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    KNOWLEDGE, PERCEPTION, ILLNESS-RELATED EXPERIENCES AND TREATMENT COMPLIANCE AMONG DIABETES MELLITUS PATIENTS IN SELECTED HOSPITALS IN IBADAN, OYO STATE, NIGERIA
    (2014-11) OYELAMI, F. I.
    Diabetes Mellitus (DM) is a chronic disease of public health importance in Nigeria. However patients’ knowledge, perceptions, practices and experiences relating to DM seems not to have been sufficiently investigated. This study was therefore designed to determine DM-related knowledge, perception, illness-related experiences and treatment compliance among diabetics in selected hospitals in Ibadan. The study was a cross-sectional survey involving systematic random sample of 600 out of 2,115 diabetes patients receiving treatment at the following purposively selected health care facilities: University College Hospital, Ring-Road State Hospital and Oluyoro Catholic Hospital. The semi-structured questionnaire used for data collection included 45-point knowledge and 32-point perception scales, questions on socio-demographic characteristics, illness-related experiences and treatment compliance. Knowledge scores of 1- 20, 21 - 35 and 36 - 45 were considered poor, fair and good respectively. Perception scores of ≤16 and ≥ 17 points were categorized as negative and positive respectively. Descriptive statistics, Chi-square test and t-test were used for data analysis at p< 0.05. Mean age of the respondents was 63.9 ± 8.6 years, 75.3% were married and 62.7% were females. Respondents’ sources of information about DM included doctor (41.0%), radio (29.3%) and friends (27.3%). Mean knowledge score was 36.6 ± 5.8. Respondents with poor, fair, and good knowledge were 2.5%, 32.5%, and 65.0% respectively. Majority (87.8%) were aware that diabetics could take most food substances in small amounts. Respondents’ mean perception score was 21.8 ± 4.8. The positive perceptions included views that DM cannot be cured (69.2%) and Physical Exercise (PE) can be used to control DM (90.0%) while negative perceptions included views that it is the best types of food health care providers tell diabetics not to eat (68.7%), and too much time is wasted in the clinic (75.8%). Respondents with overall negative and positive perceptions were 6.0% and 94.0% respectively. Perceived diabetic-related symptoms experienced within three months preceding the study included: cramps (72.0%), excessive hunger (73.8%), profuse sweating (75.5%) and severe thirst (77.8%). None of the respondents complied with all the DM recommended treatment practices. Non–compliance related practices among the respondents’ included: failure to go to the hospital for regular checkup (51.5%), failure to take drugs as a result of forgetfulness (50.2%) and excessive consumption of food which ought to be taken in small quantities (43.8%). A major challenge faced by the diabetics was high cost of drugs as stated by the respondents (69.0%). There was no significant difference in respondents’ mean scores by sex (male=36.6 ± 5.6; female = 36.5 ± 6.0). Similarly, there was no significant association between perception that DM could be controlled by PE and respondents’ age. Knowledge of majority of respondents was high and many had appropriate perceptions needed to cope with the disease. However, inadequate compliance with various measures for managing the disease constitutes a concern which could be addressed by patient education and social support.
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    HEALTH SEEKING BEHAVIOUR AND PATTERN OF ADHERENCE TO TREATMENT AMONG PATIENTS WITH TYPE-2 DIABETES MELLITUS IN CENTRAL HOSPITAL WARRI, DELTA STATE
    (2013-05) AGOFURE, O.
    Type-2 Diabetes mellitus (T2DM) could be well managed if patients adhere strictly to treatment regimen. Adherence to treatment (ATT) is a major challenge among patients with T2DM partly because the disease requires lifelong management to prevent the onset of complications. Previous studies on ATT have not been linked with studies on Health Seeking Behaviours (HSBs). Consequently, a study on HSBs and factors influencing ATT of patients with T2DM will be useful for its effective management. This study was therefore designed to investigate HSBs and pattern of ATT among T2DM patients in Central Hospital Warri, Delta State. A cross-sectional study was conducted among 350 purposively selected patients with T2DM. A semi-structured questionnaire was interviewer administered to obtain information on respondents’ socio-demographic characteristics, HSBs, level of ATT, factors influencing ATT and suggestions on ways of improving ATT. A 14-point scale graded; poor (0-8) and good (>8) was used to measure HSBs. A 24-point scale graded; partial (0-13) and strict (>13) was used to measure ATT. Descriptive statistics, Chi-square test and logistic regression were used to analyse the data with level of significance set at 0.05. Mean age of respondents was 57.9 ± 9.8 years, 60.9% were females and 78.0% were married. More than 95.0% exhibited good HSBs and 58.0% adhered strictly to treatment. Analysis of the determinants of non-adherence to treatment showed that taking alternative traditional medicines (herbs) for treatment of the disease was the major contributing variable (OR = 2.5, 95% CI = 4.55-1.69). Factors that hindered adherence included difficulty in sticking to prescribed diets (69.1%) and the least was busy schedule of doctors to listen to patients’ complaints (0.3%). Respondents who were diagnosed with T2DM at mid-adulthood (40-49 years) did not significantly exhibit strict ATT (27.7%) more than those (15.4%) who were diagnosed at late-adulthood (50-59 years). Suggestions on ways of improving ATT included self discipline (46.9%) and encouragement from healthcare personnel (44.0%). Lack of awareness about the disease (42.6%) was a major challenge confronting patients with T2DM. One of the ways of overcoming the challenges of T2DM was creation of awareness as suggested by 39.1% of respondents. Respondents exhibited good health seeking behaviour but use of alternative medicine (herbs) remains a major challenge among patients with type-2 diabetes mellitus. Health education on diabetic care with emphasis on adherence to treatment regimen, among other strategies, should be organised regularly for diabetic patients.
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    HEALTH SEEKING BEHAVIOUR AND PATTERN OF ADHERENCE TO TREATMENT AMONG PATIENTS WITH TYPE-2 DIABETES MELLITUS IN CENTRAL HOSPITAL WARRI, DELTA STATE
    (2013-05)
    Type-2 Diabetes mellitus (T2DM) could be well managed if patients adhere strictly to treatment regimen. Adherence to treatment (ATT) is a major challenge among patients with T2DM partly because the disease requires lifelong management to prevent the onset of complications. Previous studies on ATT have not been linked with studies on Health Seeking Behaviours (HSBs). Consequently, a study on HSBs and factors influencing ATT of patients with T2DM will be useful for its effective management. This study was therefore designed to investigate HSBs and pattern of ATT among T2DM patients in Central Hospital Warri, Delta State. A cross-sectional study was conducted among 350 purposively selected patients with T2DM. A semi-structured questionnaire was interviewer administered to obtain information on respondents’ socio-demographic characteristics, HSBs, level of ATT, factors influencing ATT and suggestions on ways of improving ATT. A 14-point scale graded; poor (0-8) and good (>8) was used to measure HSBs. A 24-point scale graded; partial (0-13) and strict (>13) was used to measure ATT. Descriptive statistics, Chi-square test and logistic regression were used to analyse the data with level of significance set at 0.05. Mean age of respondents was 57.9 ± 9.8 years, 60.9% were females and 78.0% were married. More than 95.0% exhibited good HSBs and 58.0% adhered strictly to treatment. Analysis of the determinants of non-adherence to treatment showed that taking alternative traditional medicines (herbs) for treatment of the disease was the major contributing variable (OR = 2.5, 95% CI = 4.55-1.69). Factors that hindered adherence included difficulty in sticking to prescribed diets (69.1%) and the least was busy schedule of doctors to listen to patients’ complaints (0.3%). Respondents who were diagnosed with T2DM at mid-adulthood (40-49 years) did not significantly exhibit strict ATT (27.7%) more than those (15.4%) who were diagnosed at late-adulthood (50-59 years). Suggestions on ways of improving ATT included self discipline (46.9%) and encouragement from healthcare personnel (44.0%). Lack of awareness about the disease (42.6%) was a major challenge confronting patients with T2DM. One of the ways of overcoming the challenges of T2DM was creation of awareness as suggested by 39.1% of respondents. Respondents exhibited good health seeking behaviour but use of alternative medicine (herbs) remains a major challenge among patients with type-2 diabetes mellitus. Health education on diabetic care with emphasis on adherence to treatment regimen, among other strategies, should be organised regularly for diabetic patients.