https://orcid.org/0000-0002-9249-0283
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Abstract
Objective
The purpose of this study was to determine the level of adherence to diabetes self-management and associated factors among adolescents living with type 1 diabetes at Public Hospitals in Addis Ababa, Ethiopia.
Methods
An institutional-based cross-sectional study was carried out among 422 adolescents with type 1 diabetes attending outpatient diabetic clinics at public hospitals in Addis Ababa. The adolescents were interviewed using pretested questionnaires to give information on adherence to diabetes self-management. A variable that has a P-value of <0.2 in bi-variable logistic regression analysis was subjected to multivariable logistic regression analysis to control the confounding factors. The level of significance was pronounced at P-value <0.05.
Results
In this study, a total of 414 adolescents living with type 1 diabetes were interviewed making a 98.1% response rate. About 218 participants (52.7%) had poor adherence to overall diabetes self-management. Self-efficacy (AOR=8.7, 95% CI:1.9–14.1, P=0.005), social support (AOR=4.6, 95% CI:1.5–13.5, P=0.006), age (AOR=0.2, 95% CI:0.1–0.4, P=0.001), good knowledge of the disease (AOR=9.046, 95% CI:3.83–13.5, P=0.000), moderate knowledge (AOR=6.763, 95% CI:2.18–12.921, P=0.001), and time since diagnosis of type 1 diabetes (AOR=0.1, 95% CI:0.02–0.2, P=0.005) were significantly associated with adherence to diabetes self-management.
Conclusions and Recommendations
More than half of this population had poor adherence to diabetes self-management. The finding suggested that implementing a comprehensive guideline of adherence and expanding the recurrence of follow-up visits could be important for this population.
Abbreviations
ADSM, Adherence to diabetes self-management; AOR, Adjusted Odd Ratio; COR, Crude Odd Ratio, DKA, Diabetic Ketoacidosis; DKT, Diabetic Knowledge test; DSMP-SR, Diabetes Self-Management Profile Self report; T1D, Type 1 Diabetes.
Data Sharing Statement
All related data have been presented within the manuscript. The data set supporting the conclusion of this article is available from the corresponding author upon reasonable request.
Ethical Consideration
To get ethical approval for this study, a letter was written by Addis Ababa University, College of Medicine and Health Sciences to the Addis Ababa Public Health Research and Emergency Management Directorate. Then Ethical approval was obtained from the Addis Ababa Public Health Research and Emergency Management Directorate (Ref.No: A/A/H/7534/227). Finally, a formal letter was written to the respective health offices and study facilities before going for data collection.
Written assent along with parental written consent was obtained from all subjects before the study. Participants and their parents were briefed about the objectives and aims of the study in detail. Participants were informed that their participation is purely voluntary and assured of the confidentiality of all information. Confidentiality of the data was assured throughout the study. Moreover, there are no invasive procedures in this study and it was conducted following the declaration of Helsinki.
Acknowledgments
Primarily, we would like to express our deepest gratitude to Addis Ababa University College of Health Sciences and Dire Dawa University for the logistic support of the study. Then, we would also like to extend our appreciation to public health facilities in Addis Ababa city for giving us the appropriate information. Finally, our heartfelt thanks go to data collectors, supervisors, study participants, and data clerks. Finally, we would like to acknowledge Addis Ababa University institutional repository that stores the thesis and allows us to retrieve this article from the thesis. The source of this article is a thesis found in the Addis Ababa University Institutional repository at: http://etd.aau.edu.et/handle/123456789/29448.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agreed to be accountable for all aspects of the work.
Disclosure
The authors declare that they have no conflicts of interest for this work.