Masters Degrees (Nutrition and Dietetics)

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Browsing Masters Degrees (Nutrition and Dietetics) by Advisor "Reid, M."

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    Diabetes-related knowledge, attitude and practices (KAP) of adult patients with type 2 diabetes in the Free State, South Africa
    (University of the Free State, 2016-01) Le Roux, Maretha; Walsh, C. M.; Reid, M.
    English: Worldwide Type 2 Diabetes Mellitus (T2DM) is a growing public health problem and is closely linked to overweight and obesity. Many patients with T2DM in South Africa are overweight or obese which has been associated with rapid urbanisation in South Africans over the past 20 years. Urbanisation has resulted in a nutrition transition, characterised by a transition from healthier traditional diets to a more Western unhealthy diet and a sedentary lifestyle. Although it is a common assumption that improvements in knowledge, attitude and practices would be the answer to the diabetic epidemic, researchers agree that good knowledge of diabetes does not always translate to behaviour change. The purpose of this study was thus to determine current diabetes-related knowledge, attitude and practices (KAP) of adults with T2DM in the Free State. This research study was designed as a quantitative descriptive observational study. The population included adult patients older than 18 years with T2DM visiting 12 community health centres and 10 primary health care clinics in the five districts in the Free State. Within the selected facilities, convenience sampling took place until a total of 255 adult participants had been included. An adapted South African-Diabetes KAP questionnaire was used to gather information about demographics and associated factors, quality of life, diabetes-related KAP and perceived care. Participants were also weighed and measured. The questionnaire was piloted in a sample of 5 adult patients with T2DM in Mangaung Metro district. Ethics approval was obtained from the Health Research Ethics Committee, University of Free State. Two hundred and fifty five questionnaires were completed in 22 public health facilities. The majority of participants were black African (92%, n= 235), which is a reflection of the national distribution in South Africa where the majority of citizens are black (80%). Only 8.6% of participants had completed high school and 10% were illiterate. The median age of participants was 57 years,[range:19 to 84] and the median age of diagnosis of T2DM was 48 years [range: 15 to 80]. An overwhelming 87% of participants were either overweight or obese. The majority of the participants (67% of males and 98% of females) had a waist circumference above the recommended cut-off points which is associated with an increased risk of developing T2DM in both sexes. It was therefore not surprising that the majority (61%; n=155) were diagnosed with T2DM following metabolic syndrome related symptoms and another 11% (n=29) with other health related symptoms. This could also explain the predominance of females (75%; n=193) was attributed to glucose intolerance that is associated with higher visceral fat, which is more common in South African women than in men. Participants in the present study had poor knowledge of T2DM. Only half of the participants knew the normal range of blood glucose, although almost 90% knew the common signs of high blood glucose and two thirds were knowledgeable about complications associated with diabetes. Participants were ignorant about food groups, which is a concern considering that healthy eating is a pivotal aspect of treatment. The attitude of the participants toward their disease, in the present study was mostly negative. The majority (81%, n=206) of participants felt that they would be a quite different person if they did not have diabetes. A further 71% (n=181) felt that diabetes was the worst thing that had ever happened to them, and 79% (n=201) felt embarrassed about having diabetes. Poor diabetes-management practices were reported by the majority of participants, characterised by low levels of physical exercise and poor eating habits. Although the majority (96%; n=245) of participants were knowledgeable about the benefits of physical exercise, only 31% (n=78) reported exercising every day during the preceding week. The poor practices were also reflected in the high rates of overweight and obesity that are closely associated with a lack of physical activity and a sedentary lifestyle in general. A statistically significant correlation was found between knowledge and attitudes, indicating that better knowledge about diabetes could be associated with a more positive attitude towards diabetes. Unfortunately this did not translate to improved behaviour. Participants with a higher level of education obtained higher scores in questions related to knowledge and attitude about diabetes, but not, interestingly, in their practice scores. Poor knowledge, a negative attitude and poor practices related to diabetes, were observed in a high percentage of the participants included in this study. Barriers to sustaining improved lifestyles and successful self-management activities should be further researched since these could make a valuable contribution to improving the health and quality of life of people with T2DM.
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    Diabetes-related knowledge, attitudes and practices [KAP] of adult patients with type 2 diabetes in Maseru, Lesotho
    (University of the Free State, 2017-06) Chiwungwe, Faith; Reid, M.
    Type 2 diabetes mellitus (T2DM) is a major public health concern in Lesotho and is the fourth ranking cause of death in that country. A steady increase in the proportion of patients admitted into hospitals with diabetes-related complications has been observed and may be attributed to poor diabetes-related knowledge, attitudes and practices of adults with T2DM. The study followed a quantitative, descriptive design. Convenient selection of clinics followed by convenient selection of participants (n=291) was used. The researcher interviewed participants using a pre-designed questionnaire based on Azjen’s theory of planned behaviour. Descriptive statistics, namely frequencies and percentages for categorical data, and medians and percentiles for continuous data were calculated. The study received ethical clearance from the University of the Free State and the Lesotho Health Research an Ethics Committee. The majority (63%) of participants were elderly (median 61 years), obese (65.6%) black females with less than four years of secondary school education completed (79%). The study found median percentage of behavioural, normative and control beliefs (reflecting the knowledge component) to be (range: 73.9%-77.8.5%), implying that most participants (85.2%) had a positive attitude towards diabetes (reflecting the attitudes component), which would positively influence the intention to act out certain positive diabetes health-related behaviour. The subjective norms and perceived behavioural control (reflecting the practices component) median was 50%. The participants (95.2%) had very strong intentions to act out certain diabetes-related behaviour. Behavioural, normative and control beliefs (knowledge) were found to be high, while normative beliefs and perceived behavioural control was low. These findings lead to specific recommendations related to the way healthcare providers comprehensively manage T2DM in Maseru. To begin with, diabetes related pamphlets should be distributed to patients to further strengthen their knowledge about the disease. Secondly, clinic based buddie or caregiver support groups are recommended to change the negative perceptions about T2DM of the community within which the patients stay, as it negatively affects patients’ self-management. Lastly, support groups focussed on skills counselling for T2DM patients are recommended to strengthen good practices that reinforce self-management.