Abstract:
Introduction: Adherence to diabetes self-care management is a lifestyle modification for people with
diabetes.
The Objective:- To assess adherence of diabetic self-care management and associated factors among type
2 diabetic patients in North shewa public hospitals, Ethiopia 2023.
Methods: The study employed a concurrent mixed-methods approach among 600 type 2 diabetic patients
in north shewa zone public hospitals, Amhara Ethiopia. The study was conducted from May 5 –May 20,
2023. The quantitative data was collected by using semi-structured interview-administered questionnaire
and chart review. Logistics regression was employed, and a p-value <0.05 was considered statistically
significant. Qualitative data was collected by in-depth interview and audio recorded was first transcribed
verbatim and then translated to the English language by the first author and was analyzed manually using
thematic approach.
Result: - Out of the total 600 type 2 diabetic patients 262 (43.7%) with (95% CI: 40–47.8%) of the study
participants had good adherence to diabetes self-care practices. The multivariable analysis indicated that
type 2 diabetic patients who lived in urban area [AOR: 5.4, 95%CI: (1.05-8.7)] were 5.4 times more likely
had good diabetic self-care practice than those rural residents. Those who attended high school level [AOR:
2.9, 95% CI: (1.3-6.6)] were 2.9 times more likely had good self-care practice, college & above [AOR: 5,
95%CI: (2-12)] were five times more likely had good self-care practice. Regarding to occupation
unemployed was less likely by 66% had good self-care practice than employed. No availability of health
care services [AOR: 0.19 95% CI: (0,09-0.37)] were less likely by 81% had good self-care practice than
availability of health care services. These are significantly associated with diabetic self-care practice. The
qualitative component clarified six themes lack of education & awareness, financial affordability,
accessibility, lack of family support & having diabetic related complication were identified as barriers.
Conclusion and Recommendation: - This study indicated that adherence of patients with type 2 diabetes
to the recommended self-care practices was considerably poor. Different factors, including the respondents
who attended in high school level, higher level of education, who were lived in urban, unemployed and the
respondents who had no availability of health care services had statistically significant with self-care
practice. This was supported by the results from the qualitative part & thus the endorsement to strengthen
diabetes health education to patients & their families. So diabetic patients require an integrated approach
through treatment as well as health education which will increase the health and well-being of the patient.
Key words: type 2 diabetes mellitus, adherence to diabetes self-care practice, North Shewa Zone
