Self-Care Practices Among Elderly Patients With Type 2 Diabetes Mellitus At The Greater Accra Regional Hospital

Abstract

Diabetes Mellitus (DM) has become a major public health problem in Ghana, Sub-Saharan Africa (SSA), and the entire globe. Diabetes is among the four non-communicable diseases globally. Studies have revealed that Ghana has been experiencing an increased number of aged populations who are likely to suffer from chronic diseases such as diabetes and increase demand for healthcare. Therefore, diabetes self-care practices among the elderly living with type-2 diabetes mellitus are very crucial in its management as poor self-care results in complications. However, in Ghana, little scholarly attention has been given to diabetes self-care practices among older adults living with Type 2 Diabetes Mellitus. Therefore, the reason for conducting a qualitative study was to explore the self-care practices of elderly patients with Type 2 Diabetes Mellitus at the Greater Accra Regional Hospital. Albert Bandura's Social Cognitive Theory (1986) was used to guide the study. An exploratory descriptive design with a purposive sampling technique was used to recruit twelve (12) participants after saturation was achieved. A face-to-face interview was done using a semi structured interview guide and audiotaped. Transcriptions of the collected data were done verbatim. Thematic content analysis was used to analyze the data received. Four major themes emerged after the analysis of collected data. These were: Knowledge of diabetes self-care, Self-regulation practices in diabetes management, Barriers that affect the management of diabetes, and a support system received by elderly patients in diabetes management. The findings of the study revealed that some of the participants knew self-care practices such as eating healthy, self-monitoring of blood glucose levels, and foot care practices among others, and were empowered, motivated, and achieved good results whilst others too were not engaging in effective diabetes self-care activities due to certain environmental impediments which served as barriers. It revealed financial hardship as one of the major barriers faced by elderly diabetes patients despite partial coverage of the National Health Insurance Scheme (NHIS). Therefore, diabetes patients should be given high-quality adequate diabetes education, and delivery of diabetes education should include other formats such as video, leaflets, and written). Diabetes education can also be done at the community level for elderly diabetes. The government should make diabetes carefree for older adults with Type 2 Diabetes Mellitus. Developing theory-based approaches to care for individuals with diabetes can create a more progressive, coherent body of knowledge to assist healthcare providers in effectively teaching and coaching patients’ diabetes self-care. Diabetes self-care among elderly patients is suboptimal. Therefore, Diabetes education by health professionals should also include patient empowerment and culturally sensitive approaches that will be accepted by individuals with diabetes. In managing diabetes, it can be concluded that diabetes self-care practices which are healthy eating, medication adherence, self-monitoring of blood glucose, physical activity, and foot care practices are the key elements required for diabetes patients to stay healthy with improved quality of life. For that barriers to diabetes management should be given serious attention by stakeholders (hospitals, health professionals, health programmers, community leaders, government, etc) of this group.