WOLISO CAMPUS SCHOOL OF HEALTH SCIENCES

DEPARTMENT OF NURSING

ASSESEMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE ON

DIABETES MALITUS SELF-CARE AMONG CHRONIC FOLLOW UP
ATTENDANTS AT SAINT LUKE CATHOLIC HOSPITAL, WOLISO TOWN
SOUTHWEST SHOA ZONE OROMIA, ETHIOPIA 2024 G.C.

ADVISOR’S: Mr. BIRHANU YADETA (BSC, MSC, ASS. PROFESSOR)

Mr. KEMAL ABDELA (BSC, MSC)

A RESEARCH PROPOSAL SUBMITTED TO DEPARTMENT OF NURSING

IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR BACHELOR
DEGREE IN NURSING (BSC NURSING).

WOLISO ETHIOPIA

SEPTEMBER, 2024 G.C

ACKNOWLEDGEMENT
We would like to express our deepest gratitude to our advisors (Mr. Birhanu Yadeta (Assistant professor
and Mr. Kemal Abdela (BSc, MSc). Next, our appreciation/gratitude also goes to Ambo University
Woliso Campus College of Medicine and Health Sciences department of Nursing for giving us a chance
to carry out this important research proposal. Moreover, we also thank staffs of Saint Luke Catholic
Hospital for giving us important document/data/information used for proposal development and their
willingness to guide us by any aspects.

i
Table of Contents
1. INTRODUCTION.................................................................................................................................8
1.1. Background.....................................................................................................................................8
1.2. Statement of the Problem...............................................................................................................9
1.3. Significance of the Study..............................................................................................................10
2. LITERATURE REVIEW...................................................................................................................11
2.1. Over View......................................................................................................................................11
2.2. Diabetes self-care practices..........................................................................................................11
2.3. CONCEPTUAL FRAMEWORK................................................................................................14
..................................................................................................................................................................14
..................................................................................................................................................................14
..................................................................................................................................................................14
3. OBJECTIVE........................................................................................................................................15
3.1. General objective:.........................................................................................................................15
3.2. Specific objectives:........................................................................................................................15
4. METHODS AND MATERIALS.......................................................................................................16
4.1. Study area and period..................................................................................................................16
4.1.1 Study area................................................................................................................................16
4.1.2 Study Period............................................................................................................................17
4.1.3 Study design................................................................................................................................17
4.1.4 Source of population...................................................................................................................17
4.1.5 Study population.........................................................................................................................17
4.1.7 Eligibility.....................................................................................................................................17
4.1.8 Inclusion criteria.........................................................................................................................17
4.2. Sample size determination...........................................................................................................17
4.3. Sampling procedure......................................................................................................................18
4.4. Data Collection instrument and procedure.................................................................................18
4.5. Study Variables.............................................................................................................................18
4.6. Operational definitions.................................................................................................................19
4.7. Data Quality Assurance................................................................................................................20

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 4.8. Data Processing and Analysis......................................................................................................20
4.9. Ethical consideration....................................................................................................................20
Dissemination of Plan..............................................................................................................................20
Chapter 4.................................................................................................................................................20
4.1 WORK PLAN................................................................................................................................20
Chapter 5.................................................................................................................................................21
5.1 BUDGETS OF THE RESEARH PROJECT...............................................................................21
5.1.1 STATIONARIES........................................................................................................................21
5.1.2 PERSONNEL..............................................................................................................................22
Table4. Budget Summary...................................................................................................................22
References.................................................................................................................................................23
Annex one: Consent Form....................................................................................................................26
ANNEX.2 English version questionnaires for interview...................................................................26

iii
List of Tables
Table 1.Work plan..................................................15

Table 2.Supply Budget breakdown........................16

Table 3.Personnel Budget breakdown....................16

Table 4.Budget Summary.......................................17

iv
List of Figures

1. Map of Woliso Town........................................................10

v
Acronyms and abbreviations

AIDS: Acquired Immune Deficiency Syndrome

BUN: Blood urea nitrogen

CDC: Center for Disease Control

DM: Diabetes Mellitus

FMOH: Federal Ministry of Health

GDM: Gestational Diabetes Mellitus

HIV: Human Immune Deficiency Virus

IDF: International Diabetic Foundation

OHA: Oral Hypoglycemic Agent

PI: Principal Investigator

SMBG: Self-Monitoring of Blood Glucose

SPSS: Statically Package for Social Science

T1DM: Type 1 Diabetes Mellitus

T2DM: Type 2 Diabetes Mellitus

WHO: World Health Organization

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SUMMARY

Introduction: Diabetes is a general term for a group of metabolic disorder that affects the body’s ability
to process and use sugar for energy. Diabetes is a serious public health problem that threatens the quality
of life. The success of long-term maintenance therapy for diabetes depends largely on patients’ adherence

with self-care practices.

Objectives: To assess self-care practices among diabetic patients at Saint Luke Catholic hospital,
Woliso town, 2024 G.C.

Methods: Institutional-based descriptive cross-sectional study will be conducted from September23-

October8 2024. The sample size will be calculated by using single population proportion which
is .......then simple random sampling will be used to select participants in Saint Luke Catholic hospital,
Woliso town. Data will be collected by using questionnaires and face to face interview and then collected
data will be edited, tail on master sheet, coded and entered into statistical software SPSS version 25 and
results will be presented in text, tables, and graphs finally descriptive statistics will be done and
summarized accordingly.

vii
1. INTRODUCTION
1.1. Background
Diabetes Mellitus is a general term for a group of metabolic disorders that affect the body’s ability to
process and use of glucose for energy. The three most common forms of diabetes mellitus are Type 1
Diabetes Mellitus, Type 2 Diabetes Mellitus, and Gestational diabetes. Type 1 diabetes results from cell
destruction usually leading to absolute insulin deficiency. Type 2 diabetes mellitus results from a
progressive insulin secretory defect on the background of insulin resistance [1]. Gestational diabetes
mellitus (GDM) is diabetes diagnosed for the first-time during pregnancy. There are also specific types of
diabetes due to other causes, for example genetic defects in cell function, genetic defects in insulin action,

diseases of the exocrine pancreas (such as cystic fibrosis), and drug or chemical induced [2].

The prevalence of diabetes has reached epidemic proportions. According to IDF Atlas, 6th edition 2013
report, an estimated 382 million people were living with diabetes in 2013. The number is expected to
grow to 592 million by 2035. This equates to approximately 3 new cases every 10 seconds or almost 10
million per year and the largest age group currently affected by diabetes is between 40-59 years. [3].

The IDF 2013 report also revealed that at the time of the study, 19 million adults in Africa were estimated
to have diabetes. This would rise to 28 million by 2030 with prevalence of 4.3%, an increase of 80%,
which exceeds the predicted worldwide increase of 55% [4]. Type 2 diabetes is responsible for 85-95% of
all diabetes in high income countries and for well over 90% of diabetes in Sub-Saharan Africa. Based on
the IDF Atlas 5th edition, 2012 report, number of cases of diabetes in Ethiopia is estimated to be about
1.4 million in 2010 [5].

According to IDF Atlas 5th edition 2012 report Diabetes caused 4.6 million deaths in 2011 globally.
WHO estimates that diabetes deaths will double between 2005 and 2030 Proportions of patients with
diabetic complications in sub Saharan region ranged from 7-63% for retinopathy, 27-66% for neuropathy,
and 10-83% for nephropathy. Diabetes is likely to increase the risk of several important infections in the
region, including tuberculosis, pneumonia and sepsis [6].

The benefits of engaging in a recommended self-care regimen is clear but research remains limited on
determining recommended self-care practices level among diabetes patients.

1
1.2. Statement of the Problem
DM is a global health problem targeted for action and currently increasing in the number and prevalence
of cases [7, 8], According to IDF 2017 report more than 425 million people worldwide are reported as
diabetic patient and nearly 80% of them are living in low- and middle income countries including
Ethiopia.

Globally more than 212 million people with diabetes are not aware of the disease and there are above 352
million people with impaired glucose tolerance [9] which put them at high risk of developing diabetes and
its complication like cardiovascular disease, stroke, kidney failure, foot ulcer, visual impairment and
nerve damage. [7, 10]

Diabetes self-care is important to keep the disease under control it includes performing activities such as
healthful eating, regular physical activity, foot care, medication adherence and self-monitoring of blood
glucose. [10]

However, it’s highly challenging since many people with DM may have contact with health care
professionals for a total of few hours per year and factors such as diabetes knowledge, physical activity,
social support and self-efficacy can affect the self-care practice. [11]

Diabetes has a great burden on the quality of life and socio-economic structures of the affected
individuals, their families and the country’s economic status. Countries like Ethiopia, where the resources
are limited and treatment costs of the disease are constantly increasing, good adherence self-care practice
may result in better economic and therapeutic outcome. [10, 12]

In Ethiopia diabetes become a fast growing and more common chronic illness in which >1 million people
are expected to be diabetic patient and it becomes the most common cause of admission which fasten the
development of complications like heart attack and stroke. As a result, it shortens individual life span 10-
15 years despite this the feature of self-care practice towards DM is not adequate. [6]

Although such studies are in such resource limited area to realizing the various complex nature of
problem and to individuals, integrate the clinical approach that will enhance the diabetic self-care practice
utilization [10, 11]. There is limited study conducted in this study area regarding self-care practice among
DM patients and all the available literatures in Ethiopia were limited in addressing factor that influence
self-care practice.

2
These studies have begun to illuminate our understanding of some of the predictors of differences in
diabetes self-care, but there are limited research findings on patients who are found in sub Saharan Africa
including Ethiopia. To address these deficits, this research had explored patient’s self-care practice in
Saint Luke Catholic Hospital Woliso town

1.3. Significance of the Study

Diabetes Mellitus is a common incurable chronic disease which emerged as an important clinical and
public health problem throughout the world. Likewise, in Ethiopia, diabetes has become more common
and it is a fast-growing disease. WHO estimated the number of cases of diabetics in Ethiopia to be about
800,000 in 2000, and projected that it would increase to about 1.8million by the year 2030. It requires
continual medical care and education to prevent its complications [6]. Although the importance of self-
care in preventing complications is well established, it is often not achieved. For that reason, this research
was attempted to provide a holistic overview on patients’ diabetes self-care practice and adherence to
diabetes self-care behaviors of Diabetes Mellitus at Saint Luke Catholic Hospital, Woliso town.

3
2. LITERATURE REVIEW
2.1. Over View
Definition: Diabetes Mellitus is a group of metabolic diseases characterized by chronic hyperglycemia
resulting from defects in insulin secretion, insulin action or both. It is a disease that prevents our body
from properly using the energy from the food we eat. There are 3 types of diabetes this are type 1, type 2
and Gestational.

According to the CDC 2012 report adults aged 18 to 64 were the most diagnosed age group for Diabetes
mellitus. But due to wide spread poor lifestyle habits and increased awareness for early screening coupled
with early diagnostic tools, it’s becoming more common in younger patients than ever before [13].

2.2. Diabetes self-care practices

Various terms have been used to describe patients’ own practices concerning diabetes treatment.
Adherence to diabetes self-care regimens has been defined as the level to which the patient daily follows
the diabetic self-care regimens established actively by the patient and health care professionals. Self-care
can be either strict adherence to prescribed regimens or active self-care. Active self-care refers to self-
monitoring, dietary adjustments, insulin dosage for daily purposes and regular exercise adherence is more
suitable term than compliance to describe diabetes care.

1. Blood and urine sugar testing adherence condition

A study was conducted in Ethiopia selected health institutions and results showed that, only 21% of
patients had access for blood glucose monitoring at the same health institutions. Only 11(5%) of diabetes
patients were able to do self-blood glucose monitoring at home. 51% of patients didn’t have urine
analysis, BUN, creatinine and lipid profile in the previous 1 -2 years. None of diabetic patients had
hemoglobin A1C (HbA1c) determination. About 87% of diabetics had regular follow ups at their
respective health centers and hospitals [6].

A survey was conducted on factors associated with self-monitoring of glycemic control among persons
with diabetes in Benin City, Nigeria and result showed that 72% subjects practiced glucose self-
monitoring, 63% by testing urine, 8% by testing blood glucose. Most tested once in week and the
frequency of testing differed on the basis of the method employed and also the level of education [14].
Another study was conducted SMBG among diabetes patients attending government health clinics in
Nigeria Sembilan, Malaysia and the result showed that among those who performed SMBG, the majority
(83.5%) monitored less than once per a day and only 16.5% monitored at least once a day. Once third of
patients adjusted their medications based on their SMBG results. Although SMBG is recognized to be

4
useful and effective in achieving diabetes control, this study has found that only a minority of patients
with diabetes performed SMBG. Hence, health care personnel must increase awareness on the
importance of SMBG and strongly promote the practice among diabetes patients [15].

A study done in India, its result showed that only 35% respondents were monitoring their urine sugar
level regularly. 227(66%) of respondents were aware about their blood sugar at home [16]. Another study
result in Malaysia showed that only 15% of subjects practiced SMBG [17].

A study in Egypt showed that only 21.4%, 26%, and 53% respondents were good, poor and no adherence
to blood glucose test respectively [18].

2. Medication adherence condition

A study done on medication adherence of Malaysian adults with diabetes and result of this study revealed
that 46% respondents were non-adherence and also tended to have higher fasting blood glucose level.
Oral anti hyperglycemic medication showed association with poor self-care practice [17]. Another study
done in Egypt revealed that 9%, 37%, and 54% respondents were showed poor, fair and good adherence
to prescribed diabetic medication [18].

Cross sectional study was done in Iran and reported that 30% male and 18% female, 45% male and 54%
female and 25% male and 28% female respondents had poor, moderate and good adherence to prescribed
medication respectively [19]. Another study done on assessment of adherence to anti diabetic drug
therapy and self-management practices among type 2 diabetes in Nigeria and results of the study showed
that only 44% of cohorts had adequate glycemic control; of these 93% were adjusted adherent with
prescribed anti diabetic drugs. Of the total study subject 59% of patients were non-adherent with the
previous anti diabetic drugs due to lack of finance (51.7%); side effects (34.5%); perceived inefficacy of
prescribed anti diabetic drugs leading to self-medication with local herbs (13.8%) [20]. A study in Finland
indicated that majority of subjects accomplished their insulin treatment as scheduled but had more
difficulties with other aspects of self-care [21].

3. Diet management practices adherence condition

A study was conducted on assessment of Dietary practice among diabetes patients in United Arab
Emirates and the result showed that 76% reported being unable to distinguish clearly between low and
high carbohydrate index food items and no one reported counting calorie intake, 46% reported that they
had never been seen by dietician since their diagnosis. Their overall risk profile, notably body weight,

5
lipid profile and blood pressure, was very unfavorable; more than half of the study sample had
uncontrolled hypertension and uncontrolled lipid profile and the majority was overweight (36%) or obese
(45%). Abdominal obesity was particularly common (59%). Only 31% had an HbA1c of less than 7%
[22]. The study in Egypt indicated that 19%, 39% and 42% respondents were showed no, less frequent
and more frequent compliance to diet management practices [21]. A study done in Iran revealed that 4%
male and 0%, 38% male and 33% female and 59% male and 67% female respondents had poor, moderate
and good adherence to diet management instructions respectively [22].

4. Physical activity adherence condition

A cross sectional study was done on physical activity and reported barriers to activity among type 2
diabetes patients in United Arab Emirates and the result of the study showed that of the 390 patients
recruited, only 25% reported an increase in their physical activity levels following the diagnosis of
diabetes and only 3% reported physical activity levels that meet the recommended guidelines. Only 32%
had an acceptable glycemic control [23]. Study in India indicated that of the total study subjects 82% of
the respondents were aware that regular physical exercise is helpful; but only 13% of them followed this
advice [16].

5. Diabetes foot care adherence condition

A cross sectional study was conducted on knowledge and practices to ward diabetic foot care among
patients attending three tertiary hospitals in Nigeria and result showed that of 352 diabetes patients, 10.2
% had good practice of DM foot care and the majority (78.4%) of patients with poor practice of foot care
[24].

Institutional based descriptive study was done on self-care and risk factors of diabetic foot care in patients
with type 2 DM and the study result of diabetic foot care assessment showed that 36% had deficit or very
deficient hygiene; 73% did not go regularly to the chiropodist, 76% used scissors, 75% did not check the
inside of the shoe. 38% had signs of neuropathy and 17% of peripheral vasculopathy, 25% were at high
risk of diabetic foot. The author concludes that the amount of self-care is very low, especially in hygiene,
which did not improve over time. [25].

A descriptive cross-sectional study was done to describe knowledge and practices regarding foot care in
diabetic patients visiting diabetic clinic in Jinnah hospital, Lahore, Pakistan and the result showed that
only 14%respondents had good practices for foot care, 54% had satisfactory practices and 32% had poor
practices [26].

6
 6. Overall self-care practices adherence condition

A study was conducted on assessment of self-care practice and its associated factors among diabetic
patients in Iran and the result showed that patients’ self-care practice was good in 15.1%, moderate in
58.7% and poor in 26%. There was a significant association between education, duration of disease and
treatment intensity and self-care of patients [19]. A study done in India indicated that despite the fact that
all respondents were aware that diabetes is not a curable disease, and regular follow up is very important,
only 168 (48%) were showing compliance to this advice [16].

As summary, the overall theme of the literature review is, patients’ self-care practices are indeed very
important part of maintaining a good diabetes status. They are especially significant because there are
good possibilities to enhance them the above research findings showed that the majority of respondents
were adhered to prescribed medication, diabetes foot care, diet management practices and physical
activity except SMBG which is suboptimal in most study subjects or a minority of study subjects
performs SMBG.

7
 2.3. CONCEPTUAL FRAMEWORK

Obesity,
Age, Race

Socio
economic Family
status history of
Diabetes DM
- Mellitus

Life style

-lack of exercise

-Diet

8
3. OBJECTIVE
3.1. General objective:
To assess self-care practices of diabetic patients at Saint Luke Catholic hospital, Woliso town, 2024 G.C

3.2. Specific objectives:

• To assess diet practice of adults with DM at the chronic follow-up in Saint Luke Catholic
hospital, Woliso town, From September 23-October 8 2024 G.C.

• To assess physical exercise practice of adults with DM at the chronic follow-up In Saint Luke
Catholic hospital, Woliso town, From September 23-October 8 2024 G.C.

• To assess blood sugar monitoring practice of adults with DM at the chronic follow-up in Saint
Luke Catholic hospital, Woliso town, From September 23-October 8 2024 G.C.

• To assess foot care practice of adults with DM at the chronic follow-up in Saint Luke Catholic
hospital, Woliso town, From September 23-October 8 2024 G.C.

• To assess medication adherence of adults with DM at the chronic follow-up in Saint Luke
Catholic hospital, Woliso town, From September 23-October 8 2024 G.C.

• To assess smoking practice of adults with DM at the chronic follow-up in Saint Luke Catholic
hospital, Woliso town, From September 23-October 8 2024 G.C.

9
4. METHODS AND MATERIALS
4.1. Study area and period

4.1.1 Study area

The study area was Saint Luke Catholic Hospital which is found in Ayetu kebele, Woliso woreda
Southwest Shoa zone, Oromia regional state which is 115 kilometers from the capital city Addis
Ababa longitudinal of with an elevation of 2063 meter above sea level. The catchment population is
expected to be ......... people according to the hospital administration. The hospital has four major
departments: Medicine, Surgery, Pediatrics and Gynecology & Obstetrics. In the hospital there is no
separated chronic follow up unit. So, they have their follow ups at the any of adult OPDs that are found in
hospital.

Figure.1. Map of Woliso Town

10
4.1.2 Study Period
The study will be conducted From September 23-October 8 2024 G.C.

4.1.3 Study design

An institution-based descriptive cross-sectional study will be conducted among diabetic patients that have
follow-up at Saint Luke Catholic hospital, to assess the diabetic self-care practices.

4.1.4 Source of population

The source population is all diabetic patients who visit chronic follow up unit at Saint Luke Catholic
hospital.

4.1.5 Study population

The study population is all diabetic patients who have chronic follow up at Saint Luke Catholic hospital at
the time of data collection period and fulfilling the inclusion criteria.

4.1.6 Study Unit

Each individual patient is our study unit.

4.1.7 Eligibility

4.1.8 Inclusion criteria

A patient is included in the study if they were diagnosed with diabetes and had follow ups for at least 6
months, if greater and equal to 18 years old and are verbally consented.

4.1.9 Exclusion criteria

Patients who have hearing impairments or any other serious health problem.

11
4.2. Sample size determination

The sample size for the study is determined using the following assumptions and using single population
proportion formula:

n= ( z/2 )2 p ( 1-p ) = (1.96)2 x 0.5(1- 0.5 ) = 384

d2 (0.05) 2

where:-

• P= assumed to be 50%, a proportion of peoples who have good diabetic self-care [27].

• 5% marginal error (d) and

• Confidence interval (CI) of 95%(1.96)

• Based on this assumption the sample size will be calculated by a single population
proportion formula = 384
The final sample size will be determined as follows by using the following correction formula:

nf = ni/ [1 + ni/N],

Where nf = the final sample size,

ni = initial sample size 384 and
N = estimated annual total diabetic patients ( ).
Nf=
After considering a 10% non-response rate, the total sample size .

4.3. Sampling procedure

Consecutive sampling technique will be used.

4.4. Data Collection instrument and procedure

Interviewer administered structured questionnaire data collection tool will be used, it contains three parts.
Part I will be used to collect socio demographic data and health status of patients, Part II will be used to
collect self-care practices of the study subjects. The data collection instrument is adopted from similar
proposal and modified for this proposal tool will be frequently used to measure the domains of diabetic
self-care practices: diet, exercise, medication, SMBG and foot care. Part III will be used to assess

12
smoking status. Three Nursing students will be collect the data after verbal consent will be taken from
respondents who came to outpatient department at Saint Luke Catholic hospital for their follow up.

4.5. Study Variables

• Socio-demographic characteristics include (age, sex, residences, monthly income,

educational level, occupation, marital status).

• Husband or Wife educational level.

• Frequency of visit of health facility.

• Age of diabetes onset,

• Duration of the disease,

• Family history of diabetes,

• Complications of diabetes,

• Treatment intensity

• Types of medication they use

• Self-care practice

4.6. Operational definitions

Good dietary Practice: - participants were asked about how many days of the last 7 days they
participated in each activity, scores ranged from 4-7 days.

Poor dietary practice: -a score of 0-3 days was considered as poor self-care.

Good physical activity practice: - a score of 5 days.

Poor physical activity practice: - a score of <5 days.
Good foot care practice: -a score ranged from 4-7 days.

Poor foot care practice- a score ranged from 0-3 days.

Good blood sugar testing practice- a score of 7 days.

Poor blood sugar testing practice: - a score of less than 7 days.

13
Good adherence to medication: - taking the recommended medication every day that means a score of 7
days.

Poor adherence to medication: - a score of <7 days.

Over all good self-care is having an overall mean score of greater than 3.

Over all poor self-care is having an overall mean of less than 3 [28].

4.7. Data Quality Assurance

The collected data will be reviewed and checked for completeness and consistency by team members on
daily bases at the spot during the data collection time.

4.8. Data Processing and Analysis

The data will be entered, cleaned and analyzed by using statistical Package for social science (SPSS).
Different socio demographic variables of the study participants will be assessed and practice will be
computed by using the overall mean score of each response to the items in the summary of diabetes self-
care activities. The overall mean score of each domain will be divided by the sum of the number of
questions under each scale. After calculating the overall mean score, it will be classified as having good
self-care practice if respondents score greater than or equal to 3 or poor if scored less than 3.

4.9. Ethical consideration

Respondents will be informed about the purpose of the study then information will be collected after
obtaining verbal consent from each participant. Respondents will be allowed to refuse or discontinue
participation at any time they want. Information will be recorded anonymously and confidentially.

Dissemination of Plan
At the end of the data dissemination final research paper will be submitted to Ambo
University, Woliso campus Department of Nursing and it will be presented for all
Department teachers and campus researchers.

14
Chapter 4
4.1 WORK PLAN
Table 1.The following table shows the schedule in which over all study program will be conducted
among Saint Luke Catholic Hospital Diabetic patients self-care.

S. Activities Responsibl Sep23 Sep30 Oct15 Oct20 Oct28 Nov1 Nov4 Nov10 R
o
N e body e
1 Topic PI
selection
2 Development PI
research
proposal
3 1st draft PI
submission of
proposal
4 Final PI
proposal
5 Data PI
collection
6 Data analysis PI
of
interpretation
7 Report PI
writing
8 Submission PI
st
of 1 draft
report
9 Final report PI
submission
10 monitoring PI,advisor
11 Research PI
defense
KEY: - PI- Principal investigation

15
Chapter 5
5.1 BUDGETS OF THE RESEARH PROJECT
5.1.1 STATIONARIES
Table2. Supply budget breakdown for the study of on the proportion of Diabetes Mellitus self-care
among chronic follow-up at Saint Luke Catholic Hospital.

Material Unit Total needed Unit cost Total cost

Duplicating paper Each 2000 3 6000
Paper pad Each 2 10 20
Pen Each 8 30 240
Pencil Each 6 10 60
Flip chart Each 2 300 600
Marker Each 8 20 160
Eraser Each 3 5 15
Flash disk Each 1 650 650
Sub total 7745

5.1.2 PERSONNEL
Table3. Personnel budget breakdown for the study on the proportion of Diabetes mellitus self-
care among chronic follow up at Saint Luke Catholic hospital.

Personnel Unit cost of Ethiopian Multiplying factors Total cost

birr
Supervisor 600 600*7 4200
Data collector 800 800*8 6400
Sub total 10600

16
Table4. Budget Summary
S.no Discretion Total cost
1 Stationeries 7745
2 Data collection 10600
3 Grand total 18335

17
References
1. Diabetics. Better medicine. 2011.Availablat: and accessed on December
http://wwwbettermedicinecom/article/diabetes 2018
2. Khardori: R. Type2DiabetesMellitusWorkup.Medscape2010 http://emedicinemedscapecom/article/
2018
3. Diabetic facts. IDA data base. 2011. http://wwwworlddiabetesfoundationorg/ 2018
4. Diabetes in the developing world. Media Backgrounder IDF data base.2011
http://wwwworlddiabetesfoundation2018.
5. Health HVaTRJoBMCP. Diabetes in Sub Saharan Africa 1999-2011: epidemiology and public
health implications. 2011;(14):564.

6. Yeweyenhareg Feleke. An assessment of the health care system for diabetes in Addis Ababa.

Ethiopia Journal of Health Development 2005;19(3):203-10.

7. WHO, global report on Dm, world health organ 2016

8. Teoz, shiA, zhao,t-epidomgical perspective of diabetes biochembiophy 2015

9. Karurang S,FendandJ,Huang Y, Malande IDF Diabetes atlas,8th edition 2017

10. American DM association standards of medical care in diabetes, 2016

11. RambiharilalSS SaurabhPS,RamasamyJ,Role of self-care management of diabetes mellitus ,2013

12. Ayele K, Tesfa B, Abebe L, Tilahun T, Girma , selfcare behavior among patients with diabetes in
Harari ,Eastern Ethiopia the health belief model perspective 2012.

13. CDC 2012 report on type 2 DM

14. An Eregie and B C unadike. Factors associated with self-monitoring of glycemic control among
persons with diabetes in Benin City, Nigeria. African journals of diabetes medicine 2010: 19(1).

15. Mastura I and Mimi O, et al. self-monitoring of blood glucose among diabetes patients attending
government health clinics. Medical journal of Malaysia 2007:62(2):147-51. 53

18
16. Dr J P, Majra. Awarness regarding self-cares among diabetes in rural area. Middle east journal of
medicine, 2009:7(6).

17. Tan M. Self-care practices of Malaysian adults with diabetes and sub-optimal glycemic control
patient. Educational Counseling. 2008; 72:252–67.

18. Eman M and Hala I. Awadalla, Compliance to diabetes self-management in rural El miana, Egypt
central european journal of public health 2011;19(1): 35-41

19. ZehraY.andrezapourali et al assessment of self-care practice and its associated factors among
diabetic patients. Journal of research in health sciences. 2016; 11(1): 33-38.

20. KazeemB.Yusuff and OlubumniObe.etal. Adherence to antidiabetic drug therapy and

selfmanagement practices among type 2 diabetics. International journal of clinical pharmacy and
pharmaceutical care, 2015: 30(6).

21. MaisaToljamo and Maija H. Adherence to self-care and glycemic control among people with
insulin dependent diabetes mellitus journal of advanced nursing. 2001; 34(6): 780 -86.

22. Juma Al kabi and Ftima Al maskari assessment of Dietary practice among diabetes patients in
United Arab Emirates. Journal of the society for biomedical diabetic research, 2015.

23. Juma Al kabi and Ftima Al maskari physical activity and reported barrier to activity among type
2 diabetes patterns in United Arab Emirates. Journal of the society for biomedical diabetic research, 2009.
54.

24. O Desalu and F K salawu, et al. Diabetic foot care: self- reported knowledge and practice among
patients. Ghana medical journal; 2013: 45(2):60-65.

25. Moreno Hernandez MI and TrillaSolerM,et al.self-care and risk factors of diabetics foot in
patients with type 2 mellitus. pub med 2007.

26. Seema H and Naheed H,knowledge and practice regarding foot care in diabetic patients visiting
diabetic clinic in Jinnah Hospital, Lahore, journal of Pakistan medical association 2007.

27. Segni Wannichali, Mohammed Hassen Salih, and AddisuTaye Abate, Self-care associated factors
among Diabetes Mellitus patients on follow up in Benishangul Gumuz Regional state public Hospitals,
Western Ethiopia 2018.

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Toober DJ, HampsonSE, GlasgowRE the summary of diabetes self-care Diabetes care
J.2000;23(7);943-50

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 Annex one: Consent Form
Introduction
Hello! We are BSC nursing student from Ambo University Woliso campus. We are interested
to do our research on assessment of Diabetes Mellitus self-care among chronic follow up in Saint
Luke Catholic Hospital.
The following questions are about your self-care of Diabetes Mellitus. Your answers to these
questions will help us to find out about the prevalence of Diabetes Mellitus self-care. The
information that you give is confidential and you do not have to answer the questions if you
do not want to. The information you provide is of vital importance, so try to answer as sincerely
and accurately as possible. This is not a test there are no right or wrong answers. What you tell
us is completely confidential and only the researchers will have access to the form. Your name or
address will never be linked to any of the information you provide.

ANNEX.2 English version questionnaires for interview

Step 1 A. Sociodemographic Information of Respondent

No Questions Alternative Choices for Skip

Response

101 Sex 1. Male

2. Female

102 Age (enter number) -----------Years

103 Occupation 1.Housewife

2.Government employee

3.Private employee

4.Business

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 5.Other (Specify)

104 Residence 1 urban

2 rural

105 Educational status: 1. No formal learning

2. primary school

3. secondary school

4. college education

5. other specify____________

106 Marital status 1 married

2 divorced

3widowed

4 single

107 Your wife or husband 1. No formal learning

educational level
2. primary school

3. secondary school

4. college education

5. other specify____________

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108 Monthly income in Eth. Birr: - ____________________

109 Frequency of visit to health 1 every month

center
2 every 2 month

3 every 3 month

110 Duration of DM (in years) 1. 1-5

2. 6-10
3. >10

111 Type of medication they use 1. Oral

2. Injectable
3. Both

112 Family history of DM 1. Yes

2. No

KNOWLEDGE QUESTION REGARDING COMPLICATIONS OF CHRONIC DM

Questions Response options
Yes no Don’t Remark
know
WHAT IS DM?
201 Dm is a condition caused by insufficient insulin 1 2 3
production

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202 Dm is a condition caused by body cell non response 1 2 3
to insulin
203 Dm is a condition of high level of blood sugar 1 2 3
204 Dm is a condition which can affect any part of the 1 2 3
body
CONTROL AND MANAGEMENT OF DM
205 Does insulin injection help for management of DM 1 2 3
206 Are tablet and capsules available for management of 1 2 3
DM
207 Does regular exercise help for the control of DM 1 2 3
208 Does healthy diet practice help for management of 1 2 3
DM
COMPLICATION OF DM
209 Does DM cause blindness 1 2 3
210 Does DM Cause kidney disease 1 2 3
211 Does DM cause heart disease 1 2 3
212 Does DM cause foot ulcers and amputations 1 2 3
213 Does DM cause stroke 1 2 3

Attitude questions towards DM

Response option
S.N variable Agree Disagree Neither agree
O nor disagree

301 I can lead a normal life if I 1 2 3

take appropriate measures
for diabetes
302 Regular exercise prevents 1 2 3
further complication

303 I could prevent diabetic 1 2 3

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 complications

304 Glycemic control has a 1 2 3

role in preventing
complications

305 Diabetic spoils my social 2 1 3

life
306 Dietary modification is 1 2 3
important to prevent
diabetic complication
307 Weight reduction is 1 2 3
important to prevent
diabetic complication
308 I don’t tell people as I have 2 1 3
diabetics
309 Diabetes is the worst thing 1 2 3
that have ever happened to
me

PRACTICE QUESTIONS TOWARD PREVENTION OF CHRONIC COMPLICATION

OF DM
S.N Variable Response options
O
401 Forget to take medicine/ insulin 1.Yes 2.no

402 Careless at times about taking 1.Yes 2.no

medicine

403 Stop taking medicine when feel better 1.Yes 2.no

404 Stop taking medicine when feel 1.Yes 2.no

worse

405 Physical work or exercise in the last 1. Never 2. Once a week

week
3. 2-3 times a week 4. Almost daily 5.

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 daily
406 Duration of physical work or exercise 1. < 10 Minutes/day 2. 10-20
Minutes/day
3. 20-30 Minutes/day 4.> 30
Minutes/day
407 Diet modification according to the 1.Yes 2.no
recommendations of physician

408 Self-Monitoring of blood glucose 1.Yes 2.no

409 checking feet 1.daily 2.once a week

3. rarely 4.never
410 Wearing footwear during exercise as 1.Yes 2.no
recommended by health professional

411 Type of water used to wash feet 1.cold 2.warm

412 Do you care during cutting toe nails 1.Yes 2.no

413 Periodic kidney examination 1.Yes 2.No

414 Regular checkup of eye by eye 1.Yes 2.No
specialist

415 Drinking alcohol 1. Never 2. Rarely 3. Weekly

4.2-3 times a week. 5. Daily
416 Cigarette smoking 1Yes 2.No

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