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Public Knowledge, Attitudes and Self-Practice Towards Diabetes Mellitus in Kangar, Perlis

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Public Knowledge, Attitudes and Self-Practice Towards Diabetes Mellitus in Kangar, Perlis Med & Health Jun 2021; 16(1): 150-162 https://doi.org/10.17576/MH.2021.1601.13 ORIGINAL ARTICLE Public Knowledge, Attitudes and Self-Practice towards Diabetes Mellitus in Kangar, Perlis SOO PP1, DALI N2, SHAKAR NS2 1Pharmaceutical Services Divisions, State Health Department of Perlis, Malaysia 2Pharmacy Unit, Kangar Health Clinic, Jalan Kolam, 01000 Kangar, Perlis, Malaysia ABSTRAK Di Malaysia, Perlis merupakan salah sebuah negeri yang menunjukkan angka tertinggi yang mempunyai pesakit diabetes mellitus (DM). Pencegahan dan pengurusan DM adalah bergantung kepada amalan kendiri dalam kehidupan seharian. Walau bagaimanapun, masih banyak informasi yang tidak diketahui mengenai faktor-faktor yang mempengaruhi penglibatan orang ramai dalam amalan kendiri terhadap DM yang mungkin telah menyumbang kepada prevalensi DM yang tinggi di Perlis. Kajian ini dilakukan untuk menilai pengetahuan, sikap, serta faktor-faktor yang berkaitan dengan amalan kendiri terhadap DM di kalangan masyarakat di Kangar, Perlis. Kajian keratan rentas telah dilakukan bermula pada Jun 2018 selama tiga bulan. Peserta yang layak dijemput untuk melengkapkan soal selidik di kawasan awam di Kangar. Analisis deskriptif mengenai ciri-ciri sosiodemografi, sejarah perubatan, pengetahuan, sikap dan amalan kendiri terhadap DM telah dilakukan. Ujian t-test dan korelasi Spearman telah digunakan untuk menilai hubungan antara sosiodemografi, sejarah perubatan, pengetahuan, dan sikap masyarakat di Kangar dengan amalan kendiri terhadap DM. Regresi linear berganda digunakan untuk menganalisis hubungan di antara pembolehubah dalam kajian ini. Sebanyak 319 responden bersetuju dan mengambil bahagian dalam kajian ini. Kebanyakan responden ialah perempuan (66.5%), Melayu (94%), dan mempunyai pendidikan tinggi (51.7%). Secara keseluruhan, kebanyakan peserta mempunyai skor pengetahuan (80.3%), sikap (98.4%), dan amalan kendiri (97.2%) yang baik terhadap DM. Hubungan positif yang signifikan secara statistik didapati antara usia, tahap pendidikan, dan skor sikap dengan amalan kendiri terhadap DM (p<0.05). Kajian ini menunjukkan bahawa program pendidikan mengenai rawatan kendiri DM harus bermula seawal dari peringkat sekolah untuk menjelaskan tentang pengurusan DM yang betul. Kata kunci: amalan kendiri, diabetes mellitus, orang awam, pengetahuan, sikap Address for correspondence and reprint requests: Pei Pei Soo, Pharmaceutical Services Divisions, State Health Department of Perlis, 48C, Jalan Raja Syed Alwi, Kampung Guar Syed Alwi, 01000 Kangar, Perlis, Malaysia. Tel: +6049765033 ext 1104 Email: [email protected] 150 Public KAP towards Diabetes Mellitus Med & Health Jun 2021;16(1): 150-162 ABSTRACT In Malaysia, the prevalence of diabetes mellitus (DM) was the second highest in Perlis. Prevention and management of DM are largely dependent on self-care in our daily lives. Nonetheless, we have little information concerning factors influencing public engagement in DM self-practice, which might have contributed to the high prevalence of DM in Perlis. This study was conducted to evaluate knowledge, attitudes, and factors associated with self-practice towards DM among the public in Kangar, Perlis. A cross-sectional study was conducted in June 2018 for three months. Eligible participants were invited to complete a self- administered questionnaire in public areas in Kangar. Descriptive analyses on the sociodemographic, medical backgrounds, knowledge, attitudes, and self-practice towards DM were performed. Independent t-test and Spearman’s correlation were performed to assess the association between sociodemographic characteristics, medical history, knowledge, and attitudes with self-practice towards DM. Multiple linear regression was used to adjust for potential confounding variables. A total of 319 respondents consented and participated in this study. Most of the respondents were female (66.5%), Malay (94%), and had tertiary education (51.7%). Overall, most participants had good scores on knowledge (80.3%), attitudes (98.4%), and self-practice (97.2%) towards DM. A statistically significant positive association was found between age, education level, and attitudes score with DM self-practice (p<0.05). This study suggests a well-structured educational program on diabetes self-care should start as early as in school to clarify public misconceptions on DM management. Keywords: attitudes, diabetes mellitus, knowledge, public, self-practice INTRODUCTION diabetic neuropathy (Fowler 2008). DM is also one of the key risk factors Diabetes mellitus (DM) is an illness that for cardiovascular diseases, which occurs when there is a chronic increase contributes to the leading causes of in blood glucose concentration or death in Malaysia (Aniza et al. 2016). hyperglycaemia (Ministry of Health The prevalence of DM has increased Malaysia 2015). DM is a silent and globally. In 2000, more than 170 progressive disease. During the million individuals in the world were initial phase of the disease, it could diagnosed with DM (Wild et al. 2004). show no symptoms. Some may take The figure is estimated to increase to 366 many years to develop the symptoms million by the year 2030. In Malaysia, and experience long-term DM DM remains the most prevalent non- complications, such as retinopathy, communicable disease affecting nephropathy, sexual dysfunction, and the public. The prevalence of DM 151 Q2 Med & Health Jun 2021;16(1): 150-162 Soo P.P. et al. increased from 11.2% in 2011, 13.4% Strycker 2000). in 2015, to 18.3% in 2019 for adults The alarming rise of non- above 18 years old, based on the latest communicable diseases, including DM National Health and Morbidity Survey in Perlis, is of great concern. Although (Institute for Public Health 2020b). various health promotion programs There was a considerable variation of have been done by health authorities DM prevalence rate between different to educate the public about DM states in Malaysia, with the second through multiple platforms, the impact highest prevalence of DM was found of these efforts has not been evaluated. in Perlis (32.6%) (Institute for Public Therefore, we have no information Health 2020b). Perlis is the smallest on how much the public knows state located in the north of Peninsular regarding this disease. The objective Malaysia. Up to 2015, a total of 33,090 of the current study was to investigate diabetic patients was found in Perlis public knowledge, attitude and factors (Institute for Public Health 2015). The associated with self-practice towards number of adults with DM in Perlis DM among the public in Kangar, Perlis. increased to 52,184 in 2019 (Institute for Public Health 2020b). MATERIALS AND METHODS Conceivable reasons for the steady increment in the prevalence of DM This cross-sectional study was carried in Asian countries may include out in Kangar, Perlis, starting from poor nutritional habits, physical June 2018 for three months. The study inactivity, urbanisation, low health targeted the public aged 18 years literacy, and poor attitudes towards old and above residing in Kangar. DM management among the overall The sample size calculation for this population and diabetic patients study was based on the population (Bollu et al. 2015). Disease awareness, proportion (Lemeshow et al. 1990). early diagnosis and patients’ active The prevalence of DM in Perlis was involvement in controlling blood 0.206 (Institute for Public Health 2015), glucose levels are associated with and the population size of Kangar knowledge, attitudes, and self-practice residents was 97,700 (Department towards DM. Patients with insufficient of Statistics Malaysia 2017). If the knowledge regarding their illness Type I error probability and precision frequently have poor self-management were 0.05, respectively; we needed skills (Perera et al. 2013). DM self-care to study 252 samples. After taking activities involve following a diet plan into consideration of a 20% dropout with high fibre, low sugar, and fat intake, rate, the final sample size was 315. staying active, regular blood glucose The quota sampling method was monitoring, and foot care. These used to collect samples from every activities could improve glycaemic administrative division in Kangar. control, reduce DM complications, There are nine administrative divisions and subsequently improve the quality in Kangar, namely Abi, Jejawi, Kechor, of life among DM patients (Glasgow & Kurong Batang, Seriab, Wang Bintong, 152 Public KAP towards Diabetes Mellitus Med & Health Jun 2021;16(1): 150-162 Sena, Kuala Perlis, and Kayang. A total towards DM, respectively (Al-Naggar of 35 subjects were selected from each et al. 2017). Univariable analyses administrative division in public areas (Independent t-test and Spearman’s such as bus stops, jetty, and markets. correlation) were performed to assess A questionnaire containing 51 the association between each of the questions was adapted from a previous sociodemographic backgrounds, study (Al-Naggar et al. 2017). This medical history, knowledge, and self-administered questionnaire was attitudes of the public in Kangar distributed to the public in Kangar with their self-practice towards DM. who fulfilled the following criteria, i.e., All variables in univariable analysis i) Inclusion: Adults aged ≥18 years old (p<0.10) were included for the residing in Kangar, Perlis; ii) Exclusion: downstream analysis. These variables Unable to read and write in Malay. The were tested for multicollinearity before questionnaire was divided into four entering multiple linear regression. All
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