BMC Research Notes | |
Factors associated with nonadherence to diet and physical activity among nepalese type 2 diabetes patients; a cross sectional study | |
Liaquat Ali2  Narbada Thapa2  Farzana Saleh3  Janaki Parajuli1  | |
[1] Department of Community Medicine, Nepalgunj Medical College, Teaching Hospital, Koholpur, Banke, Nepal;Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh;Department of Community Nutrition, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh | |
关键词: Type 2 diabetes; Physical activity; Diet; Adherence; Nonadherence; | |
Others : 1125813 DOI : 10.1186/1756-0500-7-758 |
|
received in 2013-08-28, accepted in 2014-10-02, 发布年份 2014 | |
【 摘 要 】
Background
Nonadherence to diet and physical activity is a major problem in the management of diabetes mellitus and its complications. This study was undertaken to measure the factors associated with nonadherence to diet and physical activity advice among Nepalese type 2 diabetic patients.
Methods
An analytical cross-sectional study was conducted among type 2 diabetic patients (age, M ± SD, 54.4 ± 11.5 yrs) and interviewed using three days recall method for dietary history and Compendium of Physical Activity for physical activity. Data were analysed by univariate and multivariate statistics.
Results
Out of 385 patients, 87.5% were nonadherent and 12.5% poorly adherent to dietary advice. 42.1% were nonadherent, 36.6% partially adherent while 21.3% good adherent to physical activity. Adherence to dietary advice was higher in males than females (M ± SD, 33 ± 16.7 vs 27 ± 15.5, p = 0.001), those staying nearer to hospital than farther (M ± SD, 32 ± 18.6 vs 28 ± 13.5, p = 0.013), those advice by physician than others (p = 0.001) and from nuclear family than joint and extended (p = 0.001). With increasing age, dietary advice adherence decreased (p = 0.06) and was positively correlated with the knowledge about diabetes mellitus (r = 0.115, p = 0.024). Physical activity adherence was higher in those with positive family history of diabetes than others (M ± SD, 74 ± 24.2 vs 65 ± 23.6, p = 0.001), upper middle socioeconomic class respondents than lower ones (p = 0.047) and from extended family than nuclear or joint ones (p = 0.041). Divorced were more nonadherent to physical activity than married and widowed patients (p = 0.021).
Conclusions
Determinants of nonadherence to dietary advice: Female gender, increasing age, joint or extended family members, farther distance from hospital, poor knowledge about diabetes mellitus and advice by others than physicians. Determinants for nonadherence to physical activity: negative family history of DM, divorced status, lower socioeconomic class.
【 授权许可】
2014 Parajuli et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150217025653629.pdf | 602KB | download | |
Figure 6. | 37KB | Image | download |
Figure 5. | 30KB | Image | download |
Figure 4. | 30KB | Image | download |
Figure 3. | 18KB | Image | download |
Figure 2. | 44KB | Image | download |
Figure 1. | 66KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
Figure 4.
Figure 5.
Figure 6.
【 参考文献 】
- [1]International Diabetes Federation: IDF Diabetes Atlas, 6th edn. Brussels, Belgium: International Diabetes Federation; 2013. http://www.idf.org/diabetesatlas webcite
- [2]Editorial 2003: Epidemic of diabetes in urban Nepal-time to act. J Nepal Med Assoc 2003, 42:I-II.
- [3]Bisiriyu G: Non-Adherence to Lifestyle Modification Recommendations (Diet And Exercise) Among Type 2 Diabetes Mellitus Patients Attending Extension Ii Clinic in Gaborone, Bostwana. University of Limpopo; 2008. [M Med thesis] [cited on 2011 Mar 18]; Available from: http://ul.netd.ac.za/bitstream/10386/259/1/Dr%20Ganiyu%20final.pdf webcite
- [4]Diabetic Facts, IDF, Diabetes Atlas. 4th edition. 2010. [cited on 2011 Mar 17] Available from: http://www.worlddiabetesfoundation.org webcite
- [5]Ibrahim NR, Attia SG, Sallam SA, Fetohy EM, El-Sewi F: Physicians’ therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria. J Family Community Med 2010, 17:121-128.
- [6]Anderson JW, Gustafson NJ: Adherence to high-carbohydrate, high-fiber diets. Diabetes Educ 1998, 15:429-434.
- [7]Shokair NF: Pattern and determinants of compliance of diabetes to health care in Alexandria: community-based study. Bull Alex Fac Med 2004, 1:1110-1834.
- [8]Suwannapong N, Howteerakul N, Suwannapon N, Rittichu C, Rawdaree P, Rittichu N, Rawdaree P: Adherence to regimens and glycemic control of patients with type 2 diabetes attending a tertiary hospital clinic. Asia Pac J Public Health 2007, 19:43-49.
- [9]Peyrot M, Rubin RR, Lauritzen T, Snoek FJ, Matthews DR, Skovlund SE: Psychosocial problems and barriers to improved diabetes management: results of the cross-national Diabetes Attitudes, Wishes and Needs (DAWN) Study. Diabet Med 2005, 22:1379-1385.
- [10]Ghosh A, Ghosh T: Modification of Kuppuswamy’s socioeconomic status scale in context to Nepal. Indian Pediatr 2009, 46:1104-1105.
- [11]WHO: Appropriate body-mass index for Asian population and its implications for policy and intervention strategies. Lancet 2004, 363:157-163.
- [12]Karin M, Gayle R, Edward J: Diet and exercise among adults with type 2 diabetes, findings from the third national health and nutritional examination survey. Diabetes Care 2002, 25:1722-1728.
- [13]Wendy A, Barbara B, Terry A, Pollvka A: Perceived recommended standards of care among adults with diabetes. Diabetes Educ 2002, 28:989-998. [Cited on 2012 Apr 25]; Availabe from: http://tde.sagepub.com/content/28/6/989 webcite
- [14]Mohamed E, Shams A, Enaase A, Barakot B: Measuring the rate of therapeutic adherence among outpatients with T2DM in Egypt. Saudi Pharma J 2010, 18:225-232.
- [15]Ary DV, Toobert D, Wilson W, Glasgow RE: Patient perspective on factors contributing to non-adherence to diabetes regimen. Diabetes Care 1986, 9:168-172.
- [16]Rowley C: Factors Influencing Treatment Adherence in Diabetes. Universiy of Calgary; 1999. [cited on 2012 Jan 15]; Available from: http://www.who.int/features/factfiles/diabetes/01_en.html webcite
- [17]Serour M, Alqhenaei H, Al-Saqabi S, Mustafa A, Ben-Nakhi A: Cultural factors and patients’ adherence to lifestyle measures. Br J Gen Prac 2007, 57:291-295.
- [18]Ataur RK, Zaki N, Al-Abdul L, Mohammad A, Aithan A, Ibrahim A, Shabbir AK: Factors contributing to non-compliance among diabetics attending primary health centers in the AI Hasa district of Saudi Arabia. J Family Community Med 2012, 19:26-32.
- [19]Waldo AL: Noncompliance in patients with type 2 diabetes enrolled in local diabetes education program. City of Laredo health department, Laredo, Texas. Spring 2008, 18:85-86.
- [20]Balazs H, Margit K, Peter K, Zsuzsanna H, Antal S, Zoltan V, Romana Z: Self-reported medication and lifestyle adherence in Hungarian patients with type 2 diabetes. Pharm World Sci 2007, 29:58-66.
- [21]Shobhana R, Begum R, Snehalatha C, Vijay V, Ramchandran A: Patient’s adherence to diabetes treatment. J Assoc Physicians India 1999, 47:1173-1175.
- [22]International Association for the Study of Obesity and International Obesity Task Force, World Health Organization: The Asian Perspective-redefining Obesity and its Treatment. Australia: Health Communications Australia Pty Ltd on behalf of the Steering Committee; 2000:17-18.
- [23]Juma A, Fatma A, Hussein S, Bachar A, Hasratali P, Nagelkerke N: Physical activity and reported barriers to activity among type 2 diabetic patients in the United Arab Emirates. Rev Diabet Stud 2009, 6:271-278.
- [24]Warren RE: The stepwise approach to the management of type 2 diabetes. Diabetes Res Clin Prac 2004, 65:3-8.
- [25]Welschen LMC, Oppen PV, Dekker JM, Bouter LM, Stalman WAB, Nijpels G: Study protocol: the effectiveness of adding cognitive behavioral therapy aimed at changing lifestyle to managed diabetes care for patients with type 2 diabetes – design of a randomized controlled trial. BMC Public Health 2007, 7:74-83. BioMed Central Full Text
- [26]Adisa R, Alutundu MB, Fakeye TO: Factors contributing to nonadherence to oral hypoglycemic medications among ambulatory type 2 diabetes patients in Southwestern Nigeria. J Pharm Prac 2009, 7:163-169.
- [27]Khattab MS, Abolfotouh MA, Khan MY, Humaidi MA, Alkaldi YM: Compliance and control of diabetes in a family practice setting, Saudi Arabia. East Mediterr Health J 1999, 5:755-765.
- [28]Kapur K, Kapur A, Ramachandran S, Mohan V, Aravind SR, Badgandi M, Srishyla MV: Barriers to changing dietary behavior. J Assoc Physicians India 2008., 56
- [29]Travis T: Patient perception of factors that affect adherence to dietary regimens for diabetes mellitus. Diabetes Educ 1997, 23:152-156.
- [30]Ha R, Kamar MG, Hassan MR: Evaluation of effect of education on diabetes control in Sharkir Governorate. Zagazig Med Assoc J 1992, 5:39-48.
- [31]Chan YM, Molassiotis A: The relationship between diabetes knowledge and compliance among Chinese with non-insulin dependent diabetes mellitus in Hong Kong. J Adv Nurs 1999, 30:431-438.
- [32]Gopalan R, Srinivasa DK, Dasgupta B: Perceptions & practices of diabetics in pondicherry. Indian J Med Res 1991, 94:30-35.
- [33]Lee VWY, Leung PY: Glycemic control and medication compliance in diabetic patients in the pharmaco-mangaed clinic in the Hongkong. Am J Health Syst Pharm 2003, 60:2593-2596.
- [34]Brownson RC, Eyler AA, King AC, Brown DR, Shyu YL, Sallis JF: Pattern and correlates of physical activity among US Women 40 years and older. Am J Public Health 2000, 90:264-270.
- [35]Barrett JE, Plotnikoff RC, Courneya KS, Raine KD: Physical actviity and type 2 diabetes: exploring the role of gender and income. Diabetes Educ 2007, 3:128-143.
- [36]Barwell ND: Studies of the Interaction between Diabetes, Family History, Exercise Adiposity and Metabolic Health. 2010. [PhD thesis] [cited on 2012 May 13] Available at: http://theses.gla.ac.uk/2072/01/2010barwellphd.pdf webcite
- [37]Foreyt JP, Carlos WS: The challenges of diet, exercise and lifestyle modification in the management of the obese diabetic patients. Int J Obes 1999, 23:5-11.