Predictors of Adherence to Self-Care Behavior Among Patients with Diabetes at Public Hospitals in West Ethiopia

Abstract

Background

Diabetes is a typical chronic disease that needs integrated and multifaceted approaches. Self-care practices are fundamental to achieve good blood glucose control and prevent long-term complications. Therefore, the aim of the study was to determine the level and predictors of adherence to self-care behavior among patients with diabetes on follow-up at public hospitals of western Ethiopia.

Patients and Methods

The cross-sectional study design was employed on a sample of 423 diabetic patients on follow-up at public hospitals of western Ethiopia. A systematic random sampling method was employed. The data were entered into Epi data version 3.1 and exported into Statistical Package for the Social Sciences window version 24 for analysis. All variables significant at p-value <0.05 in the bivariable were entered in multivariate regression analysis. Backward stepwise goodness of fit was used to ascertain the suitable variables in multiple linear regression analysis. Finally, multivariate linear regression analysis with adjusted B, CI at 95%, and the significance level was set at p <0.05. All predictive variables were reported in terms of adjusted R2.

Results

The overall mean and standard deviation of adherence to self-care behavior was 23.09 ±6.55. Among the study participants, 42.70% had good self-care behavior. Self-efficacy (B=0.106, p<0.001), home blood glucose test (B=0.075, p<0.001), exercise per week (0.035, P<0.002), meal planning (B=0.039, P<0.001), dietary restriction (B=0.077, P<0.001), duration of diabetes<4 years (B=0.030, P<0.013), non-pharmacological intervention (B=0.055, P<0.011), and good appetite (B=0.039, P<0.045) were significant variables associated with adherence to self-care behaviors.

Conclusion

The overall level of adherence to self-care behavior was low. Therefore, we recommended that it is better if the national health policymaker focused on dietary management modality that engages patients’ behavior change to develop self-care practices and closely monitoring of glucose level. Also, we recommended an additional longitudinal study incorporating a qualitative study that focused on behavioral changes.

Keywords:

• diabetes mellitus
• adherence
• self-care behavior
• Ethiopia

Abbreviations

ADA, American Diabetes Association; BMI, Body Mass Index; DMSES, Diabetes Mellitus Self-efficacy Scale; SDSCA, Summary of diabetes self-Care Activities; HIV, Human Immunodeficiency Virus; SE, Standard Error; SD, Standard Deviation; SMBG, self-monitoring of blood glucose; T2DM, Type Two Diabetes Mellitus; VIF, Variance Inflation Factor.

Data Sharing Statement

The data used during this study are available from the corresponding author on reasonable request.

Ethical Approval and Consent to Participate

The study was reviewed and approved by the Institutional Review Boards of Wollega University Ethical review board. The purpose of the study was explained to the medical director and staff of the hospital and permission was obtained. All participants of the study were provided written consent, clearly stating the objectives of the study and their right to refuse. No minors were involved in the study and the consent was obtained from the participants themselves. Moreover, the confidentiality of the information was assured.

Acknowledgment

We would like to acknowledge Wollega University for financial support. We also would like to acknowledge Wollega public hospitals. We are also grateful to the study participants who voluntarily agreed to be interviewed and participated in the study.

Author Contributions

All authors contributed to data analysis, drafting and revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

We declare that we have no competing interests.

Additional information

Funding

This research work was funded by Wollega University. The funder did not participate in designing and data collection, analysis, writing, and submission of the article for publication.