Predictors of self-care behavior in adults with type 2 diabetes mellitus in Abu Khalifa Village-Ismailia-Egypt

Abstract EN

Background : The patient handles the major component (more than 95 %) of the provided care to the patient of type 2 diabetes mellitus.

So, it became a partnership between the patient and the physician rather than an authoritative set of instructions issued by the physician.

The role of the patient could be emphasized through behavioral change.

The ability to understand and influence individual behaviors that enhance self-care may significantly influence the success of management plan of diabetic patients.

Four factors have been linked with self-care behaviors in patients with type 2 diabetes : (1) patient demographics, (2) doctor-patient relationship, (3) stress, and (4) social context.

Objectives: This study aimed at assessing the knowledge, attitude and practices of study subjects towards the favored self-care behaviors for the diabetic patient.

Also, it was designed to assess the relationship between predictors “patients demographics, doctor-patient relationship, stress, and social context” and self-care behaviors.

Methods : The present study was cross sectional one.

It was conducted during the period of October-December 2001 on 200 diabetic patients who are registered in the morbidity register in Abu-khalifa family practice center and fulfilled the adopted criteria.

A questionnaire was designed that included items about some independent variables (demographics, doctor-patients relationship, personal stress, and social context).

These variables considered to be predictors for self care behavior.

Also, some items (dependent variables) related to self-care behavior (diet, glucose monitoring, adherence to medication regimens, and exercise) were included.

All recruited subjects were interviewed and asked about their knowledge, attitude and practices regarding self-care behaviors during their seeking medical care.

The obtained data were coded, entered and processed on a personal computer using SPSS.

Results : The present study showed that almost all patients had perfect scores of knowledge of different self-care behaviors particularly towards prescribed treatment (100 %).

The attitude of the study population towards different self-care behaviors was not as high as their knowledge, nearly half of them paid frequent attention towards testing blood sugar (45.5 %), compliance to medications (51.3 %), and diet (41,5 %).

On the other hand, only 10.5 % of the patients paid frequent attention to performing exercise.

Concerning self-care practices, it was found that 93.5 % of the diabetic patients mentioned that they have never forgot or, they have forgot sometimes to test their blood sugar.

Concerning relation between studied predictors and self-care outcomes, there were significant associations for doctor patient relationship and social context, specifically the family with self-care behaviors.

There was significant association between doctor-patient relationship and performing exercising (P = 0.001) even after adjusting for other predictors (demographics, levels of perceived stress, and Social context).

Conclusion : Of the four categories of factors (predictors) associated with self-care behavior, the doctor patient relationship and social context, specifically the family, appears to be most strongly associated with self-care behaviors.

The importance of family context suggests that family physician, who spend a considerable time addressing family issues, are well positioned to improve family understanding of diabetes and thereby the success of diabetes care they provide to patients and their families.

Also, the authors concluded that good doctor patient relationship seems to be a strong predictor of self-care behaviors specially when it comes to regular monitoring of glucose and exercising.

So, the role of family physician could be maximized in this regard to achieve the desired self care behavior.