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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 4  |  Issue : 3  |  Page : 93-96

A comparison of self-care activities among patients with diabetes nephropathy attending government health facilities and private health facilities in Bangladesh: A cross-sectional study


Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh

Date of Web Publication26-Sep-2016

Correspondence Address:
AHM Mahmudur Rahman
Department of Pharmaceutical Sciences, North South University, Dhaka
Bangladesh
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2347-9019.191105

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  Abstract 


Introduction: Self-care activities are crucial for managing diabetes nephropathy (DN), and there is not enough data on this in Bangladesh. The main target of this study was to identify the qualitative differences of self-care activities between patients attending government health facilities and private health facilities. Materials and Methods: This is a cross-sectional study conducted among the patients of DN attending government health facilities and private health facilities in Bangladesh using self-made survey question, and SPSS software version 16 was used for analysis. Results: A total of 200 (n = 200) patients were taken, 100 from government health institutes and 100 from private health institutes. In both sectors, most of the patients were between 51 and 70 years old. In government sectors, the percentage of following healthy eating plans all days of a week was 47%, at least 30 min of physical activities on a regular basis was 39%, blood sugar testing at least once in a month was 79%, washing feet on all days of a week was 63%, having fruits/vegetables all days of a week was 27%, glomerular filtration rate (GFR) checked within the last month was 17%, having high-fat diet all days of a week was 22%, and having fried food all days of a week was 38%. In private sectors, the percentage of following healthy eating plans all days of a week was 76%, at least 30 min of physical activities on a regular basis was 58%, blood sugar testing at least once in a month was 88%, washing feet on all days of a week was 91%, having fruits/vegetables all days of a week was 63%, GFR was checked within the last month was 42%, having high fat diet all days of a week was 35%, and having fried food all days of a week was 42%. Conclusion: The patients of DN attending private health facilities were comparatively more aware and serious about self-care than the patients attending government health facilities in Bangladesh, and government health facilities should provide awareness program on this aspect.

Keywords: Diabetes nephropathy, government health facilities, private health facilities, self-care activities


How to cite this article:
Rahman AM, Hasan M, Rahman M. A comparison of self-care activities among patients with diabetes nephropathy attending government health facilities and private health facilities in Bangladesh: A cross-sectional study. Int J Health Syst Disaster Manage 2016;4:93-6

How to cite this URL:
Rahman AM, Hasan M, Rahman M. A comparison of self-care activities among patients with diabetes nephropathy attending government health facilities and private health facilities in Bangladesh: A cross-sectional study. Int J Health Syst Disaster Manage [serial online] 2016 [cited 2021 Mar 1];4:93-6. Available from: https://www.ijhsdm.org/text.asp?2016/4/3/93/191105




  Introduction Top


Bangladesh is suffering from an epidemiological changeover from transmittable and maternal diseases to noncommunicable lifestyle-related diseases akin to diabetes nephropathy (DN), cardiovascular diseases, cancers, etc.[1] Obtaining a good control, and in the interim, avoiding the beneficial adverse events symbolize the main aim of the treatment of patients with DN. The DN administration measures include two main components: the health-care professional's interferences and the patient's diabetes-related self-care interventions. Considering the particular attributes of DN, particularly being a chronic disease which is mostly treated in an outpatient situation, it is established that patient's self-management of the disease is of leading importance in achieving the therapeutic goals at the same time as avoiding the therapeutic adverse events.[2],[3]

In addition, arousing well-being is a significant part of diabetes care and self-management. Mental and societal troubles can weaken the individual's or family's aptitude to carry out DN care tasks and cooperation for health condition.[4],[5],[6],[7] A handful of qualitative studies have explored the disease-related familiarities of patients by the way of comorbid diabetes and chronic kidney disease (CKD), but none have explored patients' viewpoints on the key factors affecting the most favorable health care.[8],[9],[10],[11],[12] Self-care linked with the guidelines for dwelling exercises for the patients with DN are successful in maintaining and preventing complications.[13] Self-care activities are incredibly significant for managing DN. In this study, it was the main target to find the differences between self-cares activities among various patients.

Objective

The objective of the study was to make a comparison of self-care activities among the patients of DN attending government health facilities and private health facilities in Bangladesh.


  Materials and Methods Top


Study design

This is a cross-sectional study conducted among various diabetic nephropathy patients those who are attending various health institutes (government and private both). A well-structured and self-administered questionnaire [Annexure 1] was created and provided to the patients. The questionnaire required patient responses concerning their self-care activities. Before using the questionnaire in the study, it was tried on some patients to check whether they were able to understand and response.



Data collection

The data collection was started in January 2016 and ended in April 2016. Patients attending Sir Salimullah Medical College Hospital and Shaheed Suhrawardy Medical College Hospital were considered government health facilities' consumers and patients attending BIRDEM General Hospital and BIHS General Hospital and Hitech Multicare Hospital, Dhaka, Bangladesh, were considered private health facilities' consumers. Data were collected through survey sheets and then transferred into the Microsoft Excel Spreadsheet 2010 (Microsoft Corp., USA).

Data analysis

The analysis was done using SPSS software version 16 (IBM, USA). The statistical analysis and graphical presentations were performed. Representation of the data was performed as percentage, frequency, mean, and ratio.


  Results and Discussion Top


Here, 200 (n = 200) patients were taken. Among them, 100 were from government institutes and 100 were from private institutes. In government institutes, 65 were males and 35 were females, whereas in private institutes, 58 were males and 42 were females. In government health care, the male-to-female ratio was 1.85:1, and in private health care, the male-to-female ratio was 1.38:1. In both sectors, most of the patients were between 51 and 70 years old. [Figure 1] shows the demographic details. It is also noticeable that those patients who are from government health care had more percentage of higher body mass index than normal ranges whereas the private health care patients had less percentage.
Figure 1: Demographic variables

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In government health sectors, the percentage of following healthy eating plans all days of a week was 47%, at least 30 min of physical activities on a regular basis was 39%, blood sugar testing at least once in a month was 79%, washing feet on all days of a week was 63%, having fruits/vegetables all days of a week was 27%, glomerular filtration rate (GFR) checked within the last month was 17%, having high-fat diet all days of a week was 22%, and having fried food all days of a week was 38% [Figure 2].
Figure 2: Self-care activities among patients attending government health facilities

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In private health sectors, the percentage of following healthy eating plans all days of a week was 76%, at least 30 min of physical activities on a regular basis was 58%, blood sugar testing at least once in a month was 88%, washing feet on all days of a week was 91%, having fruits/vegetables all days of a week was 63%, GFR was checked within the last month was 42%, having high fat diet all days of a week was 35%, and having fried food all days of a week was 42% [Figure 3].
Figure 3: Self-care activities among patients attending private health facilities

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  Conclusion Top


In this study, it is revealed that there were differences between the two groups (government and private) and those were very significant. In most of the cases, private health facilities consuming patients were found more positive and concerned about their health- and self-care activities. We can make a conclusion that the patients of DN attending private health facilities were more aware and more serious about self-care than the patients attending government health facilities. We can also mention that government health sectors should offer some awareness programs to make the patients more aware of self-care activities as it is one of the most important aspects of DN management.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Hussain A, Claussen B, Ramachandran A, Williams R. Prevention of type 2 diabetes: A review. Diabetes Res Clin Pract 2007;76:317-26.  Back to cited text no. 1
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Marrero DG, Ard J, Delamater AM, Peragallo-Dittko V, Mayer-Davis EJ, Nwankwo R, et al. Twenty- first century behavioral medicine: A context for empowering clinicians and patients with diabetes: A consensus report. Diabetes Care 2013;36:463-70.  Back to cited text no. 2
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Norris SL, Lau J, Smith SJ, Schmid CH, Engelgau MM. Self-management education for adults with type 2 diabetes: A meta-analysis of the effect on glycemic control. Diabetes Care 2002;25:1159-71.  Back to cited text no. 3
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Anderson RJ, Grigsby AB, Freedland KE, de Groot M, McGill JB, Clouse RE, et al. Anxiety and poor glycemic control: A meta-analytic review of the literature. Int J Psychiatry Med 2002;32:235-47.  Back to cited text no. 4
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Delahanty LM, Grant RW, Wittenberg E, Bosch JL, Wexler DJ, Cagliero E, et al. Association of diabetes-related emotional distress with diabetes treatment in primary care patients with type 2 diabetes. Diabet Med 2007;24:48-54.  Back to cited text no. 5
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Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: A meta-analysis. Diabetes Care 2001;24:1069-78.  Back to cited text no. 6
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Kovacs Burns K, Nicolucci A, Holt RI, Willaing I, Hermanns N, Kalra S, et al. Diabetes attitudes, wishes and needs second study (DAWN2™): Cross-national benchmarking indicators for family members living with people with diabetes. Diabet Med 2013;30:778-88.  Back to cited text no. 7
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Sakraida TJ, Robinson MV. Health literacy self-management by patients with type 2 diabetes and stage 3 chronic kidney disease. West J Nurs Res 2009;31:627-47.  Back to cited text no. 8
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Wilkinson E, Randhawa G, Farrington K, Greenwood R, Feehally J, Choi P, et al. Lack of awareness of kidney complications despite familiarity with diabetes: A multi-ethnic qualitative study. J Ren Care 2011;37:2-11.  Back to cited text no. 9
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Wilkinson E, Randhawa G, Feehally J, Farrington K, Greenwood R, Choi P, et al. A multi-centre qualitative study exploring the experiences of UK South Asian and white diabetic patients referred for renal care. BMC Nephrol 2012;13:157.  Back to cited text no. 10
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Williams AF, Manias E, Walker R. Adherence to multiple, prescribed medications in diabetic kidney disease: A qualitative study of consumers' and health professionals' perspectives. Int J Nurs Stud 2008;45:1742-56.  Back to cited text no. 11
    
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Williams AF, Manias E, Walker R. The role of irrational thought in medicine adherence: People with diabetic kidney disease. J Adv Nurs 2009;65:2108-17.  Back to cited text no. 12
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Iunes DH, Rocha CB, Borges NC, Marcon CO, Pereira VM, Carvalho LC. Self-care associated with home exercises in patients with type 2 diabetes mellitus. PLoS One 2014;9:e114151.  Back to cited text no. 13
[PUBMED]    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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