الفهرس 
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Abstract
Diabetes is a complex chronic illness, characterized by elevated blood sugar levels as a result of deficiencies in insulin secretion, insulin action, or both. Diabetes type 2 is the most common type of diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn’t make enough insulin. Risk factors of diabetes can be categorized as non-modifiable risk factors genetics, family history of diabetes type 2, ethnicity, and history of gestational diabetesand modifiable behavioral risk factors as unhealthy diet, physical inactivity and the harmful use of tobacco and alcohol.
Chronic hyperglycemia is accompanied by high mortality and morbidity due to its associated microvascular complications, such as nephropathy, neuropathy and retinopathy, as well as macrovascular complications which include hypertension, hyperlipidemia, heart attacks, coronary artery disease, strokes, cerebral vascular disease, and peripheral vascular disease
The management of type 1 and type 2 diabetes focuses on improving glycemic control, by means of lifestyle modification and pharmacological therapy. For effective management of diabetes, patients must be actively involved in their care, this requires performance of many complex self-care behaviors including lifestyle modifications (such as dietary control, regular exercise and psychosocial coping skills) and medical self-care (medication use and self-monitoring of blood glucose).
Knowledge and practice are important for diabetic patients. Consequently, poor knowledge of self-care can cause poor long-term metabolic control which may lead to the development of diabetic complications. So, knowledge of disease is important to meet the challenge of increasing healthcare costs.
Nurses have a vital role in helping patients to control diabetes-associated morbidity and mortality to improve their clinical outcomes; nurses also can screen patients for early diabetes identification, recognize and initiate corrective measures for inadequate treatment regimens, help patients set and achieve therapeutic goals, and assess diabetes-related complications as they arise. Additionally, they can assume an active role in improving patient’s knowledge through educating patients about the progressive nature of the disease and the importance of early therapy.
The aim of this study is to:
Assessthe relation between knowledge and self-care practices among diabetic patients.
Research question:
What isthe relation between knowledge and self-care practices among diabetic patients?
Materials and Method
Materials:
Research Design:
A descriptive research design was utilized for this study.
Setting:
The study was conducted at kafrElziat general hospital affiliated to ministry of health, in the outpatient clinic of diabetes.
Subjects:
A convenience sample of 150 patients who were admitted to the above mentioned setting were comprised the study subjects.
The subjects were considered eligible to participate in the study if they met the following criteria:
Adult patient confirmed with diagnosis of type 2 diabetes more than 5 years.
Tools:
One tool was used for conducting this study:
Tool I: Diabetic patient’s knowledge and self-care practices structured interviewschedule:
This tool was developed by the researcher after reviewing the related literatures. It was used to assess knowledge and self-care practices among diabetic patients.
Part I: Socio-demographic and clinical data:
A) Socio-demographic data: It included patient’s personal data such as patient’s name, gender, age, level of education, occupation, religion, area of residence and social status.
B) Clinical data:It included past and present patient’s health history, family history, drug history, smoking history, duration of disease, weight, height and BMI.
Part II: Diabetic patient’s knowledge:
This part was used to assess:
- Diabetes knowledge: It included 26 questions about signs and symptoms of diabetes and its complications, diabetes dietary guidelines, benefits of physical activity, periodic checkup, importance of foot care, symptoms of diabetes complications, action performed during acute complications and precautions of insulin injection.
Part III: Self-care practices of diabetic patients:
It included data related to self-care practices: It consisted of eight sub items namely: medications, dietary pattern, physical exercises, blood glucose monitoring, skin and foot care, oral care, diabetes complications, and follow up care.
Method:
The study was accomplished as follows:
Written approvals:
Official approval to carry out the study was obtained from the Research Ethics Committee at the Faculty of Nursing, Alexandria University. Also, an official letter was directed from Faculty of Nursing, Alexandria University, to the director of selected hospital setting in order to obtain approval to collect the necessary data, after explanation the aim of the study.
The study tool:
The tool was developed by the researcher based on the review of the relevant literature and was translated into Arabic language. Then pilot study was done to test it’s feasibility and applicability.
Data collection:
• The data were collected by the researcher for each patient once using individualized interview.
• The interview ranged from 30 to 40 minutes on individual session.
• Data were collected in the morning shift at the reception of diabetic outpatients’ clinic before examination.
• Data were collected throughout a period of three months from the beginning of October 2021 up to end of December 2021.
Ethical considerations:
• Written informed consent was obtained from each study subject after explanation of the aim of the study.
• The anonymity and confidentiality of patients’ responses were assured.
• The participants were informed that their participation was not obligatory, and they had the right to refuse the participation in the study.
• The patients were informed that they have the right to withdraw from the study at any time.
Statistical analysis of the data:
After completion of data collection, statistical tests were carried out using SPSS, version 25for both data presentation and statistical analysis of the result. The number and percentage wereused for describing and summarizing qualitative data. Mean and the standard deviation were used topresent the quantitative data.
The main results of the study:
• The highest percentage of the studied patients was in the age group50-60 years, female, illiterate, housewives, Muslims, married and from rural areas (64.7%, 60.7%, 44%, 52.7%, 96.7%, 82.7%, 75.3%).
• Regarding level of knowledge, more than half 53.3% of studied patients had fair level of knowledge,and more than one-third of patients 39.3% had a good level of knowledge.
• Nearly half of the studied patients 52.7% had fair self-care practices, and less than half of patients 44% had poor self-care practices.
• There were positive statistically significant differences between the patient’s level of knowledge mean scores and the patient’s age, level of education, and marital status where p = (0.008,< 0.001, 0.031 respectively).
• There were positive statistical significant differences between patient’s level of knowledge mean scores and patients’ medications, the reason for a medical visit, health problems, duration of health problems, family history of other chronic diseases, and frequency of smoking shisha where p=(0.045, 0.057, 0.003, 0.029, 0.015, 0.022 respectively).
• There were positive statistically significant differences between patients’ self-care practices mean scores and patients’ age, sex, level of education, occupation, and marital status where p= (0.004, 0.001, <0.001, 0.004, 0.046 respectively).
• Therewere positive statistical significant differences between the patient’s self-care practices mean scores and the presence of neurological disease, the reason for a medical visit, health problems, duration of health problems, diabetic family member, family history of other chronic diseases and patients’ BMI where p= (0.042, <0.001, 0.002, 0.009, 0.007, 0.035, 0.001 respectively).
• Therewere statistically significant differences found between patients’ practice mean scores and their level of knowledge where p= 0.001.
Conclusion:
Based on the findings of the present study, it can be concluded that: more than half of the studied patients had a fair level of knowledge and self-care practices. There were positive significant statistical differences between patients’ level of knowledge mean scores and the patients’ age, level of education and marital status. In addition to, there were statistically significant relation between the total patients’ self-care practices mean scores and patients’ age, level of education, occupation and marital status. Moreover, there were statistically significant differences found between patients’ practice mean scores and their level of knowledge.
The main recommendations based on the findings of the present study were as follow:
Recommendations for patients:
-Development of health education programs for patients and their families to improve their knowledge about therapeutic regimen.
- Increased patient’s awareness about diabetes mellitus type 2 and their therapeutic regimen through mass media. Disseminate health knowledge through posters, photos, video, and booklets as educational directions to patients that help to meet health needs.
Recommendations for further studies:
- Specialized survey should be done to explore barriers associated with diabetes management, including patients healthcare providers and health systems related barriers.
- Investigate the impact of educational program on patients’ knowledge and self-care practices.