Letta Shiferaw, Aga Fekadu, Assebe Yadeta Tesfaye, Geda Biftu, Dessie Yadeta
School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
SAGE Open Med. 2022 Jun 26;10:20503121221107337. doi: 10.1177/20503121221107337. eCollection 2022.
This study investigated the level and correlates of self-care practices among patients with type 2 diabetes on follow-up in two public hospitals in Harar, Eastern Ethiopia.
We conducted a hospital-based cross-sectional study on adult patients with type 2 diabetes, surveying diabetes self-care practices using a 15-item Summary of Diabetes Self-Care Activities. Responses ranged from 0 to 7 days, and a composite score was computed representing the mean days of diabetes self-care practices. A generalized Poisson regression model with robust variance was used. The association between the diabetes self-care practices and correlates was examined using the incidence rate ratio with a 95% confidence level. The statistical significance was set at a p value of ⩽0.05.
This study included 879 patients with type 2 diabetes. The overall mean (standard deviation) diabetes self-care practices were 3.7 ± 1.1 days out of the recommended 7 days, indicating low self-care practices. After controlling for other variables, tertiary educational level (incidence rate ratio = 1.06; 95% confidence interval: 1.01, 1.12), adequate diabetes knowledge (incidence rate ratio = 1.04; 95% confidence interval: 1.00, 1.08), moderate (incidence rate ratio = 1.07; 95% confidence interval: 1.02, 1.11) and high perceived self-efficacy (incidence rate ratio = 1.14; 95% confidence interval: 1.09, 1.13) (incidence rate ratio = 1.07; 95% confidence interval: 1.02, 1.11), high to marginal food security (incidence rate ratio = 1.13; 95% confidence interval: 1.03, 1.24), and receiving dietary advice (incidence rate ratio = 1.11; 95% confidence interval: 0.06, 1.15) were positively correlated with diabetes self-care practices. A history of hospitalization, on the other hand, was found to be inversely correlated with diabetes self-care practices (incidence rate ratio = 0.94; 95% confidence interval: 0.88, 0.99).
The study indicated that adherence of patients with type 2 diabetes to the recommended self-care practices was considerably low. Therefore, tailored diabetes self-management education to enhance self-efficacy and diabetes self-care practices must be in place. This can be achieved through the system or individual-based integrated intervention efforts.
本研究调查了埃塞俄比亚东部哈勒尔市两家公立医院中2型糖尿病患者随访期间的自我护理水平及其相关因素。
我们对成年2型糖尿病患者进行了一项基于医院的横断面研究，使用15项糖尿病自我护理活动总结来调查糖尿病自我护理行为。回答范围为0至7天，并计算出一个综合分数，代表糖尿病自我护理行为的平均天数。使用具有稳健方差的广义泊松回归模型。采用95%置信水平的发病率比来检验糖尿病自我护理行为与相关因素之间的关联。统计学显著性设定为p值≤0.05。
本研究纳入了879例2型糖尿病患者。在推荐的7天中，总体平均（标准差）糖尿病自我护理天数为3.7±1.1天，表明自我护理行为水平较低。在控制其他变量后，高等教育水平（发病率比=1.06；95%置信区间：1.01，1.12）、足够的糖尿病知识（发病率比=1.04；95%置信区间：1.00，1.08）、中等（发病率比=1.07；95%置信区间：1.02，1.11）和高自我效能感（发病率比=1.14；95%置信区间：1.09，1.13）（发病率比=1.07；95%置信区间：1.02，1.11）、高至边缘粮食安全（发病率比=1.13；95%置信区间：1.03，1.24）以及接受饮食建议（发病率比=1.11；95%置信区间：0.06，1.15）与糖尿病自我护理行为呈正相关。另一方面，住院史与糖尿病自我护理行为呈负相关（发病率比=0.94；95%置信区间：0.88，0.99）。
该研究表明2型糖尿病患者对推荐的自我护理行为的依从性相当低。因此，必须开展有针对性的糖尿病自我管理教育，以提高自我效能感和糖尿病自我护理行为。这可以通过系统或基于个体的综合干预措施来实现。
