Does Psychological Distress Interact With Patients’ Illness and Treatment Perceptions to Predict Adherence to Dietary Recommendation Among Persons With T2DM in Ghana? A Facility Based Cross Sectional Survey
Abstract Background: Psychological distress is a pervasive condition that interacts with other factors to influence adherence to treatment regimens, yet information-gap exists on how psychological-distress interact with Type-2-Diabetes Mellitus (T2DM) patients’ perceptions about their disease state and treatment benefits for adherence to dietary-recommendation. This study therefore investigates how T2DM patients’ psychological-distress interacts with perception about disease state and treatment benefits for adherence to dietary-recommendation. Methods: Facility-based cross-sectional-study was conducted among 530 T2DM patients at six health-facilities in Ghana. Structured-questionnaires were used to collect socio-demographics data, and Health Belief Model (HBM) questionnaires used to assess perceived-beliefs. Perceived-Dietary-Adherence-Questionnaire (PDAQ) for T2DM patients was used to assess adherence to dietary-recommendation. SPSS version-22 was used in data analysis.Results: Weight, diabetes-duration, total-cholesterol, HbA1c and fasting-blood-sugar were statistically significant for adherence to dietary-recommendation (P-value <0.05). Perceived-Susceptibility, Perceived-Benefit and Perceived-Cue to action were statistically significant for adherence to dietary-recommendations (P-value <0.05). After adjusting for confounders, interaction between low-psychological-distress and moderately-perceive-susceptibility[Adjusted Odd ratio(Adj.OR: 0.21, 95% confidence interval CI:1.18, 9.83); interaction between high-psychological-distress and moderately-perceived-susceptibility (Adj.OR: 4.49, 95% CI: 1.41, 14.28); interaction between low-psychological distress and highly-perceived-benefit (Adj.OR: 3.20, 95% CI: 1.30, 6.62); interaction between low-psychological-distress and moderately-perceived-barriers (Adj. OR: 4.79, 95% CI: 1.82, 12.60) and interaction between moderate-psychological-distress and highly-perceived-cue to action (Adj. OR 1.93, 95% CI: 1.36, 4.50) were statistically significant for adherence to dietary-recommendations. Conclusion: Psychological-distress can interact with patients’ perceptions for adherence to dietary recommendation. Therefore, health care workers globally should be mindful of this and offer professional care.