non-adherence to dietary and physical activity recommendations and associated factors among type 2 diabetic patients on follow up in government hospitals of ilu abba bora zone, oromia region, Ethiopia.

Abstract

Background: Diabetes mellitus is one of the rapidly increasing non communicable diseases requiring continuous medical care and mainly life time patient’s adherence to self management regimens and life style changes including diet and physical activity recommendations, in order to prevent acute and chronic complications.Various factors influence patients non adherence to diet and physical activity recommendations but these factors are not typically even for all patients. Despite the importance of identifying these factors for health care providers to individualize clinical approaches, there is limited evidence in low income countries like Ethiopia including the study area. Objective: To assess the proportion of non adherence to dietary and physical activity recommendation and associated factors among type 2 diabetic patients on follow up in government hospitals of Ilu Abba Bora Zone, Oromia Region, Ethiopia , 2018. Methods: A facility based, cross-sectional study was employed from March 19 to May19, 2018 in the chronic follow up units of Ilu Abba Bora Zone governmental hospitals. The final calculated sample size was 422 which were proportionally allocated to both hospitals and systematic sampling was used. Data were collected using a structured interviewr administered questionnaire. Data were edited and entered into Epidata version 3.1 and exported to SPSS for analyses. The results of the descriptive statistics were expressed as percentages and frequencies. Associations between independent variables and dependent variables were analyzed using bivariate and multivariable logistic regression analysis. The odds ratio along with 95% CI was used to determine the association. A statistical significance was declared at p value <0.05. Results – The study included 392 respondents with 92.9 % response rate. 201(51.3%) were female and mean age was 47.9 years. The respondents‟ non-adherence to dietary and physical activity recommendation was 51.8% and 38%, respectively. On multivariable logistic regression analyses, dietary non-adherence was found to be lower in housewives [AOR=5 (95%CI: 2.5, 9.8)], diabetic association members [AOR=2.8, (95%CI: 1.6, 4.9)], patients who had high perceived susceptibility [AOR=2 (95%CI: 1.1, 3.7)] and good emotional support for dietary regimen [AOR=1.9 (95%CI: 1.2-3.1)]. Physical activity non adherence was found to be lower in males [AOR=2 ( 95%CI :1.2, 3.4)], younger patients[ (AOR=8.6 (95%CI: 2.6,28.7)], in patients who had high perceived severity[AOR=1.7 (95%CI:1.1, 2.8)] , self efficacy [AOR=2.6 (95%CI:1.6,4.4)] and with those had abdominal abesity [AOR=2.5 (95%CI:1.3,4.8 )]. Conclusion and Recommendations – The rates of non adherence to dietary and physical activity were generally found to be high. Model based and family centered educational programs that especially focus on individual habits and preferences and ongoing support for patients should be designed and qualitative studies which assess reasons for non adherence should be conducted.