Illness perceptions, behaviours and glycaemic control among type two diabetic Libyan patients

Abstract

Behaviours are important to achieve satisfactory outcomes in diabetes. According to the Common Sense Model (CSM), illness perceptions influence coping behaviours. Illness perceptions are influenced by culture; therefore, local research is needed to understand how Libyan Arab diabetics view their illness and whether their perceptions contribute to their diabetes coping behaviours. The main objective of this research was to assess illness perceptions and their influence on dietary self-care, exercise, self-blood glucose testing, foot care, medication adherence and diabetes-specific use of traditional medicine in the last one year in T2DM Libyan patients. A cross sectional study was conducted at the National Centre for Diabetes and Endocrinology (NCDE) in Tripoli, Libya, where 648 patients were systematically recruited from October to December 2013 and a final response rate of 80.7% was achieved. Data collection was through self-administered questionnaire focusing on socio-demographic and disease profile information, use of the revised illness perception questionnaire (IPQ-R), the revised Summary of Diabetes Self-Care Activities Scale (SDSCA), and the eight-item Morisky Medication Adherence Scale (MMAS-8©) questionnaire and a constructed questionnaire to measure traditional medicine use. Mean age of the respondents was 54.4 (SD=10.0) years and females comprised 58.9% of the sample. Their mean HbA1c was 8.9 (SD=2.1). Generally, the respondents showed acceptable diabetes perceptions. Respondents reported low identity (Mean=4.5, SD=3.7), high timeline duration (Mean= 22.0, SD=5.3), moderate timeline pattern (Mean= 12.4, SD=4.8), moderate consequences (Mean=6.2, SD=6.0), moderately high personal control (Mean=18.9, SD= 7.0), moderately high treatment control (Mean=19.1, SD= 4.4), moderate emotional (Mean= 16.9, SD= 7.7) and moderate coherence illness perceptions (Mean=16.1, SD= 6.7). The prevalence of inadequate self-care practices were 53.0% for general dietary care, 56.8% for exercise, 59.1% for foot care and 90.6% for self-blood glucose testing. The prevalence of low medication adherence was 36.1%, and the prevalence of diabetes-specific traditional medicine in the last one year use was 28.7%. Personal control perception contributed significantly to inadequate general dietary self-care; income to inadequate exercise self-care; age, type of medications and treatment control perception to inadequate foot care; sex, treatment control perception and identity perception to low medication adherence; sex, type of medications and medication adherence to poor glycaemic control. The findings provided some support to the CSM with three of the eight illness perceptions examined significantly contributing to three of the diabetes coping behaviours studied. The study findings are useful for policy makers and public health workers in prioritizing health care targets and for planning locally appropriate programmes.