Self-Care Management Practices Among Patients with Diabetes Mellitus in a Tertiary Care Hospital in Karachi, Pakistan: An Analytical Cross-Sectional Study

Abstract

Background:
Diabetes mellitus (DM) is a highly prevalent chronic disease in Pakistan, ranking third globally concerning diabetes prevalence, with more than 33 million adults affected. The effective management of Diabetes management is essential for regulating blood glucose levels, mitigating complications, and improving patient outcomes. quality of life. Self-care practices include medication adherence, dietary changes, regular physical activity, and blood glucose monitoring, are all integral parts of good diabetes management. management However, there is a scarcity of research examining the self-care behaviors of Pakistani DM patients, which impedes the development of targeted interventions to improve patient outcomes.
Purpose
This study aims to assess the self-care management practices among patients with diabetes mellitus in a tertiary care hospital in Karachi, Pakistan. Specifically, it seeks to evaluate the self-perceived importance of various self-care activities, identify socio-demographic factors influencing these practices, and highlight strengths and areas for improvement in current self-care behaviors. The ultimate goal is to inform healthcare providers and policymakers to develop culturally tailored strategies that promote effective diabetes self-management.
Method
An analytical cross-sectional design was employed to evaluate self-care management practices among DM patients. A convenient sample of 258 participants was recruited from inpatient and outpatient services at Aga Khan University Hospital in Karachi. Data were collected using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire, which assesses various domains of self-care, including diet, exercise, medication adherence, blood glucose monitoring, and foot care. Socio-demographic information was also gathered through structured interviews. Data analysis was performed using SPSS version 26, utilizing both descriptive and inferential statistics to identify socio-demographic predictors of self-care management scores.
Findings
The study revealed that while a significant proportion of DM patients demonstrated satisfactory self-care practices in medication adherence and blood glucose monitoring, practices related to diet and physical activity were less consistently maintained. The most important self-care activity identified was medication adherence, followed by regular blood glucose monitoring. Socio-demographic factors such as age, gender, marital status, education level, relationship with the patient, duration of hospital stay, and distance from home to the hospital were significant predictors of self-care management scores. Additionally, cultural beliefs and socio-economic status were identified as key barriers to effective self-care practices.
Conclusion
There is a pressing need for a patient- and family-centered approach for the health-care system of Pakistan. Interventions considering socio-demographic and cultural variables are also important in improving self-management behaviors among the patients with diabetes mellitus. Recommendations include patient education, improved access to health services, flexible visiting hours, and culturally sensitive interventions that improve diet and exercise adherence. These will eventually result in improvement in the health trend and decrease the rate of diabetes in Karachi, Pakistan.