ADHERANCE TO DIABETIC SELF-CARE MANAGEMENT AND ASSOCIATED FACTORS AMONG TYPE 2 DIABETIC PATIENTS IN NORTH SHEWA ZONE PUBLIC HOSPITALS AMHARA REGION, ETHIOPIA 2023.

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