Dietary self-care and associated factors among Diabetic patients in Jimma university medical Centre, south west Ethiopia; application of Health Belief Model

Abstract

Background: - Diabetes Mellitus (DM), a chronic metabolic disorders which caused about 4.2 million deaths and at least USD 760 billion dollars’ expenditure in 2019, has been targeted for action by leaders of WHO member countries. In Ethiopia deaths due to DM has reached 34,262 in 2013. Studies show effective lifestyle interventions; particularly medical nutrition therapy reduces HbA1c by 0.5 to 2%. However, practicing self-care, specifically recommended diet is reported to be difficult. Not only Knowledge and practice but also perception studies are therefore necessary to design future health programs. Objective: -To assess diabetic self-care, dietary practice and associated factors among diabetes patients. Method: - Institution based cross sectional study design was employed from february15- May15, 2020 in Jimma university medical Centre(JUMC). Systematic sampling of every other patient (K=2.7) was employed to interview 374 participants. previously validated tool was used to collect data through face-to-face interview. Path analysis was used to fit structural model and test the hypothesized Health Belief Model(HBM) relationships. Result: - Response rate was 94.6%(354). Around fifty-two percent of the participants were male and 76.8% follow diabetic education at least some times. 42.4% and 48% of respondents have good dietary and general self-care practice. Very strong correlation is detected between dietary self-care and general self-care practice (r=0.827, p<0.01). Self-efficacy being the strongest, cues to action perceived threat and perceived barrier constructs of HBM have significant effect on dietary self-care practice. Knowledge, social support and diabetes distress exert significant indirect effect on dietary practice through health belief constructs with unstandardized total path coefficient (standard error) of 0.22(0.03), 0.02(0.01), and -0.03(0.004) respectively. Conclusion: - In this study, proportion of good practice is found to be lower for both dietary as well as general self-care. HBM can best fit to explain variability in dietary self-care practice; therefore, future interventions should be designed to address the vast perception and psychosocial factors influencing dietary self-care practices.