TY - JOUR
T1 - Self-Management of Diabetes and Associated Factors among Patients Seeking Chronic Care in Tshwane, South Africa
T2 - A Facility-Based Study
AU - Zwane, Janke
AU - Modjadji, Perpetua
AU - Madiba, Sphiwe
AU - Moropeng, Lucky
AU - Mokgalaboni, Kabelo
AU - Mphekgwana, Peter Modupi
AU - Kengne, Andre Pascal
AU - Mchiza, Zandile June Rose
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/5
Y1 - 2023/5
N2 - The burden of diabetes continues to increase in South Africa and a significant number of diabetes patients present at public primary healthcare facilities with uncontrolled glucose. We conducted a facility-based cross-sectional study to determine the diabetes self-management practices and associated factors among out-patients in Tshwane, South Africa. An adapted validated questionnaire was used to collect data on sociodemography, diabetes knowledge, and summaries of diabetes self-management activities measured in the previous seven days, and over the last eight weeks. Data were analysed using STATA 17. A final sample of 402 diabetes out-patients was obtained (mean age: 43 ± 12 years) and over half of them were living in poor households. The mean total diabetes self-management of score was 41.5 ± 8.2, with a range of 21 to 71. Almost two thirds of patients had average self-management of diabetes, and 55% had average diabetes knowledge. Twenty-two percent of patients had uncontrolled glucose, hypertension (24%) was the common comorbidity, and diabetic neuropathy (22%) was the most common complication. Sex [male: AOR = 0.55, 95% CI: 0.34–0.90], race [Coloured: AOR = 2.84, 95% CI: 1.69–4.77 and White: AOR = 3.84, 95% CI: 1.46–10.1], marital status [divorced: AOR = 3.41, 95% CI: 1.13–10.29], social support [average: AOR = 2.51, 95% CI: 1.05–6.00 and good: AOR = 4.49, 95% CI: 1.61–7.57], body mass index [obesity: AOR = 0.31, 95% CI: 0.10–0.95], diabetes knowledge [average: AOR = 0.58, 95% CI: 0.33–0.10 and good: AOR = 1.86, 95% CI: 0.71–4.91], and uncontrolled glucose [AOR = 2.97, 95% CI: 1.47–5.98] were factors independently predictive of diabetes self-management. This study emphasizes that the self-management of diabetes was mostly on average among patients and was associated with the aforementioned factors. Innovative approaches are perhaps needed to make diabetes education more effective. Face-to-face sessions delivered generally during clinic visits should be better tailored to the individual circumstances of diabetes patients. Considerations should be given to the options of leveraging information technology to ensure the continuity of diabetes education beyond clinic visits. Additional effort is also needed to meet the self-care needs of all patients.
AB - The burden of diabetes continues to increase in South Africa and a significant number of diabetes patients present at public primary healthcare facilities with uncontrolled glucose. We conducted a facility-based cross-sectional study to determine the diabetes self-management practices and associated factors among out-patients in Tshwane, South Africa. An adapted validated questionnaire was used to collect data on sociodemography, diabetes knowledge, and summaries of diabetes self-management activities measured in the previous seven days, and over the last eight weeks. Data were analysed using STATA 17. A final sample of 402 diabetes out-patients was obtained (mean age: 43 ± 12 years) and over half of them were living in poor households. The mean total diabetes self-management of score was 41.5 ± 8.2, with a range of 21 to 71. Almost two thirds of patients had average self-management of diabetes, and 55% had average diabetes knowledge. Twenty-two percent of patients had uncontrolled glucose, hypertension (24%) was the common comorbidity, and diabetic neuropathy (22%) was the most common complication. Sex [male: AOR = 0.55, 95% CI: 0.34–0.90], race [Coloured: AOR = 2.84, 95% CI: 1.69–4.77 and White: AOR = 3.84, 95% CI: 1.46–10.1], marital status [divorced: AOR = 3.41, 95% CI: 1.13–10.29], social support [average: AOR = 2.51, 95% CI: 1.05–6.00 and good: AOR = 4.49, 95% CI: 1.61–7.57], body mass index [obesity: AOR = 0.31, 95% CI: 0.10–0.95], diabetes knowledge [average: AOR = 0.58, 95% CI: 0.33–0.10 and good: AOR = 1.86, 95% CI: 0.71–4.91], and uncontrolled glucose [AOR = 2.97, 95% CI: 1.47–5.98] were factors independently predictive of diabetes self-management. This study emphasizes that the self-management of diabetes was mostly on average among patients and was associated with the aforementioned factors. Innovative approaches are perhaps needed to make diabetes education more effective. Face-to-face sessions delivered generally during clinic visits should be better tailored to the individual circumstances of diabetes patients. Considerations should be given to the options of leveraging information technology to ensure the continuity of diabetes education beyond clinic visits. Additional effort is also needed to meet the self-care needs of all patients.
KW - South Africa
KW - associated factors
KW - diabetes
KW - primary health care facilities
KW - self-management
UR - http://www.scopus.com/inward/record.url?scp=85160298339&partnerID=8YFLogxK
U2 - 10.3390/ijerph20105887
DO - 10.3390/ijerph20105887
M3 - Article
C2 - 37239611
AN - SCOPUS:85160298339
SN - 1661-7827
VL - 20
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
IS - 10
M1 - 5887
ER -