| dc.description | A Project submitted to the Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, in partial fulfillment of the requirements for the award of the Degree of Master of Public Health (Health Promotion and Education) of the University of Ibadan, Ibadan, Nigeria. | en_US |
| dc.description.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. | en_US |
