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REVIEW OF LITERATURE

1. Kanchana dussa, Parimalakrishnan s, Rakesh sahay 2015 has conducted study on


assessment diabetic knowledge using diabetic questionnaire among people with type 2
diabetes mellitus. The objective was Assessment of the diabetes knowledge using diabetes
knowledge questionnaire (DKQ) among Type 2 diabetes mellitus (T2DM) subjects and its
correlation with glycated hemoglobin (HbA1c) levels. Participants age range was from 36 to
75 years; mean age was 52.22 years. 78.38% were females and 21.62% were males, 59.45%
were illiterate in this study, 75.67% were using oral hypoglycemic agents only, 24.32% were
using insulin + oral hypoglycemic agents, none was reported to diabetes educator and
14.86% consulted dietician. DKQ mean score was 5.142.205 points, which was poor. 2.7%,
n=2, who were graduates had satisfactory knowledge of diabetes. DKQ score did not show
significant correlation with HbA1c levels but correlated with disease duration. They have
concluded that the level of diabetes knowledge in people with diabetes attending Osmania
Hospital was low. Majority of people were illiterate or their level of education was less.
Improving diabetes knowledge of these people with diabetes might allow achieving better
Glycaemic control. For effective management of diabetes involving a clinical pharmacist
with endocrinologist might achieve this objective of improving patient knowledge of diabetes
when followed longitudinally.7
2. Sadikalmahdi Hussein Abdella, Mohammed Adem Mohammed 2013 has conducted
study on Awareness of Diabetic Patients about their Illness and Associated Complications in
Ethiopia. A total of 118 diabetic patients were included in the study. Among the respondents,

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70 (59.33%) were males and 30 (25.42%) respondents were in the age group of 40 -49 years.
Majority 90 (76.27%) of the respondents were literate of which, 30 (25.42%) had completed
grade 9-12 and 16 (13.56%) respondents completed grade 12. Majority 53 (44.92%) of
respondents, did not know the type of diabetes they had. Of those who knew, 40 (33.90%)
were type II and 25 (21.2%) were type I. Among respondents, 85 (72.03%) patients had
knowledge about acute complications while 80 (67.80%) patients had knowledge about
chronic complications. They concluded that most diabetic patients have good knowledge on
actions to be taken on occurrence of acute complications and reason for development of acute
complications but health education should be given on a regular basis in order to update
patients with the disease.13

3. Mafomekong Ayuk Foma, Yauba Saidu, Semeeh Akin wale Omoleke and James Jafali
2013 has conducted study on Awareness of diabetes mellitus among diabetic patients in the
Gambia: a strong case for health education and promotion. Of the 199 patients who were
aware of their condition, only 47% said they knew what DM is. Similarly, 53% of the study
participants had no knowledge of the causes of DM and about 50% were not aware of the
methods of prevention. 67% knew that DM can result to loss of sight while 46.5% knew that
DM can cause poor wound healing. Few respondents knew that DM can lead to kidney
failure (13.5%), skin sepsis (12.0%), heart failure (5.5%) and stroke (4.5%). Close to 50% of
the respondent did not know how DM can be prevented. Level of education, duration of
illness and knowledge of a family member with diabetes were important predictors of
knowledge in our study .They has concluded that the majority of patients attending the
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MOPD have poor knowledge on several aspects of the condition including its causes,
complications, management and prevention. Hence there is an urgent need to raise the level
of awareness of this silent but deadly disease condition in the Gambian population.1
4.

Andreas Schmitt, Annika Gahr, Norbert Hermanns, Bernhard Kulzer, Jrg Huber and
Thomas Haak 2013 conducted The Diabetes Self-Management Questionnaire: development
and evaluation of an instrument to assess diabetes self-care activities associated with
Glycaemic control. The items showed appropriate characteristics (mean item-totalcorrelation: 0.46 0.12; mean correlation with HbA1c: -0.23 0.09). Overall internal
consistency (Cronbachs alpha) was good (0.84), consistencies of the subscales were
acceptable (GM: 0.77; DC: 0.77; PA: 0.76; HU: 0.60). Principal component analysis
indicated a four factor structure and confirmed the designed scale structure. Confirmatory
factor analysis indicated appropriate fit of the four factor model. They concluded that this
study provides preliminary evidence that the DSMQ is a reliable and valid instrument and
enables an efficient assessment of self-care behaviors associated with Glycaemic control. The
questionnaire should be valuable for scientific analyses as well as clinical use in both type 1
and type 2 diabetes patients. Thus, the DSMQ should benefit future research and also be of
value in clinical settings.

5. Zia Ur Rahman, Muhammad Irshad, Imran Khan, Farhat Ali Khan, Alija Baig, Qazi
Yasir Gaohar has conducted A survey of awareness regarding diabetes and its management
among patients with diabetes in Peshawar, Pakistan. The main objective of this study was to
determine and compare the level of awareness regarding diabetes mellitus, its complications
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and management in male & female diabetic patients of Peshawar, Pakistan and they
concluded that the overall level of awareness in both male and female diabetics was found
low; and comparatively female patients have poorer awareness. There is a big space for
raising the educational awareness about diabetes through formal, well organized approaches
by healthcare professionals in hospitals, clinics and community based healthcare centers.
Because the American Diabetes Association, clearly defined, the critical role of diabetes
education in quality diabetes care; diabetes self-management education is a critical element
of care for all people with diabetes and is necessary in order to improve patient outcomes. It
is recommended that health-care professionals both collaboratively and individually develop
programs and projects to meet this object.8

6. Abhijit ghadge, Suresh khadke, et al., 2013 has conducted awareness towards diabetes
mellitus in urban population of pune, Maharashtra, India. The objectives of this study were to
1.Toevaluate the level of knowledge of diabetes among the population in India ; 2) identify
areas of knowledge deficiency requiring additional education effort; and 3) evaluate whether
factors such as sex, older age, education level, own self having diabetes, and having family
member with diabetes are associated with knowledge of diabetes. They has summarized that
there is an urgent need for creating strong awareness about diabetes in general public by
various means. The importance of regular medical check-up after the age of 30 should be
highlighted. The diabetes awareness can be effectively created by awareness campaigns,
workshops, street plays and wide media coverage. Private and public health care
professionals should join hands in completing this task and the local governing bodies should
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draft a robust plan for these measures so as to make sufficient awareness about this serious
and abundant metabolic disorders.16

7. H l wee, h k ho, s c li 2002 has studied public awareness of diabetes mellitus in Singapore.
The objective of the study was to identify areas of knowledge that might require additional
educational efforts. A total of 1337 subjects were interviewed. The respondents were required
to answer 45 questions from a pre-tested questionnaire divided into five main sections,
namely, general knowledge, risk factors, symptoms and complications, treatment and
management, monitoring and other miscellaneous questions. The correct answer
percentages for the individual questions from each section ranges from 22 to 83% (General
knowledge), 31 to 91% (Risk factors), 48 to 81% (Symptoms and complications), 35 to 87%
(Treatment and management), and 58 to 93% (Monitoring of condition).They concluded that
public education of diabetes had been reasonably successful in terms of passing on
knowledge. However, it is not sure how strongly public education had encouraged people to
adopt a different lifestyle to reduce their risk of developing diabetes. Future studies could
look into this aspect. The mass media and the print media will continue to be important for
dissemination of information. It is believed that the Internet will become an important source
of healthcare information. The results of this study could contribute positively and
meaningfully to the design of future educational programme and materials. An improved
educational programme that tackles the areas of weaknesses or misconceptions can
potentially increase the level of public awareness of diabetes.6

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8. Shirin Jahan Mumu, Farzana Saleh et al., 2014 has conducted study on Awareness
regarding risk factors of type 2 diabetes among individuals attending a tertiary-care hospital
in Bangladesh: a cross-sectional study. The purpose of the study was to assess the level of
awareness regarding the risk factors responsible for the development of type 2 diabetes and
its determinants among individuals who attended a tertiary care hospital. They concluded that
Diabetes education and socio-demographic factors need to be considered to improve the
awareness regarding the risk factors of type-2 diabetes. Several studies have shown that type
2 diabetes can be prevented with the modification of lifestyles and by educating people or
developing awareness about the risk factors. From public health perspective, there is a
critical need for innovative target oriented prevention programs for people who are at risk of
diabetes as awareness programs may motivate general population and high-risk individuals to
adopt a healthy lifestyle, undergo routine medical check-ups, and be an active player in the
prevention of diabetes.4

9. Arnab N. Patowary, Jiten Hazarika and Manash P. Barman 2016 has studied assessment
of knowledge and awareness towards diabetes mellitus in Majuli, Assam of India: This study
is aimed to assess the level of knowledge and awareness of diabetes mellitus among the
people of river island Majuli, Assam of India which, will be of a great help to identify areas
of knowledge that might require additional efforts to increase. It can be concluded that inspite
of the government and other organizations have been taking different steps to enhance the
awareness level of the people towards various diseases having more prevalence, its impact on
the society of the study area is not up to the mark .More health education awareness
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programmes by all available sources such as TV, lectures, workshops are needed to address
this poor knowledge in order to equip them with the right information to positively affect on
the society in order to trim down the burden imposed by the disease.17

10. Maral F Thabit 2013has conducted study on awareness regarding diabetes mellitus and its
complications in type2 diabetes patient. The objective is to evaluate the level of awareness of
diabetes mellitus type 2 patients regarding their disease and its' complications. They
concluded the study as there is a Poor awareness of the included type 2 diabetic patients
concerning different aspects of the disease, especially regarding disease etiology, ideal
measurements, complications, follow up and management by life style modifications, drug
treatment and reliance on herbal medications.18
11. Ashok J. Vankudre, Manasi S et al.,2013 has conducted a study to assess awareness
regarding Diabetes Mellitus and factors affecting it, in a tertiary care hospital in
Kancheepurum District. This study was undertaken with the aim to assess awareness
regarding diabetes mellitus and factors affecting the awareness levels. Awareness regarding
all the aspects of diabetes mellitus needs to be increased for better control of the disease and
its complications. Females and unemployed individuals need to be given special emphasis
although diabetes action has been initiated, efforts are weak and fragmented. Progress is
impeded by a health system that places a higher priority on communicable diseases and
maternal and child health services and by a private health system driven by curative
medicine. However, prevention is cost-effective and should be a focus.24

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12. C.Muninarayana, G.Balachandra 2010 et al., has studied on Prevalence and awareness
regarding diabetes mellitus in rural Tamaka, Kolar. They concluded that this study reflects
the poor knowledge and awareness about diabetes in rural India. This emphasizes the need
for increasing diabetes awareness activities in the form of mass campaigns in both urban and
rural areas of India.9

13. M. Deepa, A. Bhansali, R. M. Anjana, et al., 2014 has conducted study on knowledge and
awareness of diabetes in urban and rural India: The Indian Council of Medical Research
India Diabetes Study (Phase I): Indian Council of Medical Research India Diabetes 4 .They
summarized that the present study provides a snapshot of the current situation of knowledge
and awareness of diabetes in four study regions in India. The study emphasizes the need for
improvement in knowledge and awareness both among the general population as well as
diabetic subjects in. order to achieve prevention and better control of diabetes and its
complications.11

14. Devi Kasinathan, Nisha Rajagopalan Girijakumari, et al., 2013 has conducted study on
Awareness on Type II Diabetes and Its Complication among Sivaganga District Population in
Tamilnadu, A Cross Section Survey. We conducted a cross sectional and face to face survey
on adults age group (30-80) in Sivaganga district. The questionnaire includes general status,
causes, family history, risk factors and alternative treatment practices. A total of 539 adult
were interviewed, 284 were diabetics and 255 were non diabetics. Among diabetic, Fifty
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three per cent of adults had hyperglycemia. Overall including diabetic and non-diabetics,
74.11% of them were not aware of the long term effects of diabetes and its complication.
Merely 48% of them were aware of the alternative treatment practices for diabetes and
among the 48% few of them know the diet plan. Conclusion of this present study, Sivaganga
district adults would have a significant suggestion for future public education programme.
Health care professionals may be additional proactive in disseminates health information
about diabetes to the public. Over all, the result of the study indicates, it is essential that the
health managers and authorities to take proper steps to increase the awareness among the
population regarding causes, symptoms, alternative treatment practices and management of
type II diabetes and its complication in order to build our community healthier and
prosperous.12

15. Dr. Purvi Mehta, Dr.VarshaGodbole, Dr.FalgunGosai, Dr. KrutikBrahmbhatt 2014 has
conducted study on

Knowledge of Diabetes and Self Care Practices in Chronic Diabetic

Patients Attending a Tertiary Care Teaching Hospital in India. A total of 100 patients were
included in the study. 58% were aware that diabetes can affect eyes, 54% aware about renal
complications of DM and 44% knew that DM is a cardiovascular risk factor. 44 % knew that
annual eye examinations were essential for early diagnosis and treatment. Only 14 % were
aware of annual urine-protein check and only 30% got their lipids checked annually. 67%
had regular BP checks and 28% did regular foot check.40% know their target sugar levels.
Only 5% were aware of Hba1C test. 84% patient knew about hypoglycemia and its treatment.
47% thought that DM is curable. An educational level of middle school or higher and
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duration of DM longer than 5years was associated with higher score. They have concluded
the study as there was largely inadequate knowledge about Diabetes, its complications and
importance of annual screening for complications. The importance of better Glycaemic
control and regular screening for complication should thus be emphasized by comprehensive
education and awareness which will no doubt help in reducing the mortality and morbidity
due to DM.3
16. Anju Gautam, Dharma Nand Bhatta et al., 2015 has studied on Diabetes related health
knowledge, attitude and practice among diabetic patients in Nepal. The objective of the study
was to determine the level of diabetes related health knowledge, attitude and practice among
diabetic patient and factors associated with KAP. A total of 244 diabetic patients were
interviewed from July to November 2014 More than half (52.5 %) of all patients were
female, 18 % were illiterate, and 24.6 % were from rural residence. The diabetes related risk
factors were common among diabetic patients; 9.8 % smoker, 16 % alcohol drinking, and
17.6 % reported low or no physical activity. Median score for knowledge, attitude, and
practice were 81, 40 and 14 respectively. Among all patients, 12.3 %, 12.7 % and 16 % had
highly satisfactory knowledge, attitude and practice respectively. They had concluded that
our institutional based cross-sectional study revealed diabetes related poor health knowledge,
improper attitude and poor practice among those who are affected by diabetes in low income
country Nepal. This study highlighted the factors that we need to consider while developing
health promotion activities. Further, health literacy, counseling and education program need
to be develop in both clinical and community settings. Our results show the potential diabetes
health literacy needs to be improved or developed for improved health promotion.9
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17. KP Mashige et al., 2008 has conducted study on assessment of the level of diabetic patients
knowledge of diabetes mellitus, its complications and management in Durban, South Africa.
The objective was to establish the level of knowledge about DM, its ocular complications
and management protocol amongst diabetic patients. A questionnaire was provided to a total
of 106 diabetic patients. The respondents were mostly females (65%), aged between 30 to 85
years (mean = 52.45 3.75 years). The majority (96%) of respondents knew about the
existence of two main types of DM and 77% reported having Type 2 DM, 18% reported
having Type 1 DM, and only 5% did not know the type of DM that they had. Many
respondents thought that hereditary factors (78%), and diet and lifestyle modifications (77%),
were important risk factors in the development of DM. They has concluded that further
studies be done to evaluate diabetic knowledge in other provinces among the rural and urban
population as well as on health care providers so that comparative inferences can be drawn.
This will assist in empowering patients and health care workers with knowledge of DM and
the importance of understanding treatment and management options.31
18. Swetha thungathurthi et al., 2012 has studied on self care knowledge on diabetes among
diabetic patients in Warangal region. This study was undertaken to identify, investigate and
evaluate the knowledge on diabetes among the patients, which would be helpful in planning
health programs to the patients. Four hundred and fifty six patients participated in the study.
In our study only 3.50 % diabetic population were with >80 % knowledge. 29.38 %
population was with 60-79 % knowledgeable, in which men with 81 (35.52%) were more
knowledge compared to women 53 (23.24%). This study reflects that there is a need to
improve diabetic knowledge among the patients which can achieved through community
health centers. It emphasizes to bring the awareness among the people in a right path and
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extend the diabetic health programs in mass campaigns thoroughly. It will be beneficial if a
diabetic clinic and information center for teaching diabetic patients is established. Also
nurses, doctors, dietitians and other health team members should join hands to help these
diabetic patients live healthy by providing them with the right information at every available
opportunity.13
19. Deepa Mohan, Deepa Raj, et al., 2014 has conducted study on Awareness and Knowledge
of Diabetes in Chennai -The Chennai Urban Rural Epidemiology Study. Of the total 26,001
individuals, only 75.5% (19642/26001) of the whole population reported that they knew
about a condition called diabetes or conversely nearly 25% of the Chennai population was
unaware of a condition called diabetes. 60.2% (15656/26001) of all participants and 76.7%
(1173/1529) of the self reported diabetic subjects knew that the prevalence of diabetes was
increasing in India. Only 22.2% (5764/26001) of the whole population and 41.0% (627/1529)
of the known diabetic subjects were aware that diabetes could be prevented. Knowledge of
the role of obesity and physical inactivity in producing diabetes was very low, with only
11.9% (3083/26001) of study subjects reporting these as risk factors for diabetes. Only
19.0% (4951/26001) of whole population knew that diabetes could cause complications.
Even among the self reported diabetic subjects, only 40.6% (621/1529) were aware that
diabetes could produce some complications. In conclusion, this study done on a large
representative sample of Chennai city in southern India reflects the poor knowledge and
awareness about diabetes in urban India. This emphasizes the need for increasing diabetes
awareness activities in the form of mass media campaigns, public lectures and door to door
campaigns on a massive scale in both urban and rural India.11
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20. Idongesit L. Jackson 2014 conducted study on Knowledge of self-care among type 2
diabetes patients in two states of Nigeria. The objective of the study was to assess the
knowledge of self-care practices, as well as factors responsible for such knowledge among
type 2 diabetes patients in two states of Nigeria. A total of 303 out of 380 questionnaires
distributed were completed and returned (response rate =79.7%). The majority of the study
sample (79.5%) had 70% or more overall knowledge level about self-care. Self-care
knowledge was associated with level of education (p<0.001), monthly income (p<0.001) and
duration of diabetes (p=0.008). Negative attitude to disease condition was the only factor
associated with knowledge (chi-square value at one degree of freedom =6.215; p=0.013).
They concluded that the Diabetes self-care knowledge was generally high among the
population studied. Educational status, monthly income, duration of diabetes and negative
attitude to disease condition predicted knowledge level.20
21. Tipaporn Pongmesa, et al., 2009 has conducted study on A Survey of Knowledge on
Diabetes in the Central Region of Thailand. The objectives of this study were to evaluate the
level of knowledge of diabetes among the Thai general population, identify area of
deficiency for targeted health education effort, and identify respondent characteristics that
may be associated with knowledge of diabetes. Mean age of respondents was 33.8 years (SD
13.4), with 57.5% being female. Mean diabetes knowledge score was fair: 25.02 of
42(59.6%), SD 8.35 (19.9%). Respondents performed best in the risk factor section: mean
(%) score was 2.88 of 4 (72%), SD 1.11 (27.8%); and worst in the section on diabetes in
women: mean (%) score was 0.82 of 3 (27.3%), SD 0.96 (32.0%). In multiple linear
regression analyses, education level, older age, own self having diabetes, and having a family
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member/relative/friend with diabetes were significantly associated with knowledge of


diabetes. They have concluded that the knowledge of diabetes among the study population
was fair (defined as 50<80%). Specific aspects of knowledge of diabetes that needed further
strengthening and specific groups that are suitable for future targeted public education
campaigns were identified. Such targeted public education programs would conceivably be
more cost-effective than campaigns aimed at the masses.28
22. Maryam Al-Hussaini, Sehams Mustafa 2016 has conducted study on Adolescents
knowledge and awareness of diabetes mellitus in Kuwait. This study aimed to evaluate the
awareness and the knowledge of diabetes in adolescent about the disease which, will be of a
great help to reduce the risk of developing diabetes and its complications. A total of 4333
students contributed. The main score obtained by the students was 63.2% of the maximum
total score. For General knowledge about diabetes sections scores were 71.0%,
Knowledge of risk factors of diabetes 63%, Knowledge of symptoms and
complications55.8%, Knowledge about treatment and management 62.7%, and
Knowledge of monitoring diabetes 72.3%. They concluded that the students contributed in
this study have good general information about diabetes except for a few areas. Our study
will clarify these areas to help in designing educational programs to treat these deficiencies
of knowledge about the disease and increase the awareness. 26
23. Patricio Fernando Lemes dos Santos et al., 2014 has conducted study on Knowledge of
Diabetes Mellitus: Does Gender Make a Difference? The objective of this study was to
evaluate the knowledge regarding DM in an adult population from a Middle-western
Brazilian city. This was a cross-sectional study covering 178 adults, aged 18e64 years, who
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answered a diabetes knowledge questionnaire. In order to identify the difference between


groups, analysis of variance was used. Higher knowledge scores were found regarding the
role of sugars on DM causality, diabetic foot care, and the effects of DM on patients
(blindness, impaired wound healing, and male sexual dysfunction). However, lower scores
were found amongst types of DM, hyperglycemic symptoms, and normal blood glucose
levels. Females tended to achieve better knowledge scores than males. They concluded that
this population of an inner town of central-western Brazil lacked knowledge regarding some
aspects of DM, especially men who had lower knowledge compared to the women.25
24. Desai Rujul, Parul Vadgama, Dhruv Parth 2012 has conducted study on effect of
awareness of diabetes on clinical outcomes of diabetes: an observational study at a private
hospital in Gujarat. The objective to assess existing awareness and gaps regarding diabetes in
patients of diabetes in a private hospital. The Mean knowledge score was 19.06 (SD=3.75)
out of 50. Dividing questions in to different aspects of disease knowledge, mean scores were
found to be below half of the maximum scores in all area except symptoms where it was 4.26
out of maximum 8. Gender, level of education and age was found to be significantly
associated with level of knowledge while type of occupation is not associated with it. Mean
level of random blood sugar, BMI and systolic blood pressure were 126.12 mg/dL, 30.49
kg/m2 and 143 mmHg respectively which are higher than normal. They have concluded that
a consequence of low awareness about the diabetes among patients is affecting their ability of
self management and hence having a negative impact on outcome of diabetes.32
25. Karam Padma, Samir D Bele et al., 2012 has conducted study on evaluation of knowledge
and self care practices in diabetic patients and their role in disease management. A total of
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117 diabetic patients consented and participated in the study of whom 63 (53.85%) were
male and 54 (46. 15%) female. Majority of the respondents (45.30%) between the age of 4150 years, 75 (64.10 %) belonged to lower class, and 60 (51.28 %) had a duration of disease
between 1 to 5 years. 71 (61.68%) were aware of importance of exercise for the control of
disease while 88 (75.21%) said that modification in diet is essential for the control of the
disease. 75 (64%) of the respondents had achieved Glycaemic control. Among self care
practices, following a controlled diet (p = 0.04), regular exercise (p = 0.04) and compliance
with drugs (p = 0.03) were significantly associated with the achieving Glycaemic control. As
evidenced by the study, patients who were more self aware about the disease, having
knowledge and regularly involved in self care practices achieve better Glycaemic control and
better management of the disease. Regular inculcation of health education, making the
patient aware regarding the disease and encouraging self care management during treatment
will reduce health care burden and help achieve optimal control of the disease with minimal
long term complications. 33
26. Mohd Nadzri Mohd Najib et al., 2012 has conducted a study on Knowledge and Attitude
on Diabetes among Public in Kota Bharu Kelantan, Malaysia .The objective of the study is to
evaluate the level of diabetes awareness in central region of Kota Bharu, Kelantan, and to
identify factors that influence this awareness. Out of 150 subjects, 49.33% were male and.
the educational level of the study population was high, with 54.67% of the having diploma
and degree level. There was a significant association between high knowledge on diabetes
with level of educational background (p<0.01). Most of respondents (66.0%) showed good
attitude toward diabetes awareness. About 33.30% stated that they never check for blood
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glucose level due to busy with work. Significant associations were found between good
attitudes toward diabetes with education level. (p<0.01).and with employment status
(p<0.01). The results of this study demonstrate that public in Kelantan are knowledgeable
about the disease and have good attitude toward diabetes awareness. Individuals with high
educational level, currently employed status and aged between 21 - 30 years were more
likely to have these attributes. The study strongly implicates that educational level,
employment status and age as the significant factors that influencing the knowledge and
attitude toward the disease. 30
27. Siham Ahmed Balla, Haider Abu Ahmed, et al., 2014 has conducted study on Prevalence
of diabetes, knowledge and attitude of rural population towards diabetes and hypoglycemic
event, Sudan 2013 The objective

was to identify prevalence of diabetes, population`s

knowledge, their attitude towards hypoglycemia event and factors associated with the level
of knowledge. The study included 1423 (42.9%) males and 1893(57.1%) females. The
prevalence of diabetes in rural population was 11.2%. Adequate knowledge about diabetes
was 15%. Genetics and nutrition habits were recognized as risk factors of diabetes by the
population, 57.2% & 46.9% respectively. Dizziness as a sign of hypoglycemia was
mentioned (38.1%) followed by rigors (24.4%), sweating (21.4%) and palpitation (17.1%).
Retinopathy (31.1%) and cardiovascular diseases (16.0%) were known by the study
population as complications of diabetes. The response of diabetic population towards
hypoglycemia event was significantly higher compared to non diabetic; p-value 0.001.They
concluded that the prevalence of diabetes in rural population in Sudan is high. Adequate
knowledge about diabetes is low and attitude towards hypoglycemic events is positive with
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significant difference between diabetic and non-diabetic population. Sex, age, education,
diabetes, family history of diabetes and smoking were factors that contribute to knowledge
about diabetes. Well planned education program is needed in the rural community.27
28. Shahnooshi Javad F et al., 2014 has conducted study on awareness of diabetes risk factor &
complications among diabetic population at a tertiary care teaching hospital. Objectives of
this study are level of awareness on diabetes risk factors and complications, Identify factors
that influence the awareness of diabetes risk factors, Identify factors that influence the
awareness of diabetes complications. With a response rate of 100%, all 110 patients which
included 70 (63.63%) males and 40(36.36%) females, participated in the study. Maximum
number 74 (67.27%) of participants were in the age group 41-60 years. 81.82% of patients
were >40 years of age. 41.81% of participants were illiterate. Around 1/3 of participant had
family history of diabetes and socioeconomic status of participants showed that 58.18% of
participants had 10-20 thousand Rupees income per month. 52 patients were newly
diagnosed as diabetes patient. The mean (SD) diabetes risk factor awareness score of all
participants was 3.1376150.125536 out of a total score of 7. The mean (SD) diabetes
complication awareness score of all participants was 2.4818180.091991 out of a total score
of 6. As we considered that, three and more, correct answer to risk factor and complication
was positive answer, 70% and 52.72% of participants had positive answer for diabetes risk
factor and complication respectively. Diabetic population in MVJ hospital has enough
knowledge of the general knowledge of diabetes regarding risk factors; however, they are not
very well aware of the diabetes associated secondary complications. Education was much
more significant as highly educated participants were more aware about diabetes risk factor
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and complications. Awareness of the risk factors and complications of diabetes is important
so as to heighten the need for disease prevention and early diagnosis among the general
public and for disease control among individuals with diabetes. Most of the participants were
not aware that sedentary life style, physical inactivity and diet are risk factors of diabetes. 38
29. Ahmad Ayaz Sabri, Muhammad Ahad Qayyum has conducted study on Comparing
knowledge of diabetes mellitus among rural and urban diabetics .The objective was to assess
the awareness of diabetes mellitus among rural and urban diabetics. The total number of rural
diabetic patients surveyed was 120. The majority of the population answered 6-10 questions
correctly out of a total of 25 questions asked. Similarly, 120 urban diabetic patients were
asked the same 25 questions. In this case, the majority of diabetic patients gave 16-20
answers correctly. The mean awareness among the rural population was 13 (SD} 2) correct
answers out of a possible 25. In the case of the urban diabetic patients, the mean awareness
was 18 (SD} 2) correct answers. They concluded that our study has provided direct
evidence that urban diabetic patients are more aware than rural diabetic patients about
diabetes mellitus. We have provided some discussion with regards to other factors that
determine the awareness level of diabetes mellitus.
30. Nehad M. Hamoudi et al.2012 has conducted study on Assessment of Knowledge and
Awareness of Diabetic and Non-Diabetic Population towards Diabetes Mellitus in Kaduna,
Nigeria. The objective of the study was to assess the knowledge and awareness among
diabetic and non diabetic Nigerian population in Kaduna state towards diabetes mellitus
(DM) different knowledge domain and, to evaluate diabetic patients awareness towards antidiabetic therapy, hypoglycemia management and their practical approach towards DM
control. Three hundred forty (340) subjects included 33.7% diabetic subjects and 66.2% non
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Assessment of diabetes related health knowledge, attitude and practice among diabetics and non
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diabetic participant. 78.96% of total participants have good knowledge towards DM etiology,
disease monitoring (70.6%), management (57.1%), and physical control (52.7%). Average
knowledge was recorded towards DM clinical manifestation (47.5%) and complication
(42.4%). Low knowledge response (38.3%) towards risk problems associated with high
blood pressure. 34.2% of diabetic participants are not aware about hypoglycemic symptoms
and 53.8% not aware about management of these symptoms. 47.9% of diabetic participants
did not have eye examination and 30.8% did not have urine test. Employed participants with
age group 40-60 years have significant knowledge towards DM etiology and complication
(P< 0.005). Diabetic female was significantly aware about practical management and control
of DM (P<0.005). They concluded that this study highlighted the need of people in Kaduna
state in Nigeria for better health information through large scale awareness interventions
regarding diabetes mellitus. This may be achieved by using audio-visual aids, as well as
posters showing patients with diabetes complications and their consequences such as lower
limb amputation, blindness and renal dialysis; hypoglycemic symptoms after drug treatment
such as weakness, confusion, and visual disturbances and how to control hypoglycemia. In
addition diabetic patient adherence to their anti-diabetic therapy can be achieved through
patient counseling by clinical pharmacist or health professional to improve diabetes care and
can go a long way in the prevention and management of diabetes. 30

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Assessment of diabetes related health knowledge, attitude and practice among diabetics and non
diabetics using self prepared questionnaire for awareness of health promotion

Chapter 2

Review of literature

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Assessment of diabetes related health knowledge, attitude and practice among diabetics and non
diabetics using self prepared questionnaire for awareness of health promotion

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Assessment of diabetes related health knowledge, attitude and practice among diabetics and non
diabetics using self prepared questionnaire for awareness of health promotion