Background
Diabetes mellitus (DM) is probably one of the oldest diseases known to man. It was first reported in Egyptian manuscript about 3000 years ago.1 Type II Diabetes Mellitus is characterized by chronically elevated blood glucose and elevated blood Insulin. It is estimated that currently there are 57 million people with Diabetes in India and by 2030 is number will swell to 70 million.2 This would mean every fifth Diabetic in the world would be an Indian. Diabetes causes 6 deaths every minute and one in 20 deaths in the world is due to diabetes, every year it is estimated that 3.2 million peoples in the world die due to the Diabetes or its related causes3 Almost 90 to 95% Diabetes is of Type II or majority onset type, which affects people in their middle age, Type I or juvenile diabetes affects 70,000 children under age of 15 years every year. The major causes of increase in the incidence of diabetes are a sedentary lifestyle.4
Patients are released from hospitals and rehabilitation centers earlier in the continuum of care than ever before. Individuals with diabetes, either as a primary diagnosis or a co-morbid condition, are no exception to this trend. This, combined with an end to the fee-for-service payment structure, has challenged home care clinicians to find effective ways of transitioning patients from an acute episode of illness to a return to the community. Recognizing the impact of diabetes as an independent risk factor is key to achieving favorable health outcomes.5
Non-communicable diseases (NCDs) have globally shown increasing impact on health status in populations with disproportionately higher rates in developing countries. NCDs are the leading cause of mortality worldwide and a serious public health threat to developing countries. The objective of the symposium was to understand the current situation of different NCDs public health programs and the current trends in NCDs research and policy, promote exchange of ideas, encourage scientific debate and foster networking, partnerships and opportunities among experts from different clinical, research, and policy fields.6
Diabetes causes damage to arteries as well as nervous system damage. This artery damage results in medical problems that are both common and serious such as Dizziness when standing, Cardiovascular disease, Amputations. Kidney disease, Eye disease and blindness, Sexual Dysfunction, Diabetic neuropathy, Stomach and bowel problems Dizziness when standing, Localized nerve failures (commonly known as Bells palsy). Where in most of the complications are preventable.7
A cross sectional study was conducted in Bengaluru to assess the knowledge regarding home care management of foot care among diabetic patients. 730 types II diabetic patients aged 60 years was undertaken. Mean age was 56.64 + 11.38 years, 67% were males. 15.35% of respondents had poor, 59.9% had average and 24.8% had adequate knowledge.8
The nurse has an important role to play in the management of diabetes mellitus which is a chronic disease, as she has the responsibility of teaching the self-injection of insulin to the patient and family members or significant others and she has to begin this as soon as the need for the insulin has been established and use written or verbal instructions and demonstration techniques for teaching the patients.9
The role of home health care nurses is increasingly important as patients are discharged from hospitals and rehabilitation centers early in the course of illness and require more sophisticated nursing management at home 10 Home care nurses are the liaison among members of the health care team, patients, family members, and caregivers. These nurses are often the only professional who has a complete overview of a patient's medical regimen and, therefore, responsibility for the coordination of care.
A preliminary survey was undertaken by the researcher in the same setting to assess the knowledge of type II Diabetes Mellitus care takers on the prevention of complications. A total of 56 caretakers were surveyed out of which 17(30%) them had a moderate knowledge level and 39(70%) of them presented with an inadequate knowledge level, none of them belonged to an adequate knowledge level.
Hence the present study was undertaken to assess the knowledge of Care Takers regarding the Management of patients diagnosed with Type II Diabetes Mellitus is essential element to consider and needs emphasis to create awareness.
Research Methodology
A Descriptive Survey design was adopted among 70 caretakers at R.L.Jalappa hospital & Research center by using a purposive sampling technique. After obtaining the IEC clearance and permission from the concerned authorities followed by data collection carried out by using validated structured Knowledge questionnaire which is translated to the local regional language of Kolar. Data was analyzed using SPSS version 20.0 descriptive statistics & inferential statistics such as frequency, percentage and chi-square.
Results
Description of demographic variables of the caretakers
Table 1
Frequency and percentage distribution of sample according to sociodemographic variables N=70
Table 2
Association of knowledge scores with socio-demographic variables N= 70
Discussion
The promotion of Knowledge regarding the Management of patients diagnosed with type II Diabetes Mellitus is a very essential component to be recognized among caretakers. In this study, the Caretakers knowledge were assessed. Knowledge of caretakers regarding management of patients diagnosed with type II Diabetes Mellitus has been found to be Inadequate in our study compared to low in other studies.11 Only a few studies have reported on knowledge regarding management of patients diagnosed with Type II Diabetes Mellitus. One multicenter study in Spain reported low mean care takers knowledge which is similar to our finding.
Similarly a Randomized control Trials in Sikkim on identifying the influence of socio-demographic variables on outcome of care takers knowledge on management of type II DM, among 200 care takers revealed that majority of people who are married and employs have more knowledge 75%, compare to those who are unmarried and illiterates 25%.12 These findings are very consistent with the present study findings. Most of the studies found positive about the Knowledge regarding management of patients diagnosed with Type II Diabetes Mellitus.13 As the study was conducted in only one setting with limited sample size, further studies can be replicated to generalize the findings.
Conclusion
Knowledge of Caretakers regarding management of patients diagnosed with Type II Diabetes Mellitus found to be Inadequate. Hence its evident that, awareness and supportive interventions need to be emphasized regarding management of patients diagnosed with Type II Diabetes Mellitus among caretakers.
Implications of the study
Nursing practice: Nursing professionals play a key role in enhancing the knowledge of care takers regarding management and prevention of further complications.
Nursing education: The study emphasizes on significance of short-term in-service, Education program for nursed, peripheral health workers and for students to educate the family members regarding management.
Nursing administration: The nursing administrator can take part in developing protocols, standing orders regarding the health education program for the family members regarding management of care takers with Type II Diabetes Mellitus.
Nursing research: The study helps nursing researcher to develop appropriate health education tools for educating the care takers regarding management of Type II Diabetes Mellitus.
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