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Relationship Among Health Literacy Superstitious Beliefs and Self-Care Among Diabetic Patients in Warri, Nigeria

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Relationship Among Health Literacy Superstitious Beliefs and Self-Care Among Diabetic Patients in Warri, Nigeria Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2021 Relationship Among Health Literacy Superstitious Beliefs and Self-Care Among Diabetic Patients in Warri, Nigeria Nkemakolam Simpson Ukpabi Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Public Health Education and Promotion Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Professions This is to certify that the doctoral dissertation by Nkemakolam Ukpabi has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Peter Anderson, Committee Chairperson, Public Health Faculty Dr. Jeanne Connors, Committee Member, Public Health Faculty Dr. James Rohrer, University Reviewer, Public Health Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University August 2021 Abstract Relationship Among Health Literacy, Superstitious/Cultural Beliefs, and Self-Care Among Diabetic Patients in Warri, Nigeria by Nkemakolam Ukpabi MPH, University of Lagos, 2010 MBBS, University of Port Harcourt, 1994 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University August 2021 Abstract Diabetes imposes significant burdens in medical expenditures, medication use, outpatient visits, and treatment of its chronic complications. Self-care behaviors such as medication adherence and foot care have been shown to reduce hospitalizations and complications, and high health literacy levels have been positively associated with self-care adoption. However, the effect of superstition on this relationship has not been studied among diabetic patients in Warri, Nigeria. This study was conducted to determine the moderating effects of superstitious or cultural beliefs on the relationship between health literacy and self-care adoption among diabetes patients in Warri, Nigeria. A quantitative, observational, cross-sectional design guided this study along with the health belief model and four research questions. Data were collected using a self-reported, self-administered, and structured questionnaire that combined a Brief Health Literacy Tool, Diabetes Self- Management Questionnaire, and the modified Traditional Beliefs Scale. Data from 384 participants were subjected to descriptive and inferential analyses. Results of the analyses showed low rates of health literacy and self-care adoption (12.3% & 17.7%, respectively) but a high rate of superstition (77.1%). The moderating effect of superstition on the association between health literacy and self-care was large (effect size of 11.05) and negative. Thus, intervention programs aimed at reducing the levels of superstition among the studied population are needed to improve the rate of self-care adoption and reduce hospitalizations and complications of diabetes. This can improve the lives of those with diabetes leading to positive social change. Relationship Among Health Literacy, Superstitious/Cultural Beliefs, and Self-Care Among Diabetic Patients in Warri, Nigeria by Nkemakolam Ukpabi MPH, University of Lagos, 2010. MBBS, University of Port Harcourt, 1994 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University August 2021 Dedication I most gratefully dedicate this study to my darling wife, Barrister Mrs Ngozi Nwadiuto Ukpabi and to my lovely children, Nkemakolam Jnr, Nkemjidinma, and Nkemjika for going on this journey with me. I got your support, encouragement, and understanding all the way even when I could not give you my undivided attention when you needed it due to studying and researching. You are simply the best family anyone can ask of. An important take away from this journey is that you can achieve whatever you set out to achieve with commitment and family support as your foundation. Trusting in God and believing in yourself are equally fundamental to succeeding in this type of journey. I also dedicate the study to all diabetic patients who are battling to stay healthy and I pray that you all would understand the principle of self-management of diabetes which would help in keeping your blood glucose in check for better quality of life. May your homes and hearts be filled with peace, happiness and love. Acknowledgments Let me start by thanking God for giving me the grace, the strength, patience and determination to complete this dissertation which marks the end of this PhD journey in Walden University. The journey has been long, tortuous, and undulating but at the end of it all, it sounds sweet. Next to thank and appreciate are my committee Chair, Prof. Peter Anderson, my committee member, Dr. Jeanne Connors, and the University Research Reviewer, Dr. James Rohrer for your knowledge some of which you have transferred to me, guidance, encouragement, support and patience during the entire period of this dissertation process. You three were very vital to my successful completion of this program and I appreciate you all. I would also love to thank my lovely family and friends for their support, encouragement and contributions throughout this lengthy and strenuous period of my study. Last but not the least to thank are the medical directors of the hospitals in Warri where I collected my primary data for this dissertation. I owe this great achievement to you all and I pray that God would bless you all. Table of Contents List of Tables ..................................................................................................................... iv List of Figures ......................................................................................................................v Chapter 1: Introduction to the Study ....................................................................................1 Background to the Study ................................................................................................3 Problem Statement .........................................................................................................6 Purpose of the Study ......................................................................................................7 Research Questions ........................................................................................................8 Theoretical Framework of the Study .............................................................................9 Nature of Study ............................................................................................................10 Operational Definitions ................................................................................................10 Assumptions .................................................................................................................12 Scope and Delimitations ..............................................................................................12 Limitations ...................................................................................................................13 Significance of the Study .............................................................................................14 Implications for Social Change ............................................................................. 15 Summary and Transition ..............................................................................................16 Chapter 2: Literature Review .............................................................................................18 Literature Search Strategy............................................................................................18 Theoretical Framework ................................................................................................18 Literature Review Related to Key Concepts ................................................................21 Diabetes Mellitus .................................................................................................. 21 i Self-Care and Diabetes ......................................................................................... 25 Health Literacy and Self-Care Adoption .............................................................. 28 Superstitious Beliefs and Self-Care Among Diabetics ......................................... 33 Health Literacy and Superstitious Beliefs............................................................. 37 Health Literacy, Superstitious Beliefs, and Self-Care Among Diabetics ............. 42 Summary ......................................................................................................................46 Chapter 3: Research Method ..............................................................................................47 Research Design and Rationale ...................................................................................48 Research Questions and Hypotheses .................................................................... 49 Justification of Design and Approach ................................................................... 50 Methodology
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