published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Thesis (Ph.D. (Public Health)) -- University of Limpopo, 2022 / Background: The increase in diabetes prevalence is often accompanied by comorbidities and complications, which negatively impact on the quality of life of patients. Poor dietary intake and physical inactivity lead to obesity and contribute to diabetes prevalence and poor outcomes. Non-diabetic family members of patients are already at risk of developing diabetes due to a family history of the disease. Therefore, this study was aimed at developing and implementing a family-centred nutrition and exercise diabetes care programme for better outcomes and fewer new cases. Methodology: This study employed a mixed method approach, where convergent parallel design was used where quantitative and qualitative data were collected. For the quantitative strand, 400 subjects participated in the study (i.e., 200 diabetes patients and 200 family members). Diabetes patients were selected using stratified random sampling from rural clinics, while family members were selected using the sampled patients. For the qualitative strand, 17 diabetes patients were purposively sampled, and data saturation was reached. Two set of questionnaires (for patients and family members) were used to collect quantitative data, while one-on-one interviews with patients were used to collect qualitative data. Phase 2 involved development and validation of an intervention program. The validation involved a process where professional experts were used for validation using Delphi technique. Phase 3 included implementation and program evaluation wherein post-implementation quantitative survey was conducted on 100 participants (50 patients and 50 family members), who were purposively sampled from list of those who participated in Phase 1. Quantitative data was analysed using SPSS Software v27.0, while qualitative data analysed using 8 Steps of Tesch’s inductive, descriptive open coding technique. Results: In Phase 1, the results showed that over half of patients (57%), compared to 38% of family members, were obese; and that most patients (75%), compared to 55% of family members, had abdominal obesity. Close to half of patients (45%), compared to 31% of family members, had overall excellent nutrition and exercise diabetes care knowledge. The majority of patients (73%), compared with 25% of family members, had overall positive attitudes towards nutrition and exercise diabetes care. Only 15% of diabetes patients compared with 9% of family members had overall good practice vi related to nutrition and exercise diabetes care. In Phase 3, it was reported that the majority of both patients (84%) and family members (100%), respectively indicated that the organization of the educational intervention was commendable. All patients (100%) and family members (100%) indicated that the health education strategies used stimulated their interest and were very helpful to their learning. Conclusion: A family-centred nutrition and exercise diabetes care programme was developed, implemented and evaluated. Diabetes patients and family members indicated that the intervention was helpful to their learning and met their expectations. Therefore, there is an urgent need for the adoption of the family-centred nutrition and exercise diabetes care programme to achieve healthy eating and increased physical activity. The adoption of healthy eating and physical activity among diabetes patients and their non-diabetic family members will subsequently lead to better diabetes outcomes, and minimizing new cases, respectively.

published_or_final_version / Medicine / Master / Master of Medical Sciences

This thesis proposes intelligent decision support System in diabetes eHealth care in order to improve the quality of life of Diabetes patients. Diabetes is one of the chronic diseases that can cause the serious health complication. Patients of diabetes especially elder people need more care than others as well as regularity in medicine. Only patients themselves or doctors cannot provide the care that patient needs. To improve the quality of daily life of patient a team of care providers work together. This thesis covers the different fields of intelligent decision support system for the diabetes type2 patients. The proposed intelligent decision support system is 24-hours accessible for the patients and care providers. The system stores the patients’ information and gives them optimal advices according to their condition entered by them. It also provides adequate and detail information about the patient to the health-care providers that help them to take an optimal decision about the patients. If system analyzes any alarming condition of the patient, it generates automatic alarming message for the health-care providers to help the patients. We validate our study by conducting interviews with diabetes health-care providers and perform questionnaires filled from diabetes type2 patients.

Thesis (MMed) -- Stellenbosch University, 2010. / Bibliography / Introduction: Diabetes in Africa has been described as a pandemic, with the prevalence in South Africa estimated at 4.5% of the population. Despite clear national guidelines from the Society of Endocrinology, Metabolism and Diabetes of South Africa, an unpublished quality improvement cycle in 2007 has shown poor patient knowledge with associated uncontrolled glycaemic and hypertensive control in diabetic patients in a district health system. The purpose of the study was to identify possible reasons for this and to find solutions for improving diabetic care within the Wesbank/ Ilingu Lethu suburb of Malmesbury, Western Cape. Methods: A cooperative inquiry group was established, consisting of primary health care providers at a district hospital and a primary health care clinic. The inquiry completed several cycles of action-reflection over a period of eight months, and included training in diabetic related topics and critical reflection techniques. At the end of the inquiry consensus was reached on key findings by group and learning within the group. Findings: Consensus was expressed in two key findings. The group identified and prioritized continuity of care and diabetic education key areas where diabetic care could be improved in the research population. The first was addressed by initiating diabetic registries, establishment of a regular diabetic clinic, implementation of a diabetic schedule within the medical records and the forming of a diabetic team that could support continuity of relationships, clinical management and organisation of care between both facilities. The diabetic team involved non-governmental organizations, private health providers and the community to increase awareness and develop capacity to improve diabetic care. The other finding confirmed diabetic education as a critical area in diabetic self management. The diabetic team initiated a diabetic community forum for educational and informative group activities. There was also continued professional development with education sessions within the cooperative inquiry group themselves. Conclusions: Improving diabetic care through continuity of care and education is well supported in known evidence based literature. The challenge is to translate/ transfer the available knowledge and render it operational and clinical in any health setting. The co-operative inquiry process was a valuable tool to identify, prioritized and addresses unique challenges for improving diabetic care in our specific context.

The purpose of this study was twofold. First, the study evaluated Loma Linda University Medical Center's (LLUMC) Diabetes Treatment Center's (DTC) effectiveness in providing diabetes education and services to high risk minority populations. Second, the results of the study helped the DTC determine the need for expanding its present efforts in the form of community health prevention services to San Bernardino County residents.