Self-management and its associated factors among people living with diabetes in Blantyre, Malawi: a cross-sectional study

Background: Self-management is key to the control of glycaemia and prevention of complications in people with diabetes. Many people with diabetes in Malawi have poorly controlled glucose and they experience diabetes-related complications. This study aimed to assess diabetes self-management behaviours and to identify factors associated with it among people with diabetes at Queen Elizabeth Central Hospital, Blantyre, Malawi. Methods: This cross-sectional study recruited 510 adults attending a diabetes clinic at a teaching referral hospital in southern Malawi. The social cognitive theory was applied to identify factors associated with following all recommended self-management behaviours. Data on participants’ demographics, clinical history, diabetes knowledge, self-efficacy, outcome expectations, social support, environmental barriers and diabetes self-management were collected. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with following all self-management behaviours. Results: The mean age of participants was 53.6 (SD 13.3) years. The majority (82%) were females. Self-reported medication adherence within the last seven days was 88.6%; 77% reported being physically active for at least 30 minutes on more than three days in the previous seven days; 69% reported checking their feet every day and inspecting inside their shoes; 58% reported following a healthy diet regularly. Only 33% reported following all the self-management behaviours regularly. Multiple logistic regression analysis showed that self-efficacy was the only social cognitive factor associated with following all the self-management practices (p < 0.001). Conclusions: Participants in our study were not consistently achieving all self-management practices with dietary practices being the least adhered to behaviour by many. To improve self-management practices of people with diabetes, current health education programs should not only aim at improving diabetes related knowledge but also self-efficacy. Adopting interventions that promote self-efficacy in diabetes patients such as exposure to role models, peer education, providing positive feedback, and counselling is recommended.

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Self-management and its associated factors among people living with diabetes in Blantyre, Malawi: a cross-sectional study

AAS Open Research ◽

10.12688/aasopenres.12992.1 ◽

2019 ◽

Vol 2 ◽

pp. 161

Author(s):

Chimwemwe Kwanjo Banda ◽

Belinda T. Gombachika ◽

Moffat J. Nyirenda ◽

Adamson Sinjani Muula

Keyword(s):

Logistic Regression ◽

Self Efficacy ◽

Social Cognitive ◽

Management Practices ◽

Cross Sectional Study ◽

The Self ◽

Self Management ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated

Background: Self-management is key to the control of glycaemia and prevention of complications in people living with diabetes. Many people living with diabetes in Malawi have poorly controlled glucose and they experience diabetes-related complications. This study aimed to assess diabetes self-management behaviours and to identify factors associated with it among people living with diabetes at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi. Methods: This cross-sectional study recruited 510 adults attending a diabetes clinic at a teaching referral hospital in southern Malawi. The social cognitive theory was applied to identify factors associated with following all recommended self-management behaviours. Data on participants’ demographics, clinical history, diabetes knowledge, self-efficacy, outcome expectations, social support, environmental barriers and diabetes self-management were collected. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with following all self-management behaviours. Results: The mean age of participants was 53.6 (SD 13.3) years. Self-reported medication adherence within the last seven days was 88.6% (n=494); 77% reported being physically active for at least 30 minutes on more than three days in the previous seven days; 69% reported checking their feet every day and inspecting inside their shoes; 58% reported following a healthy diet regularly. Overall, only 33% reported following all the self-management behaviours regularly. Multiple logistic regression analysis showed that self-efficacy was the only social cognitive factor associated with following all the self-management practices (p < 0.001). Conclusions: Participants in our study were not consistently achieving all self-management practices with dietary practices being the least adhered to behaviour by many. To improve self-management practices of people living with diabetes, current health education programs should not only aim at improving diabetes related knowledge but also self-efficacy. Adopting interventions that promote self-efficacy in diabetes patients such as exposure to role models, peer education, providing positive feedback, and counselling is recommended.

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Factors associated with physical inactivity among female and male rural adolescents in Borneo – a cross-sectional study

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2013-0319 ◽

2014 ◽

Vol 26 (3) ◽

pp. 447-453 ◽

Cited By ~ 3

Author(s):

Whye Lian Cheah ◽

Hazmi Helmy ◽

Ching Thon Chang

Keyword(s):

Self Efficacy ◽

Physical Inactivity ◽

Cross Sectional Study ◽

Perceived Barriers ◽

Anthropometric Measurement ◽

Rural Adolescents ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Significant Difference

Abstract Rural communities have shown marked increase in metabolic syndrome among young people, with physical inactivity as one of the main contributing factors. This study aimed to determine factors associated with physical inactivity among male and female rural adolescents in a sample of schools in Malaysia. A cross-sectional study was conducted among 145 students aged 13–15 years. Data on socio-demographic, health-related, and psychosocial factors (perceived barriers, self-efficacy, social influences) were collected using a self-administered questionnaire. Anthropometric measurement was taken to generate body mass index (BMI)-for-age, while physical activity (PA) level was assessed using pedometers. The mean steps per day was 6251.37 (SD=3085.31) with males reported as being more active. About 27% of the respondents were either overweight or obese, with more females in this group. There was no significant difference in steps among males and females (p=0.212), and nutritional status (BMI-for-age) (p=0.439). Females consistently scored higher in most items under perceived barriers, but had significantly lower scores in self-efficacy’s items. Males were more influenced by peers in terms of PA (p<0.001) and were more satisfied with their body parts (p=0.047). A significantly higher body size discrepancy score was found among females (p=0.034, CI –0.639, –0.026). PA level was low and almost one-third of the respondents were overweight and obese. Female students faced more barriers and had lower self-efficacy with regards PA. Based on the findings, it is recommended that interventions focus on reducing barriers while increasing support for PA. This is particularly important in improving the health status of the youth, especially among the females.

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Anorectal pathology amongst HIV infected patients attending the Douala General Hospital: a cross-sectional study

International Journal of STD & AIDS ◽

10.1177/0956462416650817 ◽

2016 ◽

Vol 28 (4) ◽

pp. 389-396 ◽

Cited By ~ 3

Author(s):

Henry Namme Luma ◽

Servais Albert Fiacre Bagnaka Eloumou ◽

Ellis Atemlefeh Fualefeh-Morfaw ◽

Agnes Malongue ◽

Elvis Temfack ◽

...

Keyword(s):

Logistic Regression ◽

General Hospital ◽

Laboratory Data ◽

Study Participant ◽

Cross Sectional Study ◽

Interquartile Range ◽

People Living With Hiv ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated

While gastrointestinal disease is common among HIV infected individuals, the prevalence and distribution of ano-rectal pathology has not been well studied in our setting. The objective of this study therefore was to determine the prevalence and determinants of ano-rectal pathology in HIV infected patients attending the Douala General Hospital HIV treatment centre. A hospital-based cross-sectional study was undertaken. We collected socio-demographic, clinical and laboratory data using a structured questionnaire and patients’ files. Each study participant had a full physical and ano-rectal examination. We further studied factors associated with having at least one ano-rectal lesion by logistic regression reporting odds ratios (ORs) and their 95% confidence intervals (CI). We included 390 HIV infected patients. The mean age was 41 (SD: 8) years and 48% were men. Median duration since HIV diagnosis was 3 (interquartile range: 2–5) years and median CD4 cell count was 411 (interquartile range: 234–601) cells/mm3. Prevalence of ano-rectal pathology was 22.8% (95% CI: 18.7–27.3). Hemorrhoids and proctitis were most common lesions found; each in 10% of patients. From multivariate logistic regression, factors associated with ano-rectal pathology were CD4 < 350 cells/ml (OR: 2.1, 95% CI: 1.1–4.2), not on highly active antiretroviral therapy (OR: 2.2, 95% CI: 1.1–4.6), inpatient (OR: 2.3, 95% CI: 1.2–4.3), ano-rectal intercourse (OR: 5.0, 95% CI: 1.7–15.1), and more than one sexual partner (OR: 2.4, 95% CI: 1.3–4.2). Ano-rectal pathology is common amongst HIV infected patients. Care givers should actively investigate and treat them as this will improve the quality of life of people living with HIV/AIDS.

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Relationship between the Functional Oral Intake Scale (FOIS) and the Self-Efficacy Scale among Cancer Patients: A Cross-Sectional Study

Healthcare ◽

10.3390/healthcare8030269 ◽

2020 ◽

Vol 8 (3) ◽

pp. 269

Author(s):

Yuhei Matsuda ◽

Masaaki Karino ◽

Takahiro Kanno

Keyword(s):

Oral Health ◽

Self Efficacy ◽

Odds Ratio ◽

Oral Intake ◽

Cross Sectional Study ◽

The Self ◽

Sectional Study ◽

Cross Sectional ◽

Health Related ◽

Functional Oral Intake Scale

A few studies have provided detailed reports suggesting that subjective swallowing disorders may be related to dysphagia. Therefore, we verified the relationship between oral health-related self-efficacy and dysphagia severity in cancer treatment using a cross-sectional study. Participants included patients undergoing treatment for cancer at Shimane University Hospital in Shimane, Japan, and those receiving outpatient treatment at the hospital’s Oral Care Center between August 2018 and April 2019. In all, 203 participants enrolled in the study and completed the Functional Oral Intake Scale (FOIS), the Self-efficacy Scale for Advanced Cancer (SEAC), and the Oral Health-related Self-Efficacy Scale for Patients with Cancer (OSEC). Multivariate analysis showed a statistically significant correlation between the low FOIS score and the SEAC subscales of Activities of Daily Living Self-efficacy (ADE) (odds ratio 1.04, 95% [CI] 1.00–1.07) and Symptom Coping Self-efficacy (SCE) (odds ratio 0.61, 95% [CI] 0.42–0.88). Based on the Jonckheere-Terpstra test, the SEAC and the OSEC tended to increase as the category of the FOIS progressed. To conclude, self-efficacy played an important role in dysphagia and may affect the severity of dysphagia in cancer patients.

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Anticoagulation adherence and its associated factors in patients with atrial fibrillation: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-029974 ◽

2019 ◽

Vol 9 (9) ◽

pp. e029974

Author(s):

Pei-Ti Chen ◽

Tsae-Jyy Wang ◽

Ming-Hsiung Hsieh ◽

Ju-Chi Liu ◽

Chieh-Yu Liu ◽

...

Keyword(s):

Atrial Fibrillation ◽

Self Efficacy ◽

Associated Factors ◽

Anticoagulation Therapy ◽

Cross Sectional Study ◽

The Self ◽

Perceived Barriers ◽

Sectional Study ◽

Cross Sectional ◽

Unit Increase

ObjectiveTo investigate anticoagulant adherence and its associated factors, including demographics, clinical variables, atrial fibrillation (AF) severity, knowledge, satisfaction with services, perceived barriers, perceived benefits, symptom severity and self-efficacy in patients with AF.DesignThis is a cross-sectional study.Participants and settingA convenient sample of patients with AF were recruited from cardiology clinics of two teaching hospitals in Taiwan.MeasuresData were collected using the study questionnaires, including the AF-related symptom subscale of the AF Severity Scale, the Knowledge of Warfarin Anticoagulation Treatment Scale, the Satisfaction Scale about Service and Warfarin Treatment, the perceived benefits subscale of the Beliefs about Anticoagulation Survey, the Concerns about Anticoagulation Therapy Scale, The Self-efficacy for Appropriate Medication Use Scale and the short-form Adherence to Reﬁlls and Medications Scale.ResultsA total of 151 patients with AF participated in the study; 53 treated with warfarin and 98 treated with novel oral anticoagulants (NOACs). The difference in adherence to warfarin (mean=8.6; SD=1.6) and NOACs (mean=8.9; SD=2.0) was statistically insignificant. Multiple linear regression analysis showed that perceived barriers (β=0.18, p=0.017) and self-efficacy (β=−0.48, p<0.001) were significant predictors of anticoagulation adherence. For every 1-unit increase in the perceived barriers, there will be a 0.18-unit increase in the adherence to anticoagulation therapy. For every 1-unit increase in the self-efficacy, there will be a 0.48-unit decrease in the adherence to anticoagulation therapy. Perceived barriers and self-efficacy collectively explained 34.0% of the variance in adherence to anticoagulation therapy (F(2,149)=38.11, p<0.001).ConclusionWe found no better adherence to NOACs compared with warfarin. Patients with greater self-efficacy and perceived fewer barriers showed better adherence to anticoagulation therapy.

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Social Support, Self-Care Behaviour and Self-Efficacy in Patients with Type 2 Diabetes during the COVID-19 Pandemic: A Cross-Sectional Study

Healthcare ◽

10.3390/healthcare9111607 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1607

Author(s):

Premalatha Paulsamy ◽

Rizwan Ashraf ◽

Shadia Hamoud Alshahrani ◽

Kalaiselvi Periannan ◽

Absar Ahmed Qureshi ◽

...

Keyword(s):

Social Support ◽

Glycemic Control ◽

Self Efficacy ◽

Diabetes Management ◽

Self Care ◽

Cross Sectional Study ◽

The Self ◽

Sectional Study ◽

Cross Sectional

Diabetes mellitus is a major public health issue that considerably impacts mortality, morbidity, and healthcare costs worldwide. The COVID-19 pandemic has created havoc in diabetes management, too, like other spectrums of life. A descriptive, cross-sectional study was adopted to determine the effect of Social Support, Self-Care Behaviour and Self-Efficacy in Type 2 Diabetes Mellitus (T2D) during this COVID-19 pandemic. Two hundred T2D patients who satisfied the inclusion criteria were chosen using a convenient sampling procedure. The tool consists of four sections, including socio-demographic characteristics, Multidimensional Scale of Perceived Social Support (MSPSS), revised Summary of Diabetes Self-Care Activities (SDSCA) Scale and modified Diabetes Management Self-Efficacy Scale (DMS). Descriptive and inferential statistics were used to analyze the obtained data. The mean and SD of diabetic management self-efficacy is 5.74 (1.95) and 4.37 (1.4), respectively, for patients with HbA1c < 6.5% and HbA1c ≥ 6.5%. The self-care activities of the patients who had good glycemic control were 4.31 (2.06) compared to 3.50 (1.73) who did not. The social support received by the patients was 6.13 (2.13) vs. 5.31 (1.67) among patients with glycemic control vs. no control. The results show that social support (p = 0.04), self-efficacy (p =0.01) and self-care activities (p = 0.001) were significantly related to the level of glycemic control of the T2D patients. A significant relationship was also identified between gender (p = 0.036), age (p = 0.001) and education status (p = 0.000) with HbA1c control of the participants. This study demonstrates a significant relationship between social support, self-care behaviours, self-efficacy and glycemic management in T2D patients. During this COVID-19 pandemic, interventions to enhance the self-care activities like exercise and social support to boost their self-efficacy; for better diabetes management, reducing diabetes complications or prolonging their onset are the need of the hour.

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Internet Addiction and its Associated Factors Among Dilla University Undergraduate Students, Dilla, Ethiopia, 2019: A Cross-Sectional Study

10.21203/rs.3.rs-432680/v1 ◽

2021 ◽

Author(s):

Nebiyu Mengistu ◽

Desalegn Tarekegn ◽

Wondwosen Molla ◽

Seid Shumye

Keyword(s):

Logistic Regression ◽

University Students ◽

Undergraduate Students ◽

Internet Addiction ◽

Associated Factors ◽

Internet Use ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated

Abstract Background: Internet addiction is characterized by excessive or poorly controlled preoccupation, urges or behavior regarding computer use and internet access that lead to impairment or distress. Globally, it has been found that the occurrence rate of internet addiction among university students ranges from 0.8% to 47.7%. Despite, there are multiple challenges that related with internet addiction which remains under-recognized and largely ignored by stakeholders and also not well known especially in low income countries including Ethiopia. Therefore, this study was conducted aimed to assess the magnitude of the internet addiction and its associated factors among undergraduate students. Methods: Institutional based cross-sectional study was employed from May 1st to June 1st 2019. Multi-stage sampling technique was used to get a total of 846 undergraduate Students. Data was collected by using self-administered structured questionnaires of Young’s Internet Addiction Test. The collected data was coded and entered into EPIDATA 3.1 and analyzed by using SPSS version 22, Bivariate and multivariate logistic regression analysis was conducted to identify factors associated with internet addiction and statistically significant was considered at P-value <0.05. Results: A total of 846 study participants, giving a response rate were 761 (90%) and the prevalence of internet addiction was 19.4%. Multiple logistic regression model revealed that being male [AOR=1.69, 95% CI: (1.80, 6.41)], probable depression [AOR =3.61, 95% CI (2.40, 5.43)] and khat or caffeinated drinks [AOR=1.86, 95%CI: (1.21, 2.87)] were significantly associated with internet addiction.Conclusion: This study revealed that a high prevalence of internet addiction among Dilla university students and there were various factors associated with increased prevalence of problematic internet use. Therefore, students need to be educated about safe, valuable, and healthy practice of internet use and better to counsel on substance use and its consequences and also psychiatric evaluation (referring for mental health services) to overcome the anticipated increase in internet addiction

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Perceptions and Acceptance of mHealth in Patients With Cardiovascular Diseases: A Cross-Sectional Study (Preprint)

10.2196/preprints.10117 ◽

2018 ◽

Author(s):

Jie Jiang ◽

Qin Zhu ◽

Yimei Zheng ◽

Yajing Zhu ◽

Yuxi Li ◽

...

Keyword(s):

Logistic Regression ◽

Cardiovascular Diseases ◽

Disease Management ◽

Cross Sectional Study ◽

Self Management ◽

The Internet ◽

Sectional Study ◽

Multivariate Logistic Regression ◽

Cross Sectional ◽

Willingness To Use

BACKGROUND Mobile health (mHealth)—a method of assisting long-term care in patients with chronic cardiovascular diseases (CVDs)—is gaining popularity in China, mainly owing to the large number of patients and limited clinical resources. Patients of different ages have varying needs for CVD management. However, evidence regarding how age influences Chinese CVD patients’ use and perceptions of mHealth is limited. OBJECTIVE This study aimed to explore age-related differences among Chinese patients with CVD regarding their use and perceptions of mHealth and to determine the factors that influence this population’s willingness to use mHealth technologies. METHODS We conducted a cross-sectional study of patients with chronic CVDs in a tertiary hospital in Beijing using a new questionnaire designed by the investigators. Participants were sourced using nonproportional quota-sampling methods, being recruited consecutively in each sampling category (age 18-49, 50-64, 65-74, and ≥75 years, with at least 25 men and 25 women in each age group). The survey consisted of 5 parts, including sociodemographic profile and medical history; current disease management situation; self-evaluation of disease management; current usage of mobile and internet technology (IT); and willingness to use an mHealth solution to perform disease self-management. Responses were compared among the 4 age groups as well as between patients who were willing to use mHealth solutions and those who were not. Multivariate logistic regression model was used to identify predictors of willingness to use mHealth for self-management. RESULTS Overall, 231 patients (124 men) completed the questionnaire; of these, 53 were aged 18-49 years, 66 were aged 50-64 years, 54 were aged 65-74 years, and 58 were aged ≥75 years. Patients in the older cohorts visited hospitals more often than did those in the younger cohorts (P<.001), and they also showed lower technology skills regarding the use of mobile or internet devices (P<.001) and searched for health-related information on the internet less often (P<.001). In addition, 68.0% (157/231) of the patients showed interest in using mHealth solution to manage their disease; of these, 40.8% (64/157) were aged 65 years. Patients who were more willing to use mHealth solution to manage their diseases were younger (P<.001), more educated (P<.001), still working (P=.001), possessed higher skill regarding mobile or internet device use (P<.001), and more frequently searched for health information on the internet (P<.001). Finally, multivariate logistic regression showed that IT skill was the single indicator (P=.003) of willingness to use mHealth, not age. CONCLUSIONS Although age is associated with the use of mobile or internet devices, the sole indicator of mHealth use for self-management was participants’ IT skills. Education regarding the use of mobile devices and development of easy-to-use software might improve the acceptance of mHealth solutions among older patient populations.

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A cross-sectional study on associations of physical symptoms, health self-efficacy and suicidal ideation among Chinese hospitalized cancer patients following diagnosis.

10.21203/rs.3.rs-21297/v2 ◽

2020 ◽

Author(s):

Qingyi Xu ◽

Shuhua Jia ◽

Maiko Fukasawa ◽

Lin Lin ◽

Jun Na ◽

...

Keyword(s):

Logistic Regression ◽

Suicidal Ideation ◽

Cancer Patients ◽

Self Efficacy ◽

Epidemiological Studies ◽

Cross Sectional Study ◽

Physical Symptoms ◽

Sectional Study ◽

Cross Sectional ◽

The Impact

Abstract Background: Epidemiological studies have shown elevated suicide risk in cancer patients compare with the general population. This study was performed to examine the association between physical symptoms and suicidal ideation among Chinese hospitalized cancer patients and test the modifying effect of health self-efficacy on this association. Methods: A cross-sectional study was conducted among 544 cancer patients from oncology settings in two general hospitals in northeast China via face-to-face interviews. Suicidal ideation was measured by using four items from the Yale Evaluation of Suicidality scale, dichotomized into a positive and negative score. Multivariable logistic regression was applied to examine the impact of physical symptoms, health self-efficacy and their interactions on suicidal ideation.Results: We found a suicidal ideation rate of 26.3% in patients following cancer diagnosis. Logistic regression showed that insomnia (aOR=1.84, 95% CI 1.13 to 3.00, p =0.015), lack of appetite (aOR=2.14, 95% CI 1.26 to 3.64, p =0.005) were positively associated with suicidal ideation, low health self-efficacy showed a marginally significant exaggerating effect on the association between pain and suicidal ideation (aOR = 2.77, 95% CI 0.99 to 7.74, p =0.053), even after controlling for significant socio-demographic, clinical characteristics and depression. Conclusions: These findings demonstrate the associations between insomnia、lack of appetite and suicidal ideation and highlight the potential moderating role of health self-efficacy in the identification and prevention of suicide among cancer patients.

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