An assessment of knowledge and self-care practices in patients living with type 2 diabetes mellitus

Abstract

Background: Type 2 diabetes mellitus is a progressive and chronic disease associated with reduced quality of life, premature mortality and substantial economic costs. Self-management in persons living with diabetes is vital since these individuals, together with their families, provide 95% of the overall care of their condition. Aim: To determine whether there is an association between the level of diabetes-related knowledge and diabetes self-care practices in people living with type 2 diabetes in Malta. Design & Methods: A multi-centre, non-experimental prospective study design was conducted on 50 Maltese patients living with type 2 diabetes mellitus attending the primary healthcare setting. The participants had to be over the age of 18; living with type 2 diabetes; primarily responsible for their own care; capable of comprehending the English or Maltese language and mentally and physically fit to participate in the study. The DKQ-24 and SDSCA questionnaires were used to assess diabetes knowledge and diabetes self-management respectively. Results: The mean diabetes knowledge score was 14.40 out of a total of 24 and the mean self-care activities score was 2.89 out of a total of 7, indicating a deficit in a number of key areas in the management of diabetes. There was no statistically significant correlation between diabetes knowledge score and diabetes self-care activities (r = 0.190, p = 0.187). On analysis of the individual sub-scales a significant relationship resulted between diabetes knowledge score and diet (r = 0.324, p = 0.022) but physical activity (r = 0.179, p = 0.214), blood sugar testing (r = 0.231, p = 0.107) and foot care (r = 0.189, p = 0.189) gave no significant results. On further analysis, education level was significantly correlated to diabetes knowledge score (r = 0.374, p = 0.007) and self-care activities score (r = 0.317, p = 0.025) while age was significantly correlated to diabetes knowledge score (r = -0.373, p = 0.008) and self-care activities score (r = -0.299, p = 0.035). Conclusion: The study has highlighted knowledge deficits and inadequate levels of adherence to certain areas of self-care in the study group. This study further confirms the inconsistent relationship between diabetes knowledge and self-care. Therefore integrating theories of behavioural change into educational interventions, including psychosocial concepts such as patient-centred care, self-efficacy and empowerment, may assist in strengthening the relationship between diabetic education and self-management in type 2 diabetic patients. The need of encouraging self-care practices and educating people about the cause of disease and its complications could translate into improved care and quality of life.