KNOWLEDGE AND ATTITUDE OF TYPE II DIABETIC PATIENT AND THEIR UTILIZATION OF MANAGEMENT APPROACHES IN AKWA IBOM STATE
ABSTRACT
Diabetes as one of the major causes of death and disability globally had been a major problem affecting both the elites and the illiterates populations in Akwa Ibom State. The study was then designed to determine the knowledge and attitude of type II diabetic patients and their utilization of management approaches in Akwa Ibom State. To achieve this purpose, five specific objectives and corresponding research questions were raised, and five hypotheses postulated for the study. Cross sectional survey design was used for the study. Multi stage random sampling was used to select 1704 patients representing five per cent of the population of 34,045 diabetic patients. The instrument used for data collection was Type II Diabetic Patients Knowledge and Attitude toward Utilization of Management Approaches Questionnaire (TII DPKAUMAQ). This was validated by three experts. The instrument was subjected to reliability test using split-half approach and the reliability coefficient of 0.89 was obtained after analysis. The research questions were answered using percentages and mean while chi-square was used for hypothesis 1-2, and t-test for hypothesis 3-5. The findings showed insignificant knowledge on the disease management approaches. Low attitude in management and significant difference in attitude towards management approaches in urban and rural areas. It was recommended that mass literacy campaigns should be embarked on to enhance literal status thereby enhancing their understanding especially on health matters and more health organizations to be established and equipped to help patients in all areas.
CHAPTER ONE
INTRODUCTION
Background of the Study
The high prevalence of diabetes mellitus has been reported worldwide and its related complications continue to be of great concern (Whiting, Guariginta, Weil and Shaw, 2011). Diabetes is one of the chronic diseases which are now the major causes of death and disability globally and mainly in low income countries. Regrettably these countries bear the dual burden brought about by infectious and chronic diseases. According to World Health Organization (2009), over 30 percent of our elite population including decision makers are diabetics and majority of the Nigerians who are affected cannot afford meaningful treatment with many being ignorant of the disease.
Diabetes is a metabolic disorder or chronic disease characterized by chronic hyperglycemia with disturbances of carbohydrates, fat and protein metabolism resulting from a quantitative deficiency of insulin, an abnormal insulin level resistance to its action or a combination of deficits. Insulin is a hormone that controls glucose, fat and amino acid metabolism and is produced by beta cells from the islet of langarhan in the pancreas. The disease is a public health concern and account for 3.8 million deaths per year (World Bank, 2012).
According to Orchard (1994) two major types of diabetes are recognized – type I diabetes formerly referred to insulin dependent diabetes which comprises about ten percent of all cases, and type 2 diabetes formerly referred to as non-insulin dependent diabetes which accounts for about ninety percents of the cases. Type two diabetes may occasionally occur as a result of other diseases such as acromegaly and cushings syndrome.
Orchard (1994) also asserted that diabetes can be drug induced (for example by steroids and possibly by the thiazide discretics and oral contraceptives) or induced by the disease affecting the pancreas such as cancer of chronic pancreatitis. Gestational diabetes also occurs during pregnancy but remits shortly after delivery. Impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) which is prediabetes are conditions in which blood glucose is elevated but not high enough to be classified as diabetes but may carry increased risk of large vessel (Coronary heart) disease.
According to Park (2013) unfavourable modification of lifestyle and dietary habits that are associated with urbanization are believed to be the most important factors for the development of diabetes. He further postulated that a bulk of evidence from studies on migrants indicates that the ethnic, presumably genetic vulnerability of Asians manifests into diabetes when subjected to unfavourable lifestyles. His surveys indicated considerable increase in the prevalence rate of the disease in both urban and rural dwellers when compared to earlier result obtained. He still lamented on the inadequate awareness about the real dimension of the problem among the general public and the lack of awareness about the existing interventions for preventing diabetes and the management of complications.
Health knowledge is then necessary in curbing the menace of this diseases. According to Moronkola (2001), health knowledge is acquired from sources which directly or indirectly influence the individual’s health attitude and practice. Arogundade and Erakpotober (2005) affirmed that behaviour turns to attitude and then to habit. Ojo (2005) was of the opinion that health behaviour otherwise known as healthy life styles which help to increase an individual sense of wellbeing can act as a buffer against diseases like diabetes.
A person’s attitude therefore plays a significant role in effecting and determining his or her health. As asserted by Rennie (1999) attitude could be viewed as a way of thinking or feeling which could be positive or negative to people, objects or ideas in ones environment. Therefore a positive behaviour and attitude is favourable to health while a negative behaviour and attitude is detrimental to health. According to Mullooly & Kermis (2005) an impact can only be made on behaviour when the patient has a good understanding of the disease process (informational approach) as well as disease management. Park (2013) also added that for a successful management of any disease condition affecting man an understanding of the behaviour of the individual is necessary.
Ikorok, Ekpu and Assian (2010) refer to disease as harmful departure from normal functioning of human system, and the desire to return to good health is the basic reason for seeking healthcare services. According to Achalu (1999) various reasons come into focus, this is probably due to the fact that health issues depend on many other factors not related to medical science only. In Nigeria like many sub-saharan African countries both traditional (non-scientific health care service provided by lay men) and modern health care services (healthcare based on scientific methods and technological knowledge are available (Ademulegun, 2002).
The utilization of either of the health services depend largely on many factors which determine health. Utilization according to Crowder (1998) is an act of making use of, find use for or being used effectively. One can only make use of something with an aim of receiving maximum benefit. Therefore utilization of management approaches in this study is based on approaches used in prevention and control of diabetes. Health care services are designed to provide benefits to patients. The utilization of modern health care system implies both accessibility of care, facility and the willingness of persons to use such care available.
KNOWLEDGE AND ATTITUDE OF TYPE II DIABETIC PATIENT AND THEIR UTILIZATION OF MANAGEMENT APPROACHES IN AKWA IBOM STATE