Self-care practices of adults with poorly controlled Diabetes Mellitus in Malaysia.

Abstract

This doctoral portfolio presents two separate but related research study reports on ‘self-care practices of adults with poorly controlled diabetes in Malaysia’. It is comprised of five sections. Section one which is the introduction begins with a general discussion on diabetes mellitus (henceforth referred to as diabetes), a common, growing, serious and costly health problem. The importance of self-care in the management of diabetes and its many disabling long-term complications are emphasised. This is followed by a specific discussion of diabetes in Malaysia - its prevalence, the quality of care, cost and the need for research to uncover new information to improve the care provided to Malaysians with diabetes. Section two is the report on the first research study that investigates the four cornerstones of diabetes self-care practices, namely: dietary intakes, medication adherence, physical activity and self-monitoring of blood glucose in Malaysian adults with poorly controlled diabetes. It also explores the factors that influence these self-care practices. Section three is the report on the second research study that assessed the efficacy of an out-patient diabetes educational program based on a self-efficacy theoretical approach to improve firstly, self-care practices and secondly, clinical outcomes of adults with poorly controlled diabetes in Malaysia. It also identified some of the factors that facilitate or impede such a programme in the Malaysian context. Section four integrates the findings of the two related research studies - the first defining the problem and the second providing possible solutions in the Malaysian context. It points out limited diabetes knowledge on self-care can compromise or create problems regarding self-care practices for Malaysians with poor glycaemic control. It also identifies possible areas of research that can uncover new knowledge that may improve the quality of diabetes care and enhance the quality of life of Malaysian with diabetes. Section five includes publication originating from this work.