• Journal of Preventive Medicine and Public Health
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• v.54 no.2
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• pp.119-128
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• 2021

Objectives: Ongoing, proactive, planned, and patient-centered diabetes education is the cornerstone of care for all persons with diabetes. Thus, the aim of this study was to explore the information needs of type 2 diabetes mellitus patients receiving insulin treatment in North-East Ethiopia. Methods: The study was conducted from July 2019 to January 2020 using a qualitative enquiry (phenomenological approach) with purposive sampling. Face-to-face in-depth interviews were used to collect data until reaching theoretical saturation. The participants were type 2 diabetes patients receiving insulin treatment. They were identified from the diabetes patients' registration book at the diabetes clinic and interviewed at their appointment time, and were selected to include wide variations in terms of socio-demographic characteristics. Twenty-four participants (11 men and 13 women), with a median age of 57 years, were interviewed. The data were organized using QDA Miner Lite version 2.0.7 and analyzed thematically using narrative strategies. Results: Most participants had not heard of diabetes before their diagnosis. They had limited knowledge of diabetes, but ascribed different connotations for it in the local language (Amharic). The needs reflections of patients were categorized into diabetes education and participants' recommendations. Diabetes education was totally absent at hospitals, and patients received education primarily from the Ethiopian Diabetes Association and broadcast and digital media. Thus, the major concern of patients was the availability of diabetes education programs at health institutions. Conclusions: Patients' main concern was the absence of routine diabetes education, which necessitates urgent action to implement diabetes education programs, especially at health institutions.

• Journal of Korean Public Health Nursing
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• v.30 no.2
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• pp.221-235
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• 2016

Purpose: This study explored experiences of diabetes education among educators of diabetes. Methods: Data were collected from individual in-depth interviews with 10 nurses and 2 dieticians with had at least 3 years of experience in diabetes education. Data collection was conducted between May 2014 and February 2015. All interviews were recorded and stored as digital audio files, which were then transcribed verbatim. Data were analyzed through qualitative content analysis. Results: Analysis showed that four categories could be derived from the data: 1) barriers of diabetes education from an educator's perspective, 2) barriers of diabetes education form a patient's perspective, 3) facilitating factors of diabetes education from an educator's perspective, and 4) facilitating factors of diabetes education from a patient's perspective. Conclusion: This study suggests the necessity to strengthen the policy systems and financial support at a national level to provide diabetes education with higher quality to patients. In addition, it is required to develop various diabetes education programs with consideration to patient characteristics.

• Research in Community and Public Health Nursing
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• v.25 no.3
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• pp.217-224
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• 2014

Purpose: This study aimed to assess the levels of and relationships among health literacy, knowledge about diabetes, and self-care activities in the Korean low-income elderly with diabetes and to identify factors influencing the self-care activities of this vulnerable population. Methods: This study surveyed a total of 151 low-income elderly patients with diabetes registered at 16 Visiting Health Care Services in B City, Korea. Health literacy was measured with the Newest Vital Sign. Diabetes knowledge was measured with the Diabetes Knowledge Test. The Summary of Diabetes Self-care Activities Questionnaire was used to assess diabetes self-care activities. A stepwise multiple regression analysis was conducted to identify significant factors influencing diabetes self-care activities in these patients. Results: In the regression model, diabetes knowledge (${\beta}=.322$, p<.001), exercise (${\beta}=.337$, p<.001), and experiences of diabetes education (${\beta}=.241$, p=.001) were significantly associated with increased diabetes self-care activities in low-income elderly patients with diabetes when gender, education, health literacy, and subjective health state were controlled. Conclusion: To improve diabetes self-care activities in the low-income elderly with diabetes, it is important to develop a customized program considering their knowledge, exercise, and diabetes education experience.

• Korean Journal of Health Education and Promotion
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• v.31 no.4
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• pp.11-24
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• 2014

Objectives: The purpose of this article was to investigate the current practice of diabetes education along with the specific interventions, process, and outcomes in community health centers in Korea. Methods: Data were collected by a mail questionnaire from September 20, 2012 to December 20, 2012. Among 253, a total of 161 responded, constituting a 63.3% return rate. Results: Primary staff of diabetes education was the nurse and respondents recognized their role largely as a director. More than half of respondents provided education to people with type 2 diabetes by group. Most common service offered was nutrition therapy and the majority of respondents used printed materials. Among 4 criteria of outcomes, eating (nutrition), knowledge scores, blood pressure, and patients' survey on satisfaction were collected most frequently. Nearly three quarters of respondents were not participated in activities for quality improvement and outcomes were not reported properly. Conclusions: The results are able to draw ideas for organizing diabetes education programs and evaluating outcomes in community heath centers. This article has significance that it is the first comprehensive survey of diabetes education practice in community health centers and provides a baseline for establishing national standards of diabetes self-management education.

• Korean Journal of Health Education and Promotion
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• v.2 no.1
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• pp.97-114
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• 2000

Minority populations in the United States have a higher prevalence of non-insulin-dependent diabetes mellitus (NIDDM) and more persons die of the disease than white persons. This study was to review and compare risk factors and prevalence rates of NIDDM in African Americans, Hispanic s, Korean Americans and Native Americans in the United States. The risk factors of NIDDM, including family history of diabetes, obesity, physical inactivity, diet and age, were reviewed in the minority populations. Risk factors such as obesity, physical inactivity and family history of diabetes occurred to a greater extent in some minority populations than in the white population. Diabetes should be treated as a public health problem for minority populations. Due to the increase of older populations and the increased prevalence of obesity and sedentariness, NIDDM in minorities is nearing epidemic proportions. Good diet and regular exercise can reduce the incidence of NIDDM but an understanding of the cultural aspects of diabetes is imperative in order to provide adequate community health education programs because those programs involve diet and behavior changes, characteristics that are often culturally determined. In summary, it is important to plan a community health education program targeted on NIDDM in a culturally adapted manner that will be received with both comprehension and acceptability. In particular, the program for high-risk populations should be stressed so to prevent diabetes. Preventive approaches to diabetes should be considered because they can be both therapeutic and cost effective.

• Health Policy and Management
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• v.26 no.3
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• pp.207-218
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• 2016

Background: This study was performed to identify factors associated with the utilization of tests for diabetes complication and hemoglobin A1c (HbA1c) among diabetes patients in Jeollanam-do, Korea. Methods: The study subjects were 2,310 diabetes patients participated in 2014 community health survey in Jeollanam-do, Korea. Dependent variables were the utilizations of fundus examination, microalbuminuria test, and HbA1c test. The used statistical analysis methods were chi-square test and hierarchical regression analysis with weight in consideration of complex sample design. Results: The utilization rates of fundus examination, microalbuminuria test, and HbA1c test were 25.8%, 27.4%, and 12.3%, respectively. In the results of hierarchical regression, fundus examination was significantly related to age, education level in predisposing factors, residential area in enabling factors and recognition of blood sugar, drug therapy, and subjective health status in need factors. Microalbuminuria examination was significantly related to monthly income, residential area in predisposing and health screening, recognition of blood sugar, drug therapy, diabetic education, number of chronic disease, and subjective health status in need factors. HbA1c examination was significantly related to age, education level, marital status in predisposing factors, residential area in enabling factors and drinking, recognition of blood sugar, drug therapy, and diabetic education in need factors. Conclusion: The results of this study were shown that perception of their disease seriousness, education about diabetes management, and accessibility of tests were important to utilization of test for diabetes complication and HbA1c. It might be necessary to the develop and strength strategies for enhancing the utilization of tests for diabetes complication and management in diabetes patients.

• Journal of Korean Public Health Nursing
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• v.2 no.2
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• pp.99-116
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• 1988

This study examined the effect of Health Education on the aged. One of the Study objectives was to improve knowledge. attitude and self-care practice about diabetes of the aged who have responded positive in the urine sugar test. The other study objective was to find out factors influencing knowledge. attitude and self-care practice about diabetes. and the relationship among the three variables. The subjects, consisting of 45 positive responders in the urine sugar test, were selected from the elderly who attend elderly citizen center in southern part of Seoul Then they were divided into an experimental and a control group. The study design was set to compare the pre and post test data between the experimental and the control group with the measures of results from Health Education services including nursing care intervention programs on the aged diabetics. The first data collection was carried out in August. 1986 through questionaires and urine sugar testing. The second data collection was done in September, 1987 through the same methods. The results of the study are summarized as follows; 1. General characteristics of the subjects The experimental group has 9 females and 14 males and the control group has 12 females and 10 males. As for the educational level, more than half of the subjects in both group had completed at least 6 years of education. And there was no significant difference in urine sugar levels between the two groups. 2. The effect of Health Education on the extent of change in knowledge, attitude and self-care practice about diabetes was found to be significant. The first hypothesis that knowledge, attitude and self-care practice about diabetes in the aged will be unchanged by Health Education. was rejected by increased the three variables and decreased urine suger level in the experimental group. The second hypothesis that knowledge, attitude and self-care practice about diabetes wouldn't be concerned with each other, was rejected. That is. the three variables and urine sugar levels showed a significant positive relationship with each other but diabetic knowledge to urine sugar level had an insignificant positive relationship. The third hypothesis that the amount of learning Health Education will have no relationships with knowledge. attitude and self-care practice about diabetes. was rejected. That is, the more number of times an elderly person participated in Health Education. they increased their diabetic knowledge. attitude and self-care practice and decreased their urine sugar level. 3. Except for Health Education, an other factor influencing diabetic knowledge was educational level. And an other factor influencing the diabetic attitude was experience of the diagnosis of diabetes. 4. Except for Health Education. the other factors influencing self-care practice were experience of the diagnasis of diabetes, sex and experience of the hospitalization for diabetes. But factors influencing urine sugar level weren't found. Although the results seem to be plausible, this study is not without its problems. In paticular, the sample used is limited in its scope and size. So, more empirical work needs to be done for other diseases as well as diabetes before any general conclusions are to be made.

• Korean Journal of Health Education and Promotion
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• v.31 no.3
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• pp.1-13
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• 2014

Objectives: This study was performed to identify factors related to perceived health status among patients with type 2 diabetes. Methods: This is cross-sectional observational study. Respondents were 106 visitors in an outpatient diabetes clinic of a university hospital. Self-report questionnaire which included general information inquiry, diabetes-related, sociopsychological factors, functional health literacy and perceived health status was used for this study. The data was analyzed by using descriptive statistics, independent simple t-test, one-way ANOVA, and hierarchical multiple linear regression. All analysis were conducted using SAS 9.3. Results: Among the respondents, 43.4% engaged in poorly perceived health status. After adjusting for control variables, functional health literacy is significantly related to perceived health status(${\beta}$=0.095, p=0.016). Conclusion: Independent of diabetes-related, sociopsychological factors, higher functional health literacy is associated with better perceived health status of patients with type 2 diabetes. In order to improve perceived health status in the type 2 diabetes patients, it is necessary to develop strategy to enhance the functional health literacy.

• The Journal of Korean Academic Society of Nursing Education
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• v.21 no.4
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• pp.509-517
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• 2015

Purpose: This study examined diabetes knowledge, self-efficacy, and health promoting behaviors, and investigated factors affecting health-promoting behaviors of middle-aged people. Methods: From August to September 2014, a convenience sample of 264 subjects was recruited from B city and G province. The data analysis was done by ${\chi}^2$ test, t-test, Pearson's correlation coefficient, and stepwise multiple regression. Results: Diabetes knowledge was $11.3{\pm}3.63$ in men and $12.7{\pm}3.74$ in women. The average levels of self-efficacy and health promoting behaviors of subjects were similar with other middle-aged individuals. Diabetes knowledge, self-efficacy, and health promoting behaviors had a positive correlation with each other in both men and women. To test the mediating effect of self-efficacy in the relationship between diabetes knowledge and health promoting behaviors, a Sobel test was performed and Z-scores of 3.698(p<.001) in men and 2.748(p=.006) in women were obtained. Conclusion: Diabetes prevention education is recommended for the middle-aged community. When developing diabetes prevention program for middle-aged people, such programs should consider self-efficacy, especially in women.

• Journal of Korean Public Health Nursing
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• v.32 no.1
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• pp.44-55
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• 2018

Purpose: This study was conducted to identify factors influencing fundus examination to prevent diabetic retinopathy in diabetes patients to provide basic data to improve screening rates of fundus examinations. Methods: Raw data from the 6th Korea National Health and Nutrition Examination Survey, which is a cross-sectional and nationally representative survey, were used in this study. The subjects of the study were 1,029 adult diabetes patients over the age of 19 years who had been diagnosed with diabetes. The demographic characteristics, diabetes and disease-related characteristics and health behavior characteristics according to the fundus examinations were analyzed by the chi-squared test and logistic regression analyses were used to examine the factors influencing fundus examination. Results: A total of 333 patients underwent fundus examination at a screening rate of 32.2%. We identified factors influencing fundus examination in patients with diabetes as level of education, type of diabetes care, period of diabetes, and smoking. Conclusion: A multiple approach is required to raise the low screening rate of fundus examination, including specialized education for low-education groups. Moreover, nursing intervention should focus on subjects who do not engage in insulin and oral hypoglycemic agents and with diabetes for a long period.