Diabetic Patients’ Awareness And Compliance To Diabetic .

Volume 5, Issue 2, February – 2020International Journal of Innovative Science and Research TechnologyISSN No:-2456-2165the disease abound. The traditional and new media areutilized even groups, relatives and friends. Informationfrom these sources have impact on diabetic patient’sbehaviours (Gretchen, Susan & D’Vera, 2008). Theseinformation according to Dick, Nundy, Solomon, Bishop,Chin & Peek (2011) and Nundy, Dick, Hogan, Lu,Soloman, Bussie & Peek (2012) can be disseminated to thepatients as text messages either as mere information on thedisease or to remind them of their drugs or to remind themto monitor their glucose or to care for their feet. Also,medical libraries can be utilized for health information ondiabetes. These sources of health information on diabetescan be utilized effectively when readily available oraccessible. It is on this basis that the present study sought todetermine level of compliance of diabetic patients todiabetic information accessed through these varioussources.C. Compliance of Diabetic Patients to Diabetic HealthInformationCompliance to a diabetic health condition becomescomplete when the patients can take proper care ofthemselves based on the health messages given to them andmaintain the required blood sugar level. The seriousness ofthe disease itself alongside its complications can be viablein determining a higher quality of adherence (Shah, Murata,Duckworth, Hoffman & Wendel, 2003). Patients can easilybe at home with treatments which seems effective,treatments which its perceived benefits outweighs the costsand when they feel they have a better chance of success.Compliance of the patients can be determined from the waythe patients handle their health life in terms of medicationand things they should avoid or take as well as how oftenthey do those things (Soliman, 2003). However, someconditions like not remembering to take drugs or not beingable to reach or access the places they would be treated canlead to poor compliance or even the sizes of the drugs(Caraceni, Fainsinger & Foley, 2009).Several factors have been observed that interfere withtreatment compliance in type 2 diabetes specifically.Abdulazeez, Omole & Ojulari (2014) are of the view thateducation qualification of the patients can determinecompliance. WHO (2010) opined that non-compliance frompatients can be demographic (age, gender, educationallevel, and marital status) and psychological (patients'beliefs and motivation towards the therapy, negativeattitude, patient-prescriber relationship, understanding ofhealth issues, and patient's knowledge). Those on therapycan be route of medication, duration of treatment,complexity of treatment, and the side effects of themedicines, while those related to healthcare system can beavailability, accessibility and the physician (WHO, 2010).D. Empirical ReviewsAddisu, Eshete and Hailu (2013) conducted a study ondiabetic patients’ perception of diabetic disease and selfcare practice in Dilla University Referral Hospital, SouthEthiopia. The main focal of the study was to investigate theknowledge, perception and self-care practices of patientstowards the management of diabetes. It adopted theIJISRT20FEB511qualitative and quantitative methods. In the study, a total of310 participants with DM were interviewed. Face-faceinterviews were used for quantitative data; and qualitativedata were collected by in-depth interview. The study foundthat 76.8% of them had good practices of the recommendedself-care. Among the recommended self-care behaviours,drug adherence (93.2%), dietary in-take (49.7%), andregular exercise (44.5%) were the most practiced self-care.Self-blood glucose monitoring was the least practiced,which accounted 20%. Majority (79.4%) of the respondentswere knowledgeable about diabetes, but those diabeticpatients who were knowledgeable on DM were less likelyto practice recommended self-care practices in themanagement of their conditions.Connor, Goering, Matthias and Mac Neill (2011)investigated diabetic patients’ utilization of informationreceived. The study focused on patients’ perspectives onavailable sources of information related to diabetes. 21individuals (aged between 26 to 73 years) with Type 2 ofthe ailment were studied. In addition, interviewees wereasked to rate the importance of the most common sourcesof information. Findings were that diabetics receivedgeneral health information messages on diabetes, forexample; recommended in-take of medications, healthyeating choices, possible treatments, appropriate blood sugarcheck time and recommended supplements via sourceslike; print advertisements, television advertisements, theInternet, news reports, friends and family, doctors, spokeninformation from the pharmacist, other health providers,labels on prescriptions, written information provided bytheir pharmacist, magazine article, diabetes and educationprograms. Data also show that 71% of the respondentsrated doctors as the most important source of messages ondiabetes, closely followed by the internet, diabeteseducation programs and practitioners. 43% of diabeticpatients were discovered as not adhering to recommendedregimen by their sources.E. Theoretical FrameworkThis study is anchored on health belief model whichwas propounded by Becker and Maiman (1975). Thistheory believes that individuals will react positively againstany disease if they know that their positive actions willsave them from the severe consequences of the disease.According to Glanz, Lewis, & Rimer (1990), anindividual’s behavior can be predicted based on certainissues that the individual may consider (perceivedsusceptibility, perceived severity, perceived benefits, andperceived barriers) when making a decision about aparticular behavior concerning his or her health. Thus,diabetic patients in Southeast Nigeria may take theirtreatments if they see diabetes as severe ailment that maycost their lives.Applicably, diabetic patients in South-East Nigeriamay take heed towards recommended positive health actionif they understand their probably yet uncomplicated healthcondition may alter their existing plans, method of doingthings and attitudes in the progress of time. Furthermore,the level of believability in the efficacy of recommendedwww.ijisrt.com1150

Volume 5, Issue 2, February – 2020International Journal of Innovative Science and Research TechnologyISSN No:-2456-2165diet and aerobic regimen, as well as, the ease of practiceregarding the duo will determine the extent of adherenceamong diabetics in South-East Nigeria.III.METHODOLOGYThis study adopted the survey method. Using Comreyand Lee (1992), a sample size of 400 was drawn from atotal population of 10,612 which constituted diabeticpatients from three randomly selected federal hospitals inSouth-East Nigeria; University of Nigeria TeachingHospital, Enugu (UNTH), NnamdiAzikiwe UniversityTeaching Hospital, Nnewi (NAUTH) and Federal TeachingHospital, Abakaliki (FETHA). To arrive at the specificrespondents, a three step multi-stage sampling techniquewas adopted.IV.RESULTSResults from the survey which involved 400 diabeticpatients in South-East Nigeria were as follows:Fig 1:- Respondents’ SexThe respondents’ sex analysis presented in figure 1above shows that 64% of the respondents sampled wherefemale, while 36% were male. This data suggests adominant presence of the females among the total numberrespondents sampled in this study.Fig 2:- Respondents’ Age DistributionFigure 2 shows the respondents’ age, where the agebrackets of 31 – 43 were predominant with 57%. This wasfollowed by the respondents who fall under the age bracketof 44 and above with 29%. Only 14% were in the ageIJISRT20FEB511bracket of 18 – 30 years. These findings in figure 2 suggestthat respondents within the age bracket of 33 – 43 yearsconstitute the highest population sampled.www.ijisrt.com1151

Volume 5, Issue 2, February – 2020International Journal of Innovative Science and Research TechnologyISSN No:-2456-2165Table 1:- Respondents’ frequency of exposure to health care messagesTable 1 above establishes the frequency of exposureto health-care messages among the respondents via specificmedia channels. Across the array of media channels,through which diabetic patients receive health-caremessages, data show a regular level of exposure among lessthan half (36% down to 3%) of the respondents. Readingsfrom the data presented above also establishes that more ofthe respondents are occasionally exposed to health-caremessages, especially through interpersonal channels, healthposters, television, radio, newspapers and the Internet. Overtwo-third (85%) of the respondents sampled in the study arerarely exposed to health-care messages via magazines. Thiscould be as a result of the periodic nature of mostmagazines, with regards to its system of publication.Following this, about seventy-seven percent of therespondents are as well rarely exposed to health-careinformation on billboards. Since it appears, as shown bydata, that more of respondents are occasionally exposed tohealth-care messages through most of the possible channelsof dissemination, the implication is that this observed levelof exposure is most likely to be evident as regards theirlevel of exposure to health messages on talN 388100%Table 2:- Respondents exposure to health messages ondiabetesIn Table 2 there is an indication that (n 308) 79% ofthe diabetic patients are exposed to health information ondiabetes, whereas, (n 80) 21% are not. The stance that overtwo-third are exposed to health messages on diabetesimplies that exposure rate among the respondents is high.VariablesFrequencyPercentHealth ine41Health Workers9029NewspaperTotalN 310100%Table 3:- Respondents’ main source of exposure to healthmessages on diabetesAmong the respondents studied, the main source ofinformation was health workers. About (n 90) 29% saidthey depended on health workers for health messagesregarding diabetes. Sixteen percent noted they depended onradio for health messages on diabetes. Data also indicatedevenness (23%) among respondents who said theydepended on the Internet alongside those who depended ontelevision. About (n 25) 8% depended on health posters;while (n 4) 1% said the magazine was their main source ofinformation. This finding suggests that health workers (asinterpersonal sources of health information), the internetand television seem to be the preferred means of credibleand reliable health information among the respondents.This finding here chimes with what is obtainable inbehaviour change communication practice, whereinterpersonal communication strategy is a focal point foreffectiveness. Furthermore, giving the popularity of radio inNigeria and the audio-visual base of the television, moreuse, apparently, is made of these media for dissemination ofhealth nallyRarely8418541276013TotalN 310100%Table 4:- Respondents’ frequency of exposure to healthmessages on diabetes via their mainsources.IJISRT20FEB511www.ijisrt.com1152

Volume 5, Issue 2, February – 2020International Journal of Innovative Science and Research TechnologyISSN No:-2456-2165In the table above, an attempt was made to establishfrequency of exposure among diabetics, regarding theirmain source of information on diabetes. The data generatedshows that less than one-third of the respondents areregularly exposed to health messages on diabetes throughthe main source compared to above one-third of the samerespondents who received health messages on utritionalmanagementPhysical exercisesAccording to this table, more of the respondents areinclined to exhibit a care-free attitude towards adherence.For example, over half of the respondents (n 196, 63%), asrevealed by the data, occasionally adhere to messages onself-care education, (n 190)61% some of the time adhere todiabetic messages on self-care monitoring of blood glucose,while (n 177)57% occasionally adhere to diabetic healthmessages self-care practice of taking oor93TotalN 310100%Table 6:- Respondents’ evaluation of their level ofcompliance to health-care messages on diabetes.The study further accessed the respondents’ own viewon the nature of their adherence to diabetic information.This is intended to establish possible variations from thedata in Table 6. As seen in Table 6 above, (n 129) 42% ofthe respondents think their compliance level with regards toIJISRT20FEB511Self-monitoringblood glucoseSelf-careeducation58%37%24%30%(N 181)(N 115)(N 74)(N 94)33%36%61%63%(N 101)(N 111)(N 190)(N 196)9%27%15%7%(N 28)(N 84)(N 46)(N 20)100%100%100%100%(N 310)(N 310)(N 310)(N 310)Table 5:- Respondents’ rate of compliance to diabetic health messagesThe study then sought the opinion of the respondentson how frequently they apply some of the above diabetichealth messages to daily living. Table 5 displays thesummary of diabetic patients’ degree of adherence todiabetic health information. The data specified that thefrequency of adherence by the respondents sampled wasdistributed almost along the same percentage pattern withinthe various variables in the matrix. For example, (n 181)58% of the respondents regularly adhere to messages onnutritional management and (n 115)37% indicated thatthey adhere to messages on physical exercises all the time.In the Table also, (n 74)24% noted that they personallymonitor their blood glucose level regularly, whereas (n 94)30% affirmed to regular self-care education. Thirty-onepercent on the other hand, indicated regular adherence tomessages on self-care practice on taking medication.Variablesoccasionally through their main source, while the frequencyof exposure among those who rarely exposed to healthmessages on diabetes through their main source were intheir 10s. Thus the emerging data suggest a moderate levelof exposure to health information on diabetes among therespondents.Self-care practiceon takingmedication31%(N 96)57%(N 177)12%(N 37)100%(N 310)adherence to diabetic health messages is good. Also, morethan half (n 172 56%) of the respondents admitted to theircompliance level being fair, whereas, about 3% (N 9) seetheir compliance level as poor. This data chimes in withTable 6, where more of the respondents were inclinedtowards exhibiting a care-free attitude towards adherence torecommended positive health actions.V.DISCUSSION OF FINDINGSThis work provides insight into the extent diabeticpatients in Nigeria, particularly, South-East are exposed tohealth messages on diabetes and the level at which theycomply to recommended positive health actions via theirmain sources of information. It was revealed that there aremore female diabetic patients than the males in the sampledhospitals. The data also show that diabetic patients betweenthe age brackets of 31-43 constitute the highest number ofpatients who made up the study.From the findings of this study, the diabetic patientssampled in this study are moderately exposed to heathmessages on diabetes, through major sources like theInternet, the television and through health workers/doctors.The findings disagree with that of Addisu, Eshete and Hailu(2013), which found that 79.4%, representing the majority,were exposed to health messages on diabetes. This reducedexposure among diabetic patients as it is evident in thispresent study can imply that exposure, as a variable,changes amidst time and other influencing factors. Thefinding that major sources of information on diabetesamong the respondents were Internet, television and healthworkers closely chimes in with that of Connor, Goering,Matthias and Mac Neill (2011), which established that 71%of the respondents rated doctors as most important sourcesof information on diabetes, closely followed by other healthprofessionals and then, the Internet. Although other sourcesof information were seen to be relatively unimportant, afew of the patients indicated they were their major sourcesof information. This will suggest that believability is morewww.ijisrt.com1153

Volume 5, Issue 2, February – 2020International Journal of Innovative Science and Research TechnologyISSN No:-2456-2165likely to be accorded to interpersonal forms ofcommunicating health messages, like diabetes, more thanany other source.This study was able to establish respondents’compliance to health messages on diabetes. Data on selfevaluation of diabetic patients’ compliance equally showslaxity, giving the stance that more than half (56%)indicated a fair compliance level, while less than two-fourth(42%) affirmed otherwise. Three percent poorly complywith recommended regimen. Though the percentageinvolved in the context of this study might seem negligible,further research in other context might reveal somethingmore significant.VI.CONCLUSION AND RECOMMENDATIONSMost of the patients studied were yet to take the issueof compliance to a level that commiserates with theseriousness of the disease. This finding chimes in with thefirst scenario that had been envisaged in the frameworksupporting this study. Also, as stated, the HBM explainsthis finding, because those respondents who compliedregularly with recommended regimen, and who indicated agood compliance level, most likely have a specific healthbelief about their vulnerability to the risk or thecomplications associated with diabetes and also beliefsabout the consequence of a complicated health status. Thefindings from this study on the respondents level ofcompliance is supported by that of Oladapo, Koleosho andAyodele (2013), where it was established that the fastingblood sugar of the respondents was above the normal range,an indication that the diabetics were carefree about theirdietary lifestyles.Therefore, the researchers recommend that; Enough education and training programme should beprovided, using a multi-media approach, for all diabeticpatients and their relatives and supplemented usingposters with pictures that can be understood by all, itsmanagement and prevention of diabetes complicationsto provide the patients with the necessary and requiredknowledge and skills. Since findings indicated that doctors/other healthprofessionals emerged higher as major sources ofinformation, using the mass media, the physiciansshould therefore be encouraged and further sensitizedon the need to continue living up to expectation in thedissemination of helpful health messages while creatingand maintaining a cordial doctor-patient relationship. Considering the finding that the print media, especiallynewspapers seem to have failed in its socialresponsibility role, it becomes imperative that owners ofprint media establishments and media houses in generalto be up and doing in rendering their lawful services totheir informati

information according to Dick, Nundy, Solomon, Bishop, Chin & Peek (2011) and Nundy, Dick, Hogan, Lu, Soloman, Bussie & Peek (2012) can be disseminated to the patients as text messages either as mere information on the disease or to remind them of their drugs or to remind