Aswathi, K V (2017) Effectiveness of diabetic risk reduction package on knowledge lifestyle and biophysiological measures among prediabetic employees in selected Institutions Thiruvallur District. Doctoral thesis, The Tamil Nadu Dr. M.G.R. Medical University, Chennai.
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Abstract
INTRODUCTION: Diabetes has become a universally recognized health care problem. One in every six adult suffers from diabetes and at the same time every six seconds one individual dies because of diabetes. Diabetes is preceded by a condition known as Prediabetes, where the individual has higher levels of blood sugar but not high enough to be diagnosed as diabetes. It is a reversible condition projecting the last window opportunity against impeding diabetes. Diabetes is also known as the “Sweet heart of Diabetes” due to the increased incidence and complications of cardio vascular diseases, occurring as a result of increased blood sugar. The Centre for Disease Control and National Diabetes Statistics reports that 37% of adults >20 years and 51% adults >65 years had prediabetes during 2009-2012. Type 2 Diabetes Mellitus has given rise to enormous personal, social and economic burdens. World Health Organisation(WHO) estimates that diabetes will increase from 171 million in 2000 to 366 million by 2030.India has been declared as the diabetic capital, so far 41 million have diabetes and every 5th diabetic in the world is an Indian. Diabetes is considered as the 7th leading cause of death. The highest crude prevalence rate of diabetes and prediabetes is in Kerala and lowest crude prevalence rate in Kashmir. Diabetes Atlas published by International Diabetes Federation states that the number of diabetic people in India is currently 40.9 million and expected to rise to 69.9 million by 2025.This is mainly due to the so called “Asian Indian Phenotype” referring to the unique biochemical and clinical abnormalities in Indians including increased insulin resistance, greater abdominal adiposity (higher waist Circumference despite lower BMI), lower adinopectin and higher C-reactive protein. This phenotype makes Indians more prone to diabetes. World Heath Day Theme 2016 rallied to “Halt the Rise of Diabetes”. If rising trends are to be halted and reversed, current approaches to addressing prediabetes needs to be implemented. The following are the suggested strategies to control prediabetes and prevent its progression to diabetes, (i) creating awareness among people about prediabetes (ii) early detection of prediabetic status and (iii) following healthy life style practices by being physically active, eating healthy and avoiding excessive weight gain. A study has been conducted on the effectiveness of Diabetic risk reduction package on knowledge, lifestyle and biophysiological measures among the prediabetic employees in selected institutions of Thiruvalur District. The abstract was presented as Introduction, Method, Results, Analysis and Discussion (IMRAD) format of writing. The objectives of the study were 1. To assess and evaluate the effectiveness of diabetic risk reduction package on knowledge, life style and bio physiological measures among prediabetic employees in experimental and control group. 2. To correlate the mean differed score of knowledge, life style and biophysiolgical measures among prediabetic employees in experimental and control group. 3. To associate the mean difference level of knowledge, life style and biophysiological measures with selected demographic variables of experimental and control group The null hypotheses formulated for the study were NH1: There is no significant difference in knowledge, life style and biophysiological measures with diabetic risk reduction package among prediabetic employees at p<0.05 level. NH2: There is no significant relationship of mean differed score of knowledge, life style and bio physiological measures of experimental group and control group at p<0.05 level. NH3: There is no significant association of mean difference level of knowledge, life style and bio physiological measures with selected demographic variables at p<0.05 level. The research process for this study was guided by the conceptual framework based on the Wiedenbach Theory-helping art theory. The theory focused on health promotion strategies to prevent development of diabetes in future. MATERIALS AND METHODS: A quasi experimental research design was adopted for the study. The independent variable for the study was diabetic risk reduction package and the dependent variables for the study were knowledge, life style and biophysiological measures. The study was conducted in 20 schools at Thiruvallur district. The samples of the study were all prediabetic employees between the age group of 20-60 years. Enumerative sampling technique was used in this study. The data collection instrument was the structured questionnaire to assess the knowledge of prediabetes, Food Frequency Questionnaire to assess the lifestyle practices and height, weight, Body Mass Index (BMI), Waist Circumference (WC) and Fasting Blood Sugar (FBS) to assess the biophysiological measures. Data collection was conducted after receiving the ethical committee approval from International Centre for Collaborative Research (ICCR), Omayal Achi College of Nursing. A formal written permission was obtained from the head of the institution and school authorities. The data collection was preceded with the screening for prediabetes (Indian Diabetic Risk Score >30 and FBS 100-125mg/dl) and all the teachers identified as prediabetics were allocated to the experimental and control group. In the first week, pre test assessment of knowledge was done. After the pretest Diabetic Risk Reduction Package (Information Education Communication package along with food and activity tracker) was explained to the prediabetic employees individually in experimental group alone after obtaining written informed consent and ensuring confidentiality. The post test of knowledge was assessed after 1week in the experimental group. In the experimental group the food and activity tracker was verified after two months and the investigator assessed the achievement of the short term goal by checking the bio physiological measures (excluding FBS) again by the end of 4th month, the food and activity tracker was verified and confirmed the achievement of the long term goal by checking the bio physiological measures (excluding FBS). Finally, by the end of the 6th month food activity and biophysiological measures were verified including FBS. Reinforcement of the interventions was given by the investigator throughout the data collection period once in every 15 days. The reinforcement was given by the investigator directly and also by telephonic conversation. The volunteers who were teachers were used for the follow up and reinforcement, they aided in motivating the group to follow the food and activity tracker. The same scheme of data collection was done for the control group, with exception of intervention alone. All ethical principals were followed during the process of data collection. RESULTS: • The analysis revealed that in the experimental group, the overall mean knowledge score in the post test was 20.70 whereas in the control group, it was 12.55. The unpaired ‘t’ test value was t = 24.54 which was greater than the table value at p<0.001 level and revealed that there was a high significant difference between the experimental and control group at p<0.001 level in knowledge score. • The analysis showed that in the experimental group, in the pre test, the mean life style score was 50.86, in post test 1 the mean life style score was 54.18, in post test 2 the mean life style score was 62.47 and it was further increased to 72.65 in the post test 3. In contrast, the mean life style variable score in the control group remained the same at 50.12, 50.25, 51.05 and 51.30 in pre-test, post test 1, post test 2 and post test 3 respectively. The “F” test revealed that there was high statistically significant difference in the pre and post tests of experimental group at p<0.001, proving the effectiveness of DRRP and there was no significant difference to be found in the level of life style variable for the control group. • Regarding the biophysiological measures reduction, the analysis revealed that in the post test of experimental group, the overall mean BMI, and FBS was 27.15 and 101.60 respectively whereas in control group, it remained the same with mild increase and decrease such as 28.40, and 105.89. The unpaired ‘t’ test for BMI and FBS revealed that there was a high significant difference between the experimental and control group at p<0.05 and p<0.00I respectively. • Oneway Annova test revealed that there was statistically significant association between the study variables namely knowledge, life style, biophysiological variables and the selected demographic variables of age, marital status, type of family, educational status, family monthly income and history of DM. • The evidence generated from the study revealed that for the experimental group the Diabetic Risk Reduction Package had significant impact in improving the knowledge, at p<0.001 level. • There was positive moderate correlation among the knowledge and life style variables. There existed negative moderate correlation between lifestyle and biophysiological measures. Hence there was statistically significant difference between the experimental and control group. CONCLUSION: The study concluded that the Diabetes Risk Reduction Programme (DRRP) is an effective intervention strategy in the prevention of diabetes and management of prediabetes. Hence, the study recommended the utilization of DRRP by the Community Health Nurses, Nurse Researchers, Nurse Administrators, Nurse Educators, Primary and Secondary health care professionals to prevent or delay the occurrence of diabetes mellitus and manage prediabetes, to increase awareness towards prediabetes and empower them to make appropriate healthy lifestyle behaviour decisions.
| Item Type: | Thesis (Doctoral) |
|---|---|
| Additional Information: | 21071/2014 |
| Uncontrolled Keywords: | Diabetic Risk Reduction Package, Indian Diabetic Risk Score (IDRS), Fasting Blood Sugar (FBS), Prediabetes. |
| Subjects: | NURSING > Community Health Nursing |
| Depositing User: | Subramani R |
| Date Deposited: | 07 Nov 2021 02:48 |
| Last Modified: | 07 Nov 2021 02:48 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/18608 |
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