The practice of diabetes self-care plays an important role in achieving and maintaining good glycaemic control. However, not all patients with insulin-treated diabetes engage in their self-care activities. There is some evidence that self-care practices in patients with insulin-treated diabetes can be understood and predicted by their health beliefs, although studies are often hampered by methodological weaknesses, and the fact that less is known about adults with insulin-treated diabetes in Malaysia. This study was conducted to examine whether health beliefs (as specified in the Health Belief Model: HBM) can predict self-care practices and glycaemic control in patients with insulin-treated diabetes in Malaysia. Longitudinal design with self-reported questionnaire measures was administered at baseline (Time 1:T1) and six months later (Time 2: T2). Participants were recruited from three endocrinology clinics in Malaysia. The measures included self-care practices (diet, insulin intake, exercise and self-blood glucose monitoring: SMBG), health beliefs and diabetes knowledge. Participants’ glycaemic control was examined based on their glycated hemoglobin (HbA1c) results. Data analysis was performed at different points of the study times; T1, T1-T2 and T2. Diabetes knowledge and demographic data were controlled for in predictive statistical analyses. A total of 159 patients with insulin-treated diabetes (aged 18-40 years) completed the measures at T1. Of these, only 108 (67.9%) completed follow-up measures at T2. However, demographic characteristics were not significantly different between those who completed and dropped out of the study (p>0.05). The HBM was significantly predictive of diet self-care at T2, insulin intake practice at T1 and HbA1c at T1-T2 andT2. Of the HBM constructs, perceived benefits significantly predicted good dietary habits at T1 (OR 1.92) and T2 (OR .23) and adherence to insulin injection at T1 (OR 3.17) and T1-T2 (OR 2.68). With the exception of perceived severity, all other HBM constructs significantly predicted HbA1c [perceived susceptibility (β .169) at T1, perceived barriers (β -.206) and perceived benefits (β -.397) at T2 and cues to action (β -.233) at T1-T2]. Health beliefs predict self-care practices and glycaemic control in young to middle-aged adults with insulin-treated diabetes in Malaysia. Diabetes educators could use this knowledge in their efforts to improve diabetes self-care in this patient groupby modifying those beliefs through their diabetes education.
Study site: Endocrinology clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Hospital Putrajaya, and Hospital Melaka, Malaysia
Introduction: Severe labour pain and dissatisfaction towards supports received from midwives during labour are common experiencesamong parturient mothers. Thesenegative emotional experiences need to be given attention as they are associated with higher acute stress reactions and postpartum depressive symptoms. Therefore, this study examinedthe labour pain and satisfaction toward labour support and their influential factors. Methods: A total of 136 parturient mothersregistered for a labour in the UniversitiKebangsaan Malaysia Medical Centre were included in this studyusing simple random sampling. The mothers had met the eligibility criteria; live and singleton pregnancy, able to communicate in English, Malay or Mandarin. Visual anologue scale and Bryanton Adaptation of the Nursing Support in Labor Questionnaire (BASILIQ) which contained both quantitative and qualitative questions were used to measure the pain and satisfaction level respectively. Descriptive statistics, Spearman correlation, Mann-Whitney and Kruskal-Wallis tests and also content analysis wereutilised to analyse the data. Results: Labour pain was low (Mean=2.24, SD=2.20) and satisfaction toward the labour support was high (Mean=76.9, SD=8.75). Both the pain and satisfaction were not significantly related to each other and also to any of the mothers’ demographic (p > 0.05) and obstetrical data (p > 0.05). However, 32.9% (n=25) out of 76 subjectswho responded to the qualitative questions had highlighted the need of havingfriendly and helpful nurses during their labour.In addition, 56% (n=14) out of 25 subjects who provided additional comments had suggested to include theemotional support to reduce their labour pain, fear and anxiety. Conclusion: Friendly and helpful nurses are part of the emotional support for labour. There- fore, it is recommended that a structured emotional laboursupport should be made availableto parturient mothers. Further research examining the effectiveness of the emotional support on the pain and satisfaction, nevertheless, is warranted.