Management Of Psychosocial Complications Associated With Diabetes Mellitus Among Adult Patients At Kenyatta National Hospital

Abstract

Introduction: diabetes mellitus (DM) is a chronic illness that causes diverse psychosocial impact on the patients. Patients diagnosed with diabetes mellitus require psychosocial support right from the day when the diagnosis is made and throughout their life. This will enhance treatment adherence, improved quality of life, and decrease in long-term complications among others. Background: management of psychosocial complications in diabetic patients is part of the comprehensive holistic care for diabetes mellitus. However psychosocial support for patients with diabetes mellitus is generally inadequate due to its increasing demand and the accompanying challenges of the healthcare professionals being unable to identify these psychosocial complications associated with diabetes mellitus. At Kenyatta National Hospital, major emphasis is put on the management of physical complications of diabetes mellitus leading to the inadequate care that these patients receive. Therefore the need to carry out this study in order to identify the gaps and provide a baseline for incorporation of the management of psychosocial complications associated with diabetes mellitus in to the holistic care of patients with diabetes mellitus. Study objective: the study focused on management of psychosocial complications associated with diabetes mellitus among adult patients at Kenyatta National Hospital. Methodology: the study adopted a descriptive cross-sectional study design with utilization of mixed research methods, both qualitative and quantitative approaches. Multistage sampling method was used for the participants. The participants were patients with diabetes mellitus drawn from the medical wards and those attending the medical (diabetes) out-patient clinic. Data collection methods included questionnaires and checklists for the patients for primary data collection. Key informant in-depth interviews were conducted for assistant chief nurses managing the medical wards and medical (diabetes) out-patient clinic. On ethical considerations, consent was obtained from every participant, they were allowed to participate voluntarily and the participants’ anonymity and confidentiality were observed. Participants’ names were not used; however Codes were utilized to maintain participants’ anonymity. The collected data was computed and analyzed using SPSS (statistical package for social sciences) version 21. Results were presented by use of tables and charts for quantitative data and formation of themes for qualitative data. Study results can form a baseline for inclusion of management of psychosocial complications associated with diabetes mellitus and multidisciplinary approach in care of patients with diabetes mellitus can be incorporated. Results: The common psychosocial complications associated with diabetes mellitus identified included weakness/fatigue (75.3%), eye problems (35.5%), sexual dysfunction (22.6%) and inability to work (22.6%), anxiety (68.8%), stress (78.2%) and depression xvi (61.3%). Anxiety, stress and depression were common among patients who were admitted to the hospital. The highest percentage of the respondents (45.2%) was within the age group of 41-60 years. Male patients were more (52.7%) than the female patients (47.3%). Conclusion: The study findings demonstrate that identification of psychosocial complications associated with diabetes mellitus and their management were a major challenge to the health care professionals.