DIABETES SELF-MANAGEMENT AND ITS INFLUENCING FACTORS AMONG ADULTS WITH TYPE 2 DIABETES MELLITUS IN RURAL SRI LANKA

Abstract

Type 2 diabetes mellitus (T2DM) continues to be an escalating health problem among Sri Lankans. Poor engagement in diabetes self-management (DSM) was seen, especially in rural settings. Thus, the identification of factors influencing DSM is warranted. This study aimed to describe DSM and to examine whether perceived stress, health literacy, self-efficacy, and family support can predict DSM among adults with T2DM in rural Sri Lanka.

A correlational predictive study was conducted in a noncommunicable disease (NCD) clinic at base hospital Kalawana (BHK), Sri Lanka. 160 adults with T2DM were recruited by using a simple random sampling. The data were obtained using a socio-demographic questionnaire (SDQ), The diabetes self-management questionnaire (DSMQ), the Sinhalese version of the perceived stress scale (S-PSS-10), the functional, communicative, and critical health literacy scale (FCCHL), the diabetes management self-efficacy scale – UK version (DMSES-UK), and the family/friend involvement in adults’ diabetes (FIAD) scales after translation into Sinhala language. Data were analyzed using descriptive statistics and standard multiple regression analysis.

The findings revealed that 48.8% of the adults with T2DM had uncontrol Fasting plasma glucose (FPG > 126) levels and reported a sub-optimal overall mean score of DSM (M = 5.84 out of 10, SD = 1.25). The healthcare use subscale had the highest mean score (M = 9.38, SD = 1.06) while the physical activity subscale had the lowest mean score (M = 2.47, SD = 2.61). The perceived stress, health literacy, self-efficacy, and family support could explain 39.3 % of the variance in DSM (F(5, 154) = 21.611, p < .001) and self-efficacy better explained the variance (β = .530, p = .001) followed by harmful family involvement (β = -.169, p = .038) and health literacy (β = -.162., p = .020).

The findings of the study provided the foundation for further development of the intervention to enhance DSM by increasing self-efficacy and reducing harmful family involvement among this population.

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