KNOWLEDGE, PERCEPTION, ECONOMIC COST AND HEALTH SEEKING BEHAVIOUR RELATING TO DIABETES MELLITUS AMONG PATIENTS ATTENDING UNIVERSITY COLLEGE HOSPITAL, IBADAN, OYO STATE

Abstract

Diabetes Mellitus (DM) is a serious disease condition that is prominent in all countries of the world including Nigeria. The rising prevalence of DM and the complications is a major public health concern. The knowledge, perception, cost and patients’ health seeking behaviour have not been adequately studied among DM patients receiving care in tertiary hospitals. The study was therefore, designed to investigate knowledge, perception and cost of diabetes management among diabetes patients receiving care in University College Hospital (UCH), Ibadan. The study was a descriptive cross-sectional survey which used a purposive sampling technique in selecting 207 consenting respondents in the Medical Outpatient Unit, UCH. A semi-structured interviewer-administered questionnaire was used to elicit information on respondents’ socio-demographic characteristics, knowledge of DM, perception of DM, economic cost of DM and health seeking behaviour of respondents. Knowledge was assessed on a 36-point scale and scores <18, 19-24 and ≥25 were categorised as poor, average and good respectively. Health seeking behaviour was assessed on a 19-point scale and scores 0-10 and 11-19 were categorised as poor and good respectively. Data were analysed using descriptive statistics and inferential statistics at p=0.05. More than half (56.0%) of the respondents were females. The age range of respondents was 38 to 87 years with a mean of 64.2±10.1 years. More (38.2%) respondents had tertiary education; the mean duration of managing DM among respondents was 7.7±6.6 years. Respondents’ mean knowledge score was 25.0±4.8 and those with poor, average and good knowledge were 12.0%, 26.6% and 64.4% respectively. Majority (71.5%) perceived DM as a serious disease. The belief of 62.3% of the respondents was that drugs being prescribed for their treatment at the hospital were too expensive. Over half (53.1%) perceived that DM does not make one a burden in the family while 55.6% reported that DM management makes patients absent themselves from work occasionally. Direct cost of managing DM included the spending of N101 to N500 on transport to the hospital per week (79.5%). Majority (76.3%) spent N1,250 on consultation per clinic. The overall

mean direct cost was N7577.7±4071.8 while overall direct median cost was N6950.0. Indirect cost of DM included the challenge of being accompanied to the clinic by someone (24.6%). Less than half (48.8%) spent between 120-240 minutes in the hospital for care. Majority (87.4%) of respondents had good health seeking behaviour. The mean health seeking behaviour score of respondents was 13.7±2.8. Inferential statistics showed that there was a statistically significant difference between the means of direct cost reported for the two health seeking behaviour categories (P<0.05). Respondents’ knowledge about DM was generally good and most showed favourable perception towards the disease. However, many were not clear about the social burden of diabetes and effects of the disease on their productivity. Economic cost measures in this study reflected the expensive nature of the DM, yet respondents had good health seeking behaviour. Health promotion strategies such as social support, advocacy and training are needed to decrease out of pocket expenditure and waiting time in hospitals.