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Meiho University Graduate Institute of Health Care Thesis KNOWLEDGE, ATTITUDE AND BEHAVIOR OF DIABETIC PATIENTS ON SELF-CARE ABILITY IN VIETNAM Graduate student: Vo Thi Hong Phuong Supervisor: Dr Pi-Li Lin July 2015 KNOWLEDGE, ATTITUDE AND BEHAVIOR OF DIABETIC PATIENTS ON SELF-CARE ABILITY IN VIETNAM Graduate student: Vo Thi Hong Phuong Supervisor: Dr Pi-Li Lin Meiho University Graduate Institute of Healthcare Thesis A thesis submitted to the Graduate Institute of Health Care of Meiho University In partial fulfillment of the requirement for the degree of Master of Health Care July 2015 Acknowledgement I am grateful to my advisor, Dr Pi-Li Lin, for his great effort and support for my study and research It is his guidance with patience, motivation, enthusiasm, and immense knowledge encouraged me to finish my study I’d like to give special thanks to Dr Ho Truc Le, First degree specialist – Director of Binh Chanh hospital, Scientific and Technical Committee and Board of Internal Medicine Department of Binh Chanh hospital, who are supportive of conducting this study Many sincerely thank to the Board of Meiho University and the Board of Nguyen Tat Thanh University for providing scholarship and supporting me during my study period, and to all the staff of Foreign Department of Nguyen Tat Thanh, the staff of Meiho University helped me during the study and stay in Meiho University, Taiwan By the way, I would like to appreciate all of teachers and professors of Meiho university, who kindly guided me on study methodology and data analyses Finally, I definitely cannot finish my study without support of my husband and children Thank you for being beside me with essential emotional supports during my study, my beloved ones Abstract Background: Diabetes mellitus is an urgently topical question of public health Up to now, many studies on diabetes have been conducted on the scope of the country, but there is not any research on this issue in Binh Chanh District Hospital Moreover, in recent years, along with economic development, the living standards of residents in Binh Chanh district have been improved, the rate of diabetic patients in healthcare facilities are increasingly increased The most effective method is applied to reduce the disease progression and complications; the least expensive treatment cost is having early detection and timely patient treatment However, early detection, timely treatment as well as knowledge, attitude, and behavior of diabetic patients are very limited Therefore, the results of this study can be used as evidence if any improvement requirement of their knowledge, attitude and behaviors of people with diabetes Objectives: The objectives of this cross-sectional descriptive study are to investigate, evaluate knowledge, attitude and behavior of people with diabetes being treated in Binh Chanh District Hospital on self-care Simultaneously, I have learned and defined the people rate with diabetes having correct knowledge, attitude and behavior on self- care in Binh Chanh District Hospital Method: A cross-sectional descriptive study was adopted for this study, with the subjects selected using the purposive sampling method.227 patients being treated at internal medicine clinic and internal medicine department of Binh Chanh hospital during December 2015 participated in this study The data were designed in a questionnaire with levels of structured answers, from which patients choose the best answers Approximately 10-minute interviews using a structured questionnaire include parts: knowledge, attitude and behavior of people with diabetes being treated at Binh Chanh hospital on self-care Results: There were a total of 227 participants enrolled in the study Of those, 150 (66.10%) patients were female The mean age of participants was 60.57 ± 10.35 There were 93.39%patients got married, while widows or widowers accounted for 4.81% Housewives, retired, and manual labor gained the highest proportions (66.05%) Regarding to level of education, 57.26% patients had finished education from primary school to high school There were only 33.92% patients had admitted the hospital in emergency status Among them, a great portion of patients (61.04%) have been in the hospital less than week Age had a strong association with knowledge about self-care (p< 0.001), meanwhile education had an impact on both knowledge and behavior of diabetic patients (p< 0.05) Patients who had emergency status got lower knowledge, attitude and behavior score than patients with non-emergency status, and the differences were statistically significant (p < 0.05) Finally, length of hospital stay not only had an association with attitude but also behavior (p < 0.05) Conclusion: Our study aimed at exploring the knowledge, attitude, and behavior towards self-care among people with diabetes Results showed that diabetic patients visiting Binh Chanh hospital had poor knowledge, attitude, and behaviors scores The possible factors could be lack of awareness, unavailability of information and literacy level of the study population We recommend that implementation of adequate awareness programs may enhance the knowledge, attitude, and behavior which in turn would improve the control of diabetes Contents Pages Appendix 1: The detailed findings Appendix 2: The questionnaire Appendix 3: Informed consent Appendix 4: Ethical certification for conducting study Appendix 5: Consultant expert forms LIST OF TABLES Pages ABBREVIATIONS AD Anno Domini ADA American Diabetes Association BMI Body Mass Index CDC Centers for Disease Control and Prevention DDCT Diabetes Control and Complications Trial HLA Human Leukocyte Antigen IDF International Diabetes Federation SD Standard Deviation UK The United Kingdom UKPDS The United Kingdom Prospective Diabetes Study WHO World Health Organization Chapter Introduction 1.1 Significance of this research Nowadays, diabetes is a globally public health problem, affecting the health of many people, especially people in the working age over the world According to the World Health Organization, in 2014 the global prevalence of diabetes was estimated to be 9% among adults aged 18years and above (WHO, 2012) and more than 80% of diabetes deaths occur in low- and middle-income countries (WHO, 2014) Therefore, diabetes is a non-communicable diseases which WHO initially concerns in community healthcare strategy The complications caused by type diabetes have significant impact on the social and economic burden among patients and society more broadly (van Dieren, Beulens, van der Schouw, Grobbee, & Neal, 2010) A number of studies were implemented to investigate the economic impact of type II diabetes worldwide The results were surprising to find not only a large cost burden in high-income countries, but also in low and middle-income countries where people with diabetes and their families face high costs for treatment (Seuring, Archangelidi, & Suhrcke, 2015) As WHO stated that there are about 30 million people with diabetes in the world in 1985, and about 98.9 million people in 2004, and up to now about 180 million people and that number will be doubled to 366 million in the 2030s (Ta, 2006) This is one of three diseases with the fastest growing rate and one of the causes of death in developing countries The prevalence of diabetes is different between continents and regions There is 1.4% of the population suffered from diabetes in France; the rate of diabetics is 6.6% in America; Singapore is 8.6%; 3.5% of diabetes rate in Thailand; and the rate of diabetes is 3.01% in Malaysia (D S Nguyen, 2007); in Cambodia (2005) the age of 25 and over 10 của bác sĩ không hút thuốc (người chưa hút thuốc không cần trả lời) 25 Tôi biết phải định kỳ tái khám để kiểm tra trị bệnh 107 C HÀNH VI (Dưới hoạt động bạn tháng gần nhất, xin vui lòng chọn (x)câu tra lời phù hơp với bạn Từ trước đến Thỉnh Không Thường Liên không có thoảng đặn xuyên tục 5 5 5 5 Câu hỏi 1.Bạn tự kiểm soát được phần ăn của Mỗi tuần bạn vận động tối thiểu lần, lần từ 20 đến 30 phút Tôi ghi chép lại số lần kiểm tra đường máu theo đề nghị của người trị bệnh Mỗi ngày tiêm insulin dùng thuốc (Người không dùng thuốc hay không tiêm insulin khơng cần trả lời) Khi tơi ngồi tơi có đem theo bánh, trái ngọt để phòng tránh đường máu thấp Mỗi ngày kiểm tra chân của Khi ngồi tơi mang giầy dép thích hợp Khi ngồi tơi mang giấy bệnh tiểu 108 đường Mỗi ngày giảm số lần hút 5 thuốc (người không có hút thuốc không cần trả lời) 10 Khi bị thương tơi đến phòng khám bệnh viên để chữa trị 11 Tôi không có sử dụng phương thuốc cổ truyền để trị bệnh tiểu đường Xin chân thành cảm ơn sự hợp tác của quí Ông/bà! 109 Appendix 3: Informed consent THE INFORMED CONSENT My name : …………………………………………………… Address : ………………………………………………… After informed explicitly about the purposes and related information of the study “KNOWLEDGE, ATTITUDE AND BEHAVIOR OF DIABETIC PATIENTS ON SELF-CARE ABILITY IN VIETNAM” I am willing to allow the authors access my medical records All utilization of my data out of the purposes of that study were unlegal Ho Chi Minh city, Day Month Year Signature 110 111 112 113 114 115 116 117 118 119 120 ...KNOWLEDGE, ATTITUDE AND BEHAVIOR OF DIABETIC PATIENTS ON SELF-CARE ABILITY IN VIETNAM Graduate student: Vo Thi Hong Phuong Supervisor: Dr Pi-Li Lin Meiho University Graduate... also behavior (p < 0.05) Conclusion: Our study aimed at exploring the knowledge, attitude, and behavior towards self-care among people with diabetes Results showed that diabetic patients visiting... prevalence of people with diabetes having behavior on self- care in Binh Chanh District Hospital − To evaluate the relationship between knowledge, attitude and behavior on self-care of people with