 'n Gemengde metode is met behulp van 'n gefaseerde benadering toegepas; kwantitatiewe data is met behulp van 'n gestruktureerde vraelys versamel, gevolg deur kwalitatiewe onderhoude. Sewe-en-sestig opeenvolgende steekproefnemers wat die Diabetes Life Clinic bygewoon het, het die studiepopulasie gevorm en die vraelys voltooi. Ses deelnemers is telefonies ondervra vir die kwalitatiewe fase. Beskrywende statistieke is gebruik vir kwantitatiewe gegewens, sowel as basiese afleidende statistieke, met P <0,05 as statisties beduidend. Tematiese analise is toegepas op kwalitatiewe data. Resultate: `n Kennis telling van 60.6 was gevind. 'n Beduidende verband is gevind tussen minder ongunstige houding en gedrag. Die gedragsyfers van vroulike deelnemers was beduidend laer as dié van mans (p = .16). Daar was 'n positiewe betekenisvolle assosiasie tussen gedrag en hoër opvoedingsvlakke (p = .049), en 'n beduidende assosiasie tussen depressie (p = <. 001) en stres / angs (p = .026) en lewensgehalte. Kwalitatiewe data het drie temas ontlok; 'Waar dit alles begin het - hoe die diagnose my lewe verander het'; 'Die diabetesreis - 'n daaglikse keuse'; 'Dit verg 'n dorp ... ondersteuning is die belangrikste!'. Gevolgtrekking: Ondanks n redelike kennistelling, het hierdie studiemonster minder as gunstige gedrag en houdings getoon. Die kwalitatiewe bevindings illustreer die stres en probleme om daagliks diabetes te hanteer. Aanbevelings was vir professionele persone in die gesondheidsorg en hul rol in die bemagtiging van vennootskappe met pasiënte, NRO's en hul rol in ondersteuningsgroepe en -programme, pasiënte en hul gesinne, en die behoefte om eienaarskap van hul DM te aanvaar.

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