Determinants of diabetes knowledge in a cohort of Nigerian diabetics

BACKGROUND: One of the consequences of the generational paradigm shift of lifestyle from the traditional African model to a more "western" standard is a replacement of communicable diseases by non-communicable or life style related diseases like diabetes. To address this trend, diabetes education along with continuous assessment of diabetes related knowledge has been advocated. Since most of the Nigerian studies assessing knowledge of diabetes were hospital-based, we decided to evaluate the diabetes related knowledge and its sociodemographic determinants in a general population of diabetics. METHODS: Diabetics (n = 184) attending the 2012 world diabetes day celebration in a Nigerian community were surveyed using a two part questionnaire. Section A elicited information on their demographics characteristics and participation in update courses, and exercise, while section B assessed knowledge of diabetes using the 14 item Michigan Diabetes Research and Training Centre's Brief Diabetes Knowledge Test. RESULTS: We found that Nigerian diabetics had poor knowledge of diabetes, with pervasive fallacies. Majority did not have knowledge of "diabetes diet", "fatty food", "free food", effect of unsweetened fruit juice on blood glucose, treatment of hypoglycaemia, and the average duration glycosylated haemoglobin (haemoglobin A1) test measures blood glucose. Attaining tertiary education, falling under the 51-60 years age group, frequent attendance at seminars/updates and satisfaction with education received, being employed by or formerly working for the government, and claiming an intermediate, or wealthy income status was associated with better knowledge of diabetes. CONCLUSION: Nigerian diabetics' knowledge of diabetes was poor and related to age, level of education, satisfaction with education received, employment status and household wealth

Ensuring quality of life in palliative care physiotherapy in developing countries

Palliative care (PC) focuses on the body, mind, and spirit and can also provide pain and symptom relief, clarifying and focusing the provision of care on the patient's desires and goals, and helping them understand their disease and its treatment plans. Although PC is widely recognized for its applicability near the end of life or during terminal illness, it is also applicable and beneficial for patients with diseases in their earlier stages. Near the end of life, palliative care often focuses on providing continual symptom management and supportive care. Although palliative care has been noted to improve some life expectancy, its primary aim is to improve quality of life via focusing on the comfort of the patient, maintaining dignity, reducing intensive care utilization, and avoidance of expensive hospitalizations. One major challenge to quality of life for patients in PC is the physical and functional decline that occurs with disease progression. These issues can be addressed by specialized PC physiotherapy. Uniform provision of high-quality PC services (and physiotherapy in palliative care) faces substantial challenges in resource-challenged settings, including low- and middle-income countries. When properly integrated into PC teams and adequately supported, physiotherapy within PC can address common symptoms (pain, breathlessness, weakness) and assist patients to remain in an adapted home setting to optimize their quality of life, safety, and dignity