Prevalence And Impact Of Diabetes Mellitus Among Female Patients Attending Nnamdi Azikiwe University Teaching Hospital Nnewi

Project and Seminar Material for Nursing (Science)

Prevalence And Impact Of Diabetes Mellitus Among Female Patients Attending Nnamdi Azikiwe University Teaching Hospital Nnewi


Abstract


This study focus was on the prevalence and impact of diabetes mellitus among female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi. The study is was specifically focused on describing the knowledge about the symptoms, risk factors and complications of diabetes mellitus as well as the sources of knowledge among female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi; describing the perceptions of female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi about diabetes mellitus; describing the attitudes of female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi towards diabetes mellitus and determining factors associated with the observed levels of knowledge, attitudes and perceptions towards diabetes mellitus among female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi. The study adopted the survey research design and randomly enrolled participants in the study. A total of 300 responses were validated from the enrolled participants where all respondent are female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi. Of the 300 respondents interviewed, 50.3% were males, 49.3% were females and 0.4 were missing. The majority of the respondents were between 26 – 30 years. Knowledge about diabetes mellitus was higher amongst females (51.2%) compared to males (48.2%) and was associated with age. Only 34.7% of respondents had poor perceptions about diabetes (i.e. diet, curability and distribution). About 49.7% respondents had good knowledge about risk factors for diabetes mellitus while 50.3% had poor knowledge thereof.


Chapter One


Introduction

1.1 Background to the Study

The World Health Organization (WHO) estimates that more than 220 million people worldwide have diabetes mellitus (DM) and without interventions, this number is likely to increase more than double by 2030. Almost 80% of diabetes deaths occur in low and middle- income countries (WHO, 2010). Diabetes mellitus (DM) defined as a metabolic disorder or disease characterised by abnormally high glucose levels in the blood, excessive urination and persistent thirst (Ugo, 2010) has been on the increase in Nigeria.

According to the ministry of health 2009 from January to December 2009 there was 1.6% new cases of diabetes aged 5 to 17 years Nigeria is one of the African countries where diabetes mellitus ranks among the top ten health conditions contributing to the disease burden and among the top 15 in-patient causes of death (DHIS) 2009. In 2010 within the same age group the percentage of new diabetes cases increased to 3.9%. In 2009, the incidence of diabetes among children under 5 years old was 2.2%; and according to diabetes records the incidence in the same age group was 4.1%. In addition, in 2010 there were 625 deaths attributable to diabetes in females between the ages of 20 to 69 years (Roglic and Unwin, 2010). Such findings suggest the need for diabetes awareness which will assist in the control and prevention of this disease.

During the commemoration of the World Diabetes Day in 2010, in his speech, a Physician Specialist, Dr. I. Katjitae stated that Namibia is commemorating World Diabetes Day 2010 to raise awareness about how to prevent diabetes through following a healthy lifestyle, the signs and symptoms of diabetes including the management of the illness. He noted with concern that, since early diagnosis is critical to reduce diabetic cases, the MoHSS is thus targeting health workers by, alerting them to the fact that with modern lifestyles, non-communicable diseases (NCDs) are on the increase, with diabetes being a major illness (MoHSS, 2010).

Dr. I. Katjitae further highlighted that through improved knowledge, diagnosis and treatment, the country can take control of diabetes. Therefore, both health workers and members of the public should be educated about diabetes mellitus (MoHSS &WHO, 2010).

Diabetes is the most common form of diabetes and primarily affects the poorest people living in urban areas in Africa (McManus, Stitt &Bargh, 2006). Studies conducted show that NCDs are on the increase, and Roglic and Unwin (2010) confirmsed that changes in demographic status, development, urbanization and the impact of globalization have resulted in the rapid emergence of NCDs and their risk factors in Africa, particularly urban areas. It is projected that by 2020, NCDs such as diabetes mellitus and high blood pressure will be the leading causes of death ahead of communicable diseases.

McManus, Stitt and Bargh (2006) acknowledge that diabetes is a public health challenge that is escalating in proportion to an ageing population and increasing incidence of overweight and obesity. Furthermore effective interventions have been shown to prevent or delay the onset of diabetes and reduce the risk of chronic complications (McManus, Stitt & Bargh, 2006). It is however noted that, successful transfer of these protective strategies to improved population health remains a major challenge.


1.2 Statement of the Problem

The prevalence of diabetes mellitus is increasing in Nigeria. Diabetes is widespread in all the regions in Nigeria and the western part of the country was ranked the lowest with 1.8 % (new cases) of diabetics aged 18 years and older in 2009.. In comparison to many other diseases, there is little recognition of diabetes mellitus as a severe public health issue. Too many people, including those with the disease and health care providers, remain either uninformed, or unconvinced of the potentially devastating complications and seriousness of diabetes mellitus. Various studies conducted in many parts of the world suggest that there is a lack of public awareness and knowledge of various factors related to diabetes mellitus (Gunay, 2006; Munigesai, 2007). Karlsson, (1998); Malik and Koot (2009); Viklund and Wikblad, (2009) in their studies claim that previous researches on social support in chronic illness have focused largely on older adult. Research has also been lacking on how this age group uses technology – e.g. social networking websites to augment their social support. The need, therefore, is now emerging to study how an average nursing student in Nigeria is being reached and communicated to about diabetes mellitus.

In Nigeria, little or no attention has been paid to communicate and create awareness to teenagers about diabetes mellitus. Unadike and Chineye (2009) posit that adequate information about diabetes is not provided for the people to know. Therefore, due to insufficient knowledge and information about diabetes, many people in Nigeria most especially teenagers have the erroneous or inadequate information about diabetes mellitus.

In this regard, creating awareness through the use of effective communication strategy is a driving point for this research. Increased awareness about the seriousness of diabetes, its frequency, its complications, and its associated costs, is essential for teenagers to realise that diabetes is a concern that applies to them.

Awareness (information) cannot be handled without communication; hence, it is imperative that communication plays the major role in awareness creation for behaviour change towards the disease. It is on this premise that this study seeks to assess the female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi knowledge on the risk factors of diabetes mellitus.


1.3 Objectives of the Study

The aim of this study was an assessment of female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi knowledge on the risk factors of diabetes mellitus.

Specifically, we aim;

  1. To describe the knowledge about the symptoms, risk factors and complications of diabetes mellitus as well as the sources of knowledge among female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi.
  2. To describe the perceptions of female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi about diabetes mellitus.
  3. To describe the attitudes of female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi towards diabetes mellitus.
  4. To determine factors associated with the observed levels of knowledge, attitudes and perceptions towards diabetes mellitus female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi.

1.4 Research Question

  1. What is the knowledge about the symptoms, risk factors and complications of diabetes mellitus as well as the sources of knowledge among female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi ?.
  2. What is the perceptions of female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi about diabetes mellitus.?
  3. What is the attitudes of female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi towards diabetes mellitus.?

1.5 Hypothesis of the Study

There are factors associated with the observed levels of knowledge, attitudes and perceptions towards diabetes mellitus among female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi.


1.6 Significance of the Study

The burden of diabetes mellitus is increasing globally, particularly in developing countries. Diabetes Mellitus is still a challenging issue worldwide. There is still need for proper management and coping strategies for young adults (Rasmussen, Wardand Jenkins 2011) describes diabetes Mellitus as a life-long disease; it needs continued information for managing the disease process. Diabetes mellitus has become one of the major causes of premature illness and death in most countries, mainly through the increased risk of cardiovascular diseases (CVD). It accounts to between 50 -80% of deaths among people with diabetes. Lack of awareness about diabetes mellitus, combined with insufficient access to health services and essential medicines, can lead to complications such as blindness, amputation and kidney failure (Nathan 1993). This study is considered as a step or contribution to ways of preventing diabetes mellitus especially among the teenagers who are mainly in secondary schools in Nigeria.
In spite of great advances in diabetes mellitus care, diabetes is still linked with considerable premature mortality resulting from both acute and chronic complications of diabetes mellitus (Harjutsalo, Thomas, Moran, Forsblom, Thorn, Ahola, and Groop, 2011).

Young diabetic patients constitute a challenging group in diabetic care. In adolescence, self- image is being constructed and diabetes mellitus self-care becomes an integral part of daily life. It is the most appropriate time for diabetes mellitus education to in still a mastery over everyday care as well as an informed and right attitude towards diabetes mellitus (Tulokas, Luoto, Kinnunen, Aittasalo, Kolu, Raitanen, and Ojala 2011). Taking all the above mentioned facts, there is no doubt that this is a very relevant and current topic that needs to be investigated as it concerns the study areas.


1.7 Scope of the Study

The scope of this study is to ascertain the female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi Knowledge On The Risk Factors Of Diabetes Mellitus. The research also looks at the use of various communication channels to enhance students‟ knowledge about diabetes mellitus, while the research is limited to female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi.

The study assessed the effectiveness of various communication channels in aiding information about diabetes mellitus most especially to female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi.


1.8 Limitation of Study

Finance, inadequate materials and time constraint were the challenges the researchers encountered during the course of the study.


1.9 Definition of Concepts

Diabetes:

Diabetes mellitus is a condition where the blood sugar level is higher than normal.

Type 1 Diabetes Mellitus:

Is a condition caused by an autoimmune reaction, where the body’s defence system attacks the insulin-producing beta cells in the pancreas. The disease can affect people of any age, but usually occurs in children or young adults.

Diabetes:

Type of diabetes and usually occurs in adults, but is increasingly seen in children and adolescents. In diabetes, the body is able to produce insulin but either this is not sufficient or the body is unable to respond to its effects, also known as insulin resistance, leading to a build-up of glucose in the blood.

Gestational Diabetes:

Condition that occurs in women who develop a resistance to insulin and subsequent high blood glucose during pregnancy. Gestational diabetes tends to occur around the 24th week of pregnancy.

Insulin:

A hormone secreted by the pancreas that allows glucose from food to enter the body’s cells where it is converted into energy needed by muscles and tissues to function.

Knowledge:

This refers to what is known by an individual regarding diabetes mellitus, such as signs and symptoms, prevention, complications and treatment of diabetes.

Attitude:

This refers to the thinking or feeling of a person towards a healthy lifestyle including causes and prevention of diabetes

Risk Factors:

Contributory risks that leads to getting diabetes mellitus, such as family history of diabetes, obesity and overweight, inactive lifestyles, poor dietary intake.

Obesity:

Abnormal or excessive fat accumulation that may impair health.

Neuropathy:

The disease or dysfunction of one or more peripheral nerves and usually caused by diabetes mellitus.

Hypoglycemia:

Low blood sugar.

Hyperglycemia:

Elevated blood sugar level which over time leads to organ damage.


1.10 Organizations of the Study

The chapter one consist of the introductory part of the study which includes the study background, the statement of the research problem, the study objective and scope of the study.

The second chapter is a critical review of other literatures relevant to the study and its objectives including the theoretical framework for the study. While the third chapter is methods of data collection, sampling and data analysis used in conducting the study. The fourth chapter centres around the research findings including an analysis of how it relates to previous findings. The fifth chapter consists of the summary of findings, conclusion and recommendations base on the study objectives.


Chapter Five


Summary of Findings, Conclusion and Recommendations

5.1 Introduction

This chapter summarizes the findings on the prevalence and impact of diabetes mellitus among female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi as case study. The chapter consists of summary of the study, conclusions, and recommendations.


5.2 Summary of the Study

In this study, our focus was on the assessment of female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi knowledge on the risk factors of diabetes mellitus. The study is was specifically focused on describing the knowledge about the symptoms, risk factors and complications of diabetes mellitus as well as the sources of knowledge among female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi; describing the perceptions of female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi about diabetes mellitus; describing the attitudes of female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi towards diabetes mellitus and determining factors associated with the observed levels of knowledge, attitudes and perceptions towards diabetes mellitus female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 300 responses were validated from the enrolled participants where all respondent are female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi.


5.3 Conclusion

This study reveals that the general knowledge on diabetes mellitus was good among the female patients attending Nnamdi Azikiwe University Teaching Hospital Nnewi. Despite the respondents having good knowledge there were still misconceptions about diabetes related complications, risk factors and its treatment. In addition, attitudes and perceptions of respondents about diabetes were favourable and thus suggesting some level of understanding about diabetes.

This study demonstrates knowledge in the area of diabetes which requires the active involvement of the various actors in health education. Accounting for the disparities and uniqueness of the community will facilitate the development of appropriate strategies that will be culture sensitive as well as context specific. Furthermore, strategies will improve knowledge and therefore clear misconceptions thus leading to improvements in practices that promote healthy living.


5.3 Recommendations

Following the findings of this study, the following recommendations are made:

1. Health Education and Promotion:
  • A comprehensive health education and promotive programme for diabetes is necessary in order to raise awareness. Additionally, awareness should cover areas such as diabetes prevention, management and treatment as well as risk factors.
  • Diabetes prevention interventions need to focus on health education directed to the needs of heterogeneous communities in order to increase knowledge.
  • Intensive awareness through health education and information sharing needs to be advocated from a health perspective on diabetes to inform and educate the public at large.
  • Knowledge on management of diabetes and strategies for dealing with the condition was poor thus suggesting that management of diabetes should be included in education of the general public. Such action will allow non-diabetics to be able to have information that will help in assisting and supporting those with diabetes.
  • A more systematic education programme for diabetes education is necessary and should be implemented at all levels of healthcare, from the community to the highest referral level.
  • Such community health education interventions for diabetes need to take into account the disparity and uniqueness that exist between genders, age groups, place of residence, education level and employment status.
2. Policy Issues:
  • Community Health and Health Promotion Strategies of the Ministry of Health and Social Services should be tasked with health education and promotion related to diabetes in order for diabetes to be constantly on the agenda.
  • Health education on diabetes should be included in the continuing education programme for health care workers.
  • Health education on diabetes should be incorporated into the school health curriculum and be taught at all levels of education so that people can be aware of the condition very early in life.
3. Management Issues:
  • Health education and promotion should be included in the national, regional and district health plans.
  • Diabetes awareness campaigns should be allocated financial and human resources under the district, regional and national level budgets.
4. General Issues:
  • It is important to make diabetes management everybody‘s business due to the fact that everyone is affected directly or indirectly, that is, individual, families, communities, churches, schools, all government sectors, nongovernmental organizations, business communities and industries.
  • Include and encourage healthy lifestyle practices into the social and cultural ways of the lives of communities’ health education and awareness.

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