Diabetes related knowledge, self-care behaviours and adherence to medications among diabetic patients in Southwest Ethiopia: a cross-sectional survey

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background The provision of health education involving self-care and good adherence to medications has been acknowledged to be a cost effective strategy for improving quality of life of diabetes patients. We assessed levels of knowledge about type 2 diabetes mellitus (T2DM), self-care behaviours and adherence to medication among DM patients. Methods A facility based cross-sectional survey of 325 adults with T2DM patients attending Jimma University Teaching Hospital, Southwest Ethiopia was conducted. We used diabetes Knowledge Test, Expanded Version of the Summary of Diabetes Self-Care Activities and Morisky 8-Item medication adherence as tools to measure diabetic knowledge, self-care behaviours and adherence to medications respectively. Multinomial logistic regression analyses were used to assess the independent predictors of diabetes knowledge and adherence to medications. The binary logistic regression was applied for self-care behaviours. Results 309 respondents were included in the survey. Of all the respondents, 44.9 %, 20.1 % and 34.9 % had low, medium and high level diabetic knowledge respectively. High level of diabetic knowledge was the reference group. Being illiterate (AOR = 3.1, 95%CI: 1.03-9.3), having BMI <18 kg/m2 (AOR = 6.4, 95%CI: 1.2-34.9) and duration of DM < 5 years (AOR = 4.2, 95%CI: 1.9-9.5) were significantly associated with low level of diabetic knowledge. T2DM patients who practiced good self-care (AOR = 0.5, 95%CI: 0.3-0.9) were less likely to have low knowledge. Duration of DM < 5 years (AOR = 9.8, 95%CI: 3.2-30.2) was significantly associated with medium level of diabetic knowledge. 157(50.8 %) patients had poor self-care behaviour and this was associated with level of education and adherence to medication. The proportions of patients with low, medium and high adherence to medication were 24.9 %, 37.9 % and 37.2 % respectively. Being a merchant, having medium level of diabetic knowledge and having good glycemic control level were associated with low adherence to medications. Conclusions Significant number of DM patients had low level of knowledge, poor self-care behaviours and low level of adherence to medications. These findings call for the need of integrated interventional management on diabetic knowledge, self-care behaviours and adherence to medications. To ensure effective T2DM management, a strategic approach that improves health literacy could be a cross cutting intervention. Electronic supplementary material The online version of this article (doi:10.1186/s12902-016-0114-x) contains supplementary material, which is available to authorized users

Postoperative pain management among surgically treated patients in an Ethiopian hospital.

Incidence of postoperative pain has been reported to be between 47-100%. Ineffective postoperative pain management results in tangible and intangible costs. The purpose of this study was to assess the processes and outcomes of pain management in the surgical wards of Jimma University Specialized Hospital, Ethiopia.A prospective cross sectional study was conducted among 252 postoperative patients during February 13 to April 30, 2012. A contextually modified and validated (Cronbach's α coefficient of 0.78) American Pain Society Patient Outcome Questionnaire was used to assess pain experience of patients. Patients' charts were reviewed to assess the pattern of analgesic use. Incidence of postoperative pain was 91.4%, and remained high over 3 measurements (McNemar's; p<0.05), and 80.1% of the patients were undertreated. The mean pain intensity, and pain interference on functional status were 6.72±1.44 and 5.61±1.13 on a 10 point Numerical rating scale respectively; both being strongly correlated(r = 0.86: p<0.001). Pain intensity was varied by ethnicity, education and preoperative information (ANOVA; P<0.05). Only 50% of the patients were adequately satisfied with their pain management. As needed (prn), solo analgesic, null analgesic, and intramuscular orders were noted for 31.3%, 89.29%, 9.7% and 20.1% of the prescription orders respectively. Though under dose, diclofenac and tramadol were the top prescribed medications, and only 57% of their dose was administered. Linear regression model showed that the predictors of satisfaction were sex of an individual and pain interference with functional status.Despite patients' paradoxical high satisfaction with pain management, the majority of patients were inadequately and inappropriately treated. Thus, further research is needed to determine how best to break down current barriers to effective pain management

Schematic representation of patient recruitment and data analysis.

<p>Schematic representation of patient recruitment and data analysis.</p

Mean pain intensity rating over the three measurements.

<p>Mean pain intensity rating over the three measurements.</p

Processes of pain management.

<p>*N is 279, because 27 patients received two drugs.</p>§<p>234 is the orders with medication regimen written.</p>†<p>244 is patient cards with physician qualification written on.</p

Demographic and clinical characteristics of participants (n = 252).

<p>*Includes: “Waqafata”; those without religion affiliations.</p><p>**includes: Tigrai, Amhara, Gambela.</p

Patients’ agreement with barrier statements, sorted in increasing order.

<p>Patients’ agreement with barrier statements, sorted in increasing order.</p

Prevalence and predictors of metabolic syndrome among people living with human immunodeficiency virus (PLWHIV)

Abstract Background Use of combination antiretroviral therapy (cART) has led to significant reductions in morbidity and mortality. However, there is a growing concern about metabolic syndromes (MS), among patients receiving cART. Despite this fact, there is limited evidence for the prevalence of the MS among HIV-infected persons receiving cART in developing countries, particularly Ethiopia. Objective To determine the prevalence and predictors of MS among people living with HIV/AIDS in Jimma health centre, Jimma Zone south west Ethiopia. Methods A cross-sectional study was conducted on people living with HIV/AIDS (PLWHA) in Jimma health centre that fulfilled the inclusion criteria. Data on demographic and anthropometric characteristics were collected using World health organization (WHO) stepwise approach. Fasting blood glucose and lipid profile was measured. The Third Report of National Cholesterol Education Program-adult treatment panel III (NCEP-ATP III)-2001, the International Diabetes Federation (IDF)-2005 and the Joint interim statement-2009 (JIS) criteria were used to define MS. Data were analyzed using statistical software package (SPSS) version 20.0. Logistic regression analysis was done to identify predictors of MS and predictors with p value  25 kg/m2 was elevated to 13.4 times (AOR = 13.39, 95% CI [3.943–45.525]) and exposure to D-drugs was attributed to 59% increment in the odds of MS (AOR = 1.59, 95% CI [0.58–4.56]), although the finding lacks statistical significance. Conclusions Metabolic syndromes was relatively common to the study population. Hence, promoting health education and monitoring patient’s clinical and laboratory parameters at every visit and taking appropriate measure is ideal