K Ramu
Background of the study
In today’s fast- paced life, people manage to get everything earlyinformation, money, and even, diseases. Industrialization, socio- economic development, urbanization, changing age structure, changing lifestyle have placed India in a position where it is facing a growing burden of diabetes mellitus and being responsible for a major proportion of morbidity and mortality. India is currently experiencing an epidemic of type 2 diabetes mellitus and has the largest number of diabetic patients. It is estimated that every fifth person with diabetes will be Indian and every fifth adult in Indian urban areas is diabetic. Keeping in view the alarming increase in incidence and prevalence of diabetes in India, the WHO declared India as the ‘Diabetic Capital’ of the world. Increasing patient knowledge regarding diabetes and its complication has significant benefits with regard to patient compliance to treatment and to decreasing complications associated with diabetes. The real burden of the disease is however, due to its associated complications, which lead to increase in morbidity and mortality.
Awareness of various aspects of diabetes mellitus in diabetic individuals is low. Diabetes care aims at improving the quality of life of individuals with type 2 diabetes through good glycemic control, control of risk factors, lifestyle modification, prevent of complications and diabetes education. Diabetes education is the cornerstone of diabetes care.
Even after diagnosis, monitoring of diabetes is very poor. Most of the patients initially visits a doctor and then discontinue their therapy once their symptoms are controlled. Further, more patients with poor control avoid insulin for fear of injection and belief of addiction of insulin. The health personnel could spare limited time for their diabetic individuals and search for complications were ignored by most. By personal experience, the researcher found that the diagnosis of diabetes created anxiety and doubts among diabetics on how to adjust with restrictions imposed on them to control diabetes, and diabetic individuals had inadequate knowledge about selection of diet, exercises and improving health status and preventing complications of diabetes.
AIM
The aim of the study was to improve the knowledge, practice,develop positive attitudes, and reduce blood glucose levels among type 2 diabetic individuals.
METHODOLOGY
Quasi- experimental design was used in which a pre-test and post- test design was adopted for the study.
The setting of the study was the Govt. District Hospital, Tumkur. Type 2 diabetic individuals who fulfilled the inclusion criteria were considered as the population. The study consists of 200 samples, out of which 100 experimental group and 100 control group. Non- probability purposive sampling was adopted to select the subjects. Those who are newly diagnosed as type 2 diabetes and admitted to the ward formed the sample for the study. In the demographic data, age, gender, education, family income, residence, marital status, type of family food habits, smoking, alcohol, and type of management year of diagnosis of type 2 diabetes were collected. Assessment of glycemic levels was done by taking Random Blood Sugar (RBS) through subject’s record (through lab investigation). The glycemic levels were categorized as 200-260 mg/d1, 261-320 mg/d1, and more than 320 mg/d1.
To assess knowledge and practice the structured interview schedule was used. To ascertain attitude, the diabetes attitude scale was used.
To assess glycemic levels (RBS) the patient clinical records were referred to. The knowledge questionnaire consisted of 85 items and the practice questionnaire of 65 items. The knowledge scores were interpreted in the following way: below 50% as inadequate knowledge, 50-75% as moderate knowledge, and above 75% as adequate knowledge. The practice scores were interpreted in the following way: below 50% as poor practice, 50-75% as moderate practice, and above 75% as good practice. The attitude scores were interpreted in the following way: below 50% as unfavourable attitude, 50-75% as moderately favourable attitude, and above 75% as favourable attitude.
The score was converted into percentage by using the following formula- Percentage= Obtained Score x 100 Total Score
Assessment of glycemic level was done by taking random blood sugar [RBS] through subjects’ record (lab investigation). The glycmeic levels were categorized as 200-260 mg/dl, 261-320 mg/dl, and more than 320 mg/dl. Before collecting data, prior permission was obtained from the Medical Superintendent, Govt. District Hospital, Tumkur and from the study participants. The pretest was conducted on both, experimental group and control group. The Structured Teaching Programme includes knowledge and practice, stress, lifestyle modification, and health maintenance, which includes diabetic diet, exercises, rest and sleep, leisure activities, rest and sleep SMBG and urine test, food and skin care, uses of diabetes medication, and weight reduction and also meaning, causes, clinical manifestation, pathophysiology, diagnostic procedures, and complications of type 2 diabetes. It was administered with AV aids and its duration was 75 minutes. The SMBG, self- insulin administration, and diabetes exercises were shown through video clips. The control group was withheld from the structured teaching programme and exposed to the daily routine of the hospital. After 7 days of structured teaching programme, post- test was conducted for both experimental group and control group, and the questionnaire used in pretest was administered in post-test.