Type 2 diabetes in Hulu Selangor: Factors influencing self-care practices from a cross sectional survey / Cassidy Devarajooh
The prevalence of diabetes in Malaysia has been increasing from 6.3% in 1986 to 17.5% in 2015. The main aim of diabetes treatment is to achieve optimal glycaemic control, thus preventing or delaying complications. Good diabetes self-care practice is needed to achieve optimal glycemic control. In...
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| Format: | Thesis |
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2018
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| Online Access: | http://studentsrepo.um.edu.my/9198/ http://studentsrepo.um.edu.my/9198/5/cassidy.pdf |
| Summary: | The prevalence of diabetes in Malaysia has been increasing from 6.3% in 1986 to
17.5% in 2015. The main aim of diabetes treatment is to achieve optimal glycaemic
control, thus preventing or delaying complications. Good diabetes self-care practice is
needed to achieve optimal glycemic control. In Malaysia, limited information is available
about diabetes self-care practices and its associated factors. This study aimed to identify
and determine factors influencing diabetes self-care practices among type 2 diabetics in
the district of Hulu Selangor. This was an interviewer administered, cross sectional study,
involving 371 randomly selected patients with type 2 diabetes recruited from 6 health
clinics in the district of Hulu Selangor, Malaysia. A conceptual model regarding the
association between age, sex, education level, diabetes duration, knowledge, social
support, empowerment, self-efficacy, depression and diabetes distress with diabetes selfcare
practices was developed and analyzed using structural equation modelling. The mean
HbA1c level was 8.8 ± 2.3%. Eighteen point one percent had good glycemic control. The
mean self-care score was 3.87 ± 0.82. Forty five point eight percent practiced good
diabetes self-care. Self-care was not associated with diabetes control. Diabetes self-care
practices were similar between sex, age group, ethnicity, and education level. The
prevalence of diabetes distress and depression was 5.7% and 4.3% respectively. There
was a significant direct positive effect from self-efficacy (path coefficient=0.315,
p<0.001) to diabetes self-care. There was a significant direct negative effect from diabetes
distress (path coefficient=-0.134, p=0.007) to self-care. Social support had a direct
positive effect (path coefficient=0.399, p<0.001) and indirect effect via self-efficacy (path
iv
coefficient=0.078, p=0.001) on self-care. Though depression had no direct effect on selfcare
(path coefficient=0.024, p=0.684), there was an indirect negative effect via selfefficacy
(path coefficient=-0.098, p=0.001).In summary, the glycemic control and
diabetes self-care practices were poor among the study population. Having higher social
support, higher levels of self-efficacy and a lower level of diabetes distress leads to better
diabetes self-care practices. Higher levels of social support and being less depressed were
associated with better self-efficacy. In conclusion, to improve self-care practices, effort
must be focused on enhancing support and self-efficacy levels, while not forgetting to
deal with depression and diabetes distress, especially among those with poorer levels of
self-efficacy. |
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