Effectiveness of Structured Teaching Programme on Fasting Blood Sugar among Patients with Type II Diabetes Mellitus in a selected Community Health Centre of Dadra and Nagar Haveli area

 

Sharma Priya¹*, Malik Sujeeta²

¹Assistant Professor, Shri Vinoba Bhave College of Nursing, Silvassa.

²M.Sc. Nursing Student, Shri Vinoba Bhave College of Nursing, Silvassa.

 

ABSTRACT:

Background: Diabetes is one of the incurable but easily controllable diseases. It is a chronic disease due to impaired between glucose and insulin in the body. Methods: An evaluative research method was selected. A pre-experimental (one group pretest – posttest) design was adopted for this study. The samples for the study were 80 Patients with Type II DM which were selected by using non- probability purposive sampling technique. Pretest and Posttest score were utilized to achieve goal of the study. Results: Result showed that in pretest mean score of fasting blood sugar was 164.65 and post-test mean score was 110.91. It Shows that there was significant difference in the mean pre-test knowledge score and mean post-test knowledge score of Patients with Type II DM on management of Diabetes as measured by ‘t’ test (22.01) which was significant at 0.05 level of significance. Conclusion: The study concluded that the STP was effective. Hence the patients with diabetes should be encouraged to attend health education programme.

 

 

INTRODUCTION:

Diabetes mellitus (DM) is a group of common metabolic disorders that share the phenotype of hyperglycaemia with disturbance of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action or both. Several distinct types of DM are caused by a complex interaction of genetics and environmental factors.¹ According to world diabetes atlas close to one-fifth of all adults with diabetes in the world live in the South-East Asia Region. Current estimates indicate that 8.8% of the adult population, or 78.1 million people, have diabetes, 69.2 million of whom live in India.²

 

The number of people with diabetes in India will increase to 123 million by 2040- 12.1% of the adult population. A further 36.5 million people have impaired glucose tolerance, and this will increase to 65.3 million by 2040.³ India has the second highest prevalence of diabetes among adults (9.1%) in the south East Asian region. About 1.1 million people die from diabetes related illnesses in India every year.⁵ A cross - sectional study was conducted to assess the knowledge regarding self care knowledge among diabetic patients in Warangal region, Andhra Pardesh. Four hundred and fifty six patients participated in the study using non probability convenient sampling technique. The results revealed that only 3.50 % diabetic population were with >80 % knowledge. 29.38 % population were with 60-79 % knowledgeable, in which men with 81 (35.52%) had knowledge compared to women 53 (23.24%). They found that there is a definite need to empower patients with the knowledge required to help them obtain maximum benefit from their treatment for diabetes.⁶ Diabetes education, with consequent improvement in knowledge, leads to better control of the disease, and is widely accepted to be an integral part of comprehensive diabetes care.⁷

 

This research aimed to assess the effectiveness of structured teaching program on knowledge regarding management of Diabetes Mellitus among Patients with Type II DM in a selected community health centre of Dadra and Nagar Haveli.

 

MATERIAL AND METHODS:

Pre- experimental study was conducted in Community Health Centre of Dadra Nagar Haveli. Community Health Centre was previously served as Primary Health Centre. In 2016 it was upgraded as Community Health Centre. Approximately 100 patients with Type II Diabetes Mellitus are coming for follow up at the interval of 15 days. Samples were selected by purposive sampling during January, 2018 and patients with Type II Diabetes Mellitus attending OPD were included as study population. After written consent from each study respondents after inclusion and exclusion criteria, data was collected from 80 study subjects who were participated in study. Structured interview schedule method was used to collect data from study respondents by utilizing structured questionnaire that includes demographic characteristics as well as knowledge variables related to management of Diabetes Mellitus. The response with right or correct answer was marked as knowledge score ‘1’ and with don’t know or wrong scored as ‘0’ for variables under study.

 

The maximum and minimum knowledge score was obtained and respondents were categorized into inadequate, moderately adequate and adequate knowledge quality. Knowledge variable and demographic characteristics frequency percentage distribution of study subjects were done and Chi-square test was applied to find out statistical association between knowledge and demographic characteristics.

 

RESULTS:

Table I: Distribution of respondents according to Baseline Characteristics. n =80

Characteristics	Category	Frequency	Percentage
Age (In years)	18 – 28 29 – 38 39 – 48 49 – 58 ≥ 59	0 10 27 19 24	0% 12.5% 33.75% 23.75% 30%
Gender	Male Female	49 31	61.25% 38.75%
Educational Qualification	Profession or Honors Graduate or Post Graduate Intermediate or post high school diploma High School Certificate Middle School Certificate Primary School Certificate Illiterate	2 0 1 11 22 21 23	2.5% 0% 1.25% 13.75% 27.5% 26.25% 28.75%
Occupation	Profession Semi-Profession Self Employed Skilled Worker Semi-skilled Worker Un-skilled Worker Unemployed	1 0 3 21 20 8 27	1.25% 0% 3.75% 26.25% 25% 10% 33.75%

 

Table II: Distribution of Patients with Type II DM Based on Clinical Variables.       n = 80     

S. NO.	Category	Frequency (f)	Percentage (%)
1	Duration of Illness ≤ 1 ˃1 – ≤5 ˃5 - ≤10 ˃10	12 42 18 8	15 52.5 22.5 10
3	Complication of disease Yes No	32 48	40 60
4	Complications (n = 32) Cardiac Renal Eye Neurological Thyroid Foot Care	23 1 18 1 4 4	71.875 3.125 56.25 3.125 12.5 12.5
6	Blood sugar testing Yes No	80 0	100 0
6.1	Blood sugar value Normal (70-110) Pre diabetes (111- 126) Diabetes (Above 126)	0 5 75	0 6.25 93.75
6.3	Timing of testing After each meal Before each meal Before and after each meal	22 49 9	27.5  61.25  11.25
6.4	Record of value No Yes Only unusual values	30 9 41	37.5  11.25  51.25
7	Difficulty in ADL Yes No	47 33	58.75  41.25

 

Table III: Evaluation of the Effectiveness of Structured Teaching Programme on Fasting Blood Sugar Level of Patients with Type II DM. n = 80

Knowledge score	Mean	Mean difference	S. D.	Paired ‘t’ test value	Df	Table value of ‘t’ test	Level of significance (p value)
Pretest	164.65	53.74	25.43	22.01*	79	1.994	0.05
Posttest	110.91		14.16

*Significant at 0.05 level of significance.

 

The Data presented in Table-II showed that the mean Posttest score 110.91 of fasting blood glucose level is lower than the pretest score 164.65, with the mean difference of 53.74. The obtained mean difference was found to be statically significant as evident from paired ‘t’ value (t_{c79, 0.05} = 22.01>1.994). This shows that the obtained mean difference was a true difference and not by chance. Hence it can be inferred that the structured teaching programme was effective for improving the fasting blood glucose level among patients with type II diabetes mellitus.

 

Figure 1: Diagrammatic Presentation of Mean Score of Fasting Blood Glucose Level of Patients with Type II DM.

n = 80

 

ACKNOWLEDGEMENT:

The authors are grateful to the authorities of Shri Vinoba Bhave College of Nursing, Silvassa for the facilities.

 

 

CONFLICT OF INTEREST:

The authors declare no conflict of interest.

 

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Received on 02.10.2018          Modified on 19.11.2018

Accepted on 03.12.2018     © A&V Publications all right reserved