ADHERENCE TO DIABETIC SELF-CARE MANAGEMENT AND ASSOCIATED FACTORS AMONG TYPE 2 DIABETIC PATIENTS IN NORTH SHEWA ZONE PUBLIC HOSPITALS AMHARA REGION, ETHIOPIA

Agizew Endale^1*Fisum Hundessa^1*Eyasu Tamru^2*Fetene Nigussie³Minyahil Hailu^4*

• ¹Department of Nursing, Debre Birhan Health Science College, Debre Birhan, Ethiopia
• ²Department of Midwifery, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University,, Department of Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Amhara, Ethiopia
• ³Department of Nursing, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Department of Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Amhara, Ethiopia
• ⁴Department of midwifery, Debre Birhan Health Science College, Debre Birhan, Ethiopia

Background: Adherence to diabetes self-care management is a lifestyle modification for people with diabetes.Objective: To assess adherence to diabetic self-care management and associated factors among type 2 diabetic patients in North Shewa Zone public hospitals, Ethiopia,Method: The study employed a concurrent mixed-methods approach among 600 type 2 diabetic patients in north Shewa zone public hospitals, Amhara, Ethiopia. The quantitative data was collected by using a semi-structured interview administered questionnaire and chart review. Logistic regression was employed, and a p-value < 0.05 was considered statistically significant. Qualitative data was collected by in-depth interview, and audio recorded was recording first transcribed verbatim and then translated to the English language by the first author and was were analyzed manually using a thematic approach. Result: Out of the total 600 type 2 diabetic patients, 262 (43.7%) with 95% CI: 40-47.8% of the study participants had good adherence to diabetes self-care practices. The multivariable analysis indicated that type 2 diabetic patients who lived in urban areas [AOR: 5.4, 95% CI: (1.05-8.7)] were 5.4 times more likely to have good diabetic self-care practice than those rural residents. Regarding occupation, unemployed people were 66% less likely to have good self-care practices than employed people. No availability of health care services [AOR: 0.19, 95% CI: (0.09-0.37)] was less likely by 81 % to have good selfcare practice than availability of health care services. These are significantly associated with diabetic self-care practice. The qualitative component clarified six themes: lack of education & awareness, financial affordability, accessibility, lack of family support, and having diabetic-related complications were identified as barriers. This study indicated that adherence of patients with type 2 diabetes to the recommended self-care practices was considerably poor. Different factors, including the respondents who attended at high school level, had a higher level of education, and who lived in urban areas. This was supported by the results from the qualitative part and thus endorsement to strengthen diabetes health education to patients and their families. So diabetic patients require an integrated approach through treatment as well as health education, which will increase the health and well-being of the patient.