Factors Influencing Adherence to Diabetes Treatment Recommendation among Diabetic Clients at Kampala International University Teaching Hospital Bushenyi District

ABSTRACT 

Poor adherence to treatment of chronic diseases is a worldwide problem of particular concern. Globally, studies have indicated that recommended glycemic control is achieved by less than 50% of patients on anti-diabetes treatment due to non-adherence this was contrary to the findings of across sectional study carried out in Iganga and Bugiri in Uganda between October 2012 and January 2013 where adherence rate was found out to be 83.3%. Therefore to assess factors influencing adherence to diabetes treatment recommendations, a cross-sectional study design quantitative in nature was employed to recruit 61 respondents for the study out of whom 61 questionnaires were returned completely filled thus a response rate of 100%. The researcher found out that 72.1%, 80.3% and 70.5% of the respondents strongly agreed that level of income, route of drug administration and co morbidities respectively influence adherence to diabetes treatment recommendations. The researcher concluded that demographic factors influencing adherence to diabetes treatment recommendations include; Age, gender, occupation, education level and income level of the client. Therapy related factors influencing adherence to diabetes treatment recommendation include; Route of drug administration, complexity of treatment regimen, side effects, cormorbidities and other perceived barriers. Health care related factors influencing adherence to diabetes treatment recommendations include; Affordability, clinic attendance, health education, waiting time and accessibility.

TABLE OF CONTENTS

Abstract………………………………………………………………………................................i

Copyright……………………………………………………………………...……......................ii

Authorization………………………..……………………………………………..……………..iii

Dedication..……………………………………………………………………………………….iv

Acknowledgement…………………………………………………………..…………………….v

List of figures……………………………………………..……………………...……................ix

List of tables……………………………………………………………………………………..xi

List of acronyms……………………………………………………………...……....................xii

Definition of terms………………………………………………………….....…….................xiii

CHAPTER ONE…...…………….………………………………………………………………1

Introduction………………..………………………………………………………...……………1

Background………………..…………………………………………………………...................1

Problem statement……………..…………………………………………………...……………..3

Study purpose………………………..………………………………………………....................4

Specific objectives…………………………..…………………………………………………….4

Research questions………………………..……………………………….………………………4

Justification………………….…………………………..…………………………..…………….4

CHAPTER TWO…………………..………………….…………………………….....................6

Literature review………………………………………….……………………...………………6

Introduction………………………………………………………………………………………6

Demographic factors………………..…………….……………………………………………...6

Therapy related factors……………………………..………………………………....................8

Health care related factors…………….………………………………………………………….9

CHAPTER THREE………………………………..……………………………………………11

Methodology……………………………………………………………………………………11

Introduction………………………………………………..……………..…………..................11

Study Design and rationale……………………………………………………...………………11

Study setting………………..……………………………………….………………..................11

Study Population………………………...……………………………………….....……………12

Sample size determination…..………………...…………………………………...……………12

Sampling procedure……………………………..…………………………………....................13

Selection criteria…………………………………………………………………………………13

Inclusion criteria…………………………………………………………………………………13

Exclusion criteria…………………………………………………………….………………….13

Study variables………………………………………………………………………………….13

Dependent variable………………...………..…………………………………….……………..13

Independent variable………………………..……………………………………..……………..13

Research Instruments…………..………………………………………………………………..14

Data collection procedure……………………………………...………………………………...14

Data management………………………………………………….……………….....................15

Data analysis and presentation…………………………………………………………………..15

Quality control techniques…………………………….………………………………………..15

Ethical consideration……………………..………………………………………......................15

Study limitations/delimitations………………………………...……………………………….16

Dissemination of results…………………………………………...……………........................16

CHAPTER FOUR……………………………………………………….……………................17

Data analysis and presentation………………………………………………...........……………17

Introduction………………………………………………………………………..…………….17

Bio demographic data……………………………………………………………………………17

Demographic factors influencing adherence to diabetes Treatment recommendations…………19

Therapy related factors influencing adherence to diabetes treatment recommendation…………………..21

Health care related factors influencing adherence to diabetes Treatment recommendations……………..24

CHAPTER FIVE……………………………………………………………….……..................27

Discussion, conclusion, recommendations and implications to the nursing practice……………27

Introduction…………………………………………………………………………....................27

Discussion of findings……………………………………………………………………………27

Bio demographic data……………………………………………………………………………27

Demographic factors influencing adherence to diabetes treatment….……………......................29

Therapy related factors influencing adherence to diabetes treatment recommendation…………………..31

Health care related factors influencing adherence to diabetes treatment recommendations……………...34

Conclusion……………………………………………………………………….……………………….36

Recommendations………………………………………..……………….……………………..36

REFERENCES……………………………………………………………….….………………………..38

Appendix I: Informed consent…………………………………………………...………………41

Appendix II: Questionnaire…………………………………………..…………………………..42

Introductory letter………………………………………………………………………………..46

Appendix V: Map of Uganda showing Bushenyi district………….…………………………….47

Appendix vii: Map of Bushenyi district showing KIU-Teaching Hospital……………………..48