FACTORS INFLUENCING ADHERENCE TO RECOMMENDED SELF-CARE PRACTICES IN THE MANAGEMENT OF TYPE II DIABETES MELLITUS AMONG PATIENTS ATTENDING KAKAMEGA COUNTY REFERRAL HOSPITAL, KENYA

Abstract

Type II Diabetes Mellitus is estimated to be 3.3% prevalent in Kenya. Adherence to recommended self-care practices is essential for the prevention of complications and premature deaths associated with Type II Diabetes Mellitus. However, unsatisfactory adherence to self-care practice has been reported even with health education programs at the Kakamega County Referral Hospital. The primary objective of this research was to establish the factors influencing adherence to recommended self-care behaviors. The specific aims were to establish the patientrelated, hospital-related, and disease-related factors that impacts adherence to recommended selfcare behaviors in Type II Diabetes Mellitus patients visiting Kakamega County Referral Hospital. A cross-sectional study was prioritized where a simple random selection was utilized to choose 145 patients out of a total of 198. 4 Key informants were selected from a pool of 30 medical staff using purposive sampling. The link between the independent factors and their dependent variables was examined using two methods: chi-square and multiple logistic regressions. Content analysis was used to assess qualitative data. The variables: patient related factors, hospital related factors and disease related factors were mostly associated with adherence to the recommended self-care practices at (p =0.000), (p =0.004) and (p =0.000) respectively. The study found age and marital status as the patient related factors influencing adherence to self-care practices. Hospital related factors influencing adherence included quality of healthcare services, physician patient relationship and delivery of key information. Disease-related factors influencing adherence to self-care included duration and co-morbidity. For the purpose of reducing the complications and deaths associated with T2DM, policies should be made towards scaling up adherence in those subgroups of diabetics found to be at risk of low adherence as informed by the findings of this study i.e. the elderly and single. Awareness among newly diagnosed cases is critical in management of T2DM to ensure improved adherence