الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
SUMMARY
Diabetes mellitus is a serious and costly public health problem in the world today. It is a leading cause of disability and a major contributor to medical care cost in most countries, and its prevalence is still increasing both nationally and worldwide (ADA, 2010). Self-efficacy is an important predictor for health behaviors of patients with diabetes and therefore has important theoretical and practical application for health promotion in this population (Veronica, 2010).
Aim of the study:
This study aims to:
Assess factors affecting self-efficacy for patients with type 2 diabetes mellitus.
Setting
The study was conducted at the Outpatient Diabetes Clinic in Ain Shams University Hospital.
Subjects of the study:-
The study was composed of a purposive sample of 80 adult patients with type 2 diabetes mellitus from both sexes, based on the flow rate of patients with type 2 diabetes. It were found that 2600 cases was seen in the Outpatient Clinic in years 2010-2011,with statistical power analysis of 80% and confidence level of 95% .
Tools of data collection:
I. Patient’s interview questionnaire, developed by the researcher in Arabic language, it contains two parts: (Appendix I)
A) Demographic characteristics of patients such as age, sex, marital status, level of education, working status, residence, and monthly income etc.
B) Patient’s medical history including the type of diabetes, duration of diabetes, family history, associated chronic disease, prescribed medication, and smoking status.
II. Patient’s interview questionnaire it contains two parts:
A) Patient’s knowledge about diabetes: (Appendix II)
It was developed by the researcher in Arabic language based on recent literature and it was consists of 18 items about DM, such as: definition, causes, symptoms, complications, and management activities as diet, exercise, self-monitoring glucose level, medication and hygienic care.
B). Diabetes Self Care Activities Scale (DSCAS): (Appendix III)
The scale consists of 12 items; it was adapted from Tobberts and Glasgow (1994) modified by the researcher to assess four aspects of activities for diabetes such as diet, exercise, glucose test, and medication.
IV. Diabetes Management Self-Efficacy Scale (DMSES): (Appendix IV)
The scale was adapted from van der Bijl et al. (1999) modified by the researcher. The scale consists of 20-items to assess self-efficacy for patients with type 2 diabetes mellitus. It was translated from English to Arabic and retranslation.
V. Factors affecting self-efficacy for patients with type 2 DM through: (Appendix V)
1-Diabetes Empowerment Scale (DES):
The scale consists of 28 items, it was adapted from Anderson et al. (2000) modified by the researcher to assess patient’s beliefs translated from English to Arabic and retranslated. It assesses satisfaction and readiness to change, achieving treatment goals, psychological aspect, social support, and treatment of DM.
2-Diabetes Family Behavior Scale (DFBS):
The scale was adapted from Schafer et al. (1986) it consists of 16 items and was modified by the researcher to assess patient’s family support. It was translated from English into Arabic and retranslated was done.
Pilot study:
The pilot study was done on 8 patients of studied sample to test applicability and feasibility of the study tools. Based on the results of the pilot study, some modifications were carried out and the patients were excluded from the study .
Results:
The main study findings can be summarized as the following:
-About two thirds of studied sample (67.5%) were females and the majority of them (88.75%) aged 30 years or more. Less than two thirds (65%) of the patients were married.
- Concerning level of education, illiteracy was found among 31.3% of the studied sample, 20.0% had just preparatory education, 35.0 completed secondary school, 12.5% had a university degree, and a minority 1.25% had post graduate education.
- As regards patients’ residence, it all of studied sample (100.0%) lived in urban areas.
- Regarding patients’ working status, about two thirds of diabetic patients (70.0%) were not working and more than one-half of studied samples (58.75%) had sufficient monthly income.
- Regarding duration of illness, about half of studied sample (47.5%) had diabetes for ten years and more, 35.0% of them had diabetes form five to less than ten years, 11.5% had diabetes form one to less than five years, while only 6.25% of the patients had diabetes for less than one year.
- Regarding family history of diabetes, more than half (53.75%) of the study sample had relatives complaining of diabetes.
- All of patients were suffering from diabetic complications; 40.0% had hypertension.
- Most of the studied sample 82.5% were obese (59.5% moderate obesity& 30% overweight).
- About three quarters of studied sample (76.3%) had satisfactory knowledge about diabetes regarding definition, symptoms, complications, diet, and exercise while the patients under studied sample had unsatisfactory knowledge regarding causes (48.8%), medication (46.3%), and hygienic care (41.3%).
- Regarding patients activities of diabetes, the majority of studied sample (85.0%) had satisfactory level regarding diabetic diet and, 98.75% had satisfactory level regarding taking their medications in time). However, most of them (93.75%) had unsatisfactory level regarding practicing physical exercise and 37.5% had satisfactory level regarding monitoring their blood sugar daily. About three quarters of studied sample (76.25%) had unsatisfactory level regarding total activities of diabetes.
- Regarding self-efficacy of studied sample, all of them (100%) had satisfactory level regarding glucose test and medication, most of the study sample (96.3%) had satisfactory level regarding glycemic control, 86.25% of study had sample satisfactory level regarding foot care, about two thirds of them 68.75% had unsatisfactory level regarding diet, and about half of them (51.25%) had unsatisfactory level regarding exercise. More than half of the studied sample (57. 5%) had satisfactory level regarding total self-efficacy toward diabetes.
- Regarding patients beliefs, all of study sample (100%) had satisfactory level regarding assessing satisfaction toward disease and readiness to change, and most (92.5%) of study sample had unsatisfactory level regarding achieving treatment goals. About one third of studied sample (32. 5%) had satisfactory level regarding total beliefs toward diabetes.
- Most of the study sample (96.3%) had unsatisfactory level with total family support.
- About two thirds of the study sample (66.25%) were taking insulin to control blood glucose level, 25.0% of them were taking both insulin and oral hypoglycemic agents (pills), and 8.75% of the patients were taking pills.
- There was no relation (P=0.156) between patients’ self-efficacy and complications of diabetes.
- There was a highly positive statistically significant relation between patients’ self-efficacy regarding their level of education (P=0.000).
- There was a statistically relation between patients’ self-efficacy and activities regarding exercise (P=0.047), while there was no relation between patients’ self-efficacy and activities regarding diet, medication, and glucose test.
- There was a highly statistically significant positive relation between patients’ total knowledge and beliefs regarding their self-efficacy with different treatment regimens, (P = 0.000).
- There was a negative relation between patients’ self-efficacy and total family support (P=0.040).
Conclusion:
Based on the findings of the present study, it can be concluded that:
The highest percentages of the studied sample had satisfactory knowledge about DM regarding definition, symptoms, complications, diet, and exercise while the patients under studied sample had unsatisfactory knowledge regarding causes, medication, and hygienic care. Majority of the studied patients had satisfactory level about activities regarding taking their medications in time. More than two thirds of them had unsatisfactory level of self-efficacy regarding diet, and slightly more than half of them had unsatisfactory level regarding exercise. Most of studied sample had unsatisfactory level with total family support. In addition, there is a statistically significant negative relation between the patients’ family support and self-efficacy. There are highly statistically significant positive relations between patients’ self-efficacy and their knowledge, activities and, beliefs.
Recommendation:
(Based on the findings of this study, the following can be recommended:
1) Based on the finding developing educational materials to improve patient’s knowledge, activities, beliefs and family support as (booklet- procures).
2) Assessing self-efficacy of diabetic patients routinely in Outpatient Clinics.
3) Further research studies are needed to focus on studying factors affecting self-efficacy for patients with type 2 diabetes mellitus.