A Quasi-experimental study on the effectiveness of primary caregiver social support capacity on self-management practices of clients living with type II diabetes in Machakos county, Kenya

Authors

  • Jackline Njeri Kiarie School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
  • Susan Njoki Mambo School of Public Health Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
  • George Kimathi Kamundi Amref International University, Nairobi, Kenya

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20240034

Keywords:

Diabetes type 2, Primary caregivers, Social support, Diabetes self-management, Africa

Abstract

Background: Diabetes is a fast-growing public health emergency, projected to affect 643 million people by 2045. While primary caregiver social support can influence the self-management practices of Type 2 diabetes (T2D) clients, there's often limited capacity to provide it. The study determined the effectiveness of enhanced caregivers' social support capacity on self-management practices of T2D clients in Machakos.

Methods: A six-month quasi-experimental study design that adopted quantitative and qualitative data collection and analysis approaches. Primary caregivers at the Matungulu intervention site were trained on T2D self-management and types of social support, with no intervention conducted at the Masinga control site.

Results: Over 90% of the 227 primary caregivers were female, with a mean age of 43.28, supporting approximately three T2D clients each. Post-intervention, a 27.2% change in capacity to identify all T2D self-management practices was noted compared to a 7.6% change in the control group. The greatest contribution was in the primary caregivers' ability to provide tangible, followed by emotional and informational social support, resulting in a statistically significant improvement in the self-management practices in the intervention site, B=0.140 (95% CI: 0.072, 0.208), t=4.046, p<0.001. Consequently, the difference in blood glucose levels was statistically significant, crude OR=3.213 [95% CI: 2.039, 5.063], p<0.001.  

Conclusions: Enhanced capacity to provide social support positively correlates with the T2D clients' self-management practices. Further investigation of factors that hinder the full realization of primary caregiver social support capacity benefits in improving self-management capacities among T2D clients is recommended.

References

Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119.

Lemos Macedo JC, de Carvalho VCHDS, Cortes TBA, Soares DA, Mistro S, et al. Community-Based Interventions to Improve the Control of Non-Communicable Diseases in Underserved Rural Areas in Brazil: A Before-and-After Study. Front Pharmacol. 2021;12:644599.

Karachaliou F, Simatos G, Simatou A. The Challenges in the Development of Diabetes Prevention and Care Models in Low-Income Settings. Front Endocrinol. 2020;11:518.

WHO. WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights. Geneva: WHO; 2019.

Lee CS, Westland H, Faulkner KM, Iovino P, Thompson JH, Sexton J, et al. The effectiveness of self-care interventions in chronic illness: A meta-analysis of randomized controlled trials. Int J Nurs Stud. 2022;134:104322.

Stephani V, Opoku D, Beran D. Self-management of diabetes in Sub-Saharan Africa: a systematic review. BMC Public Health. 2018;18(1):1148.

Otanga H, Semujju B, Mwaniki L, Aungo J. Peer support and social networking interventions in diabetes self-management in Kenya and Uganda: A scoping review. PLoS ONE. 2022;17(9):e0273722.

Florea M, Puia A, Pop RS, Florea M, Puia A, Pop RS. The Family as Recipient and Provider of Home Care: A Primary Care Perspective. In: Suggestions for Addressing Clinical and Non-Clinical Issues in Palliative Care. IntechOpen: 2010.

Plöthner M, Schmidt K, Jong L, Zeidler J, Damm K. Needs and preferences of informal caregivers regarding outpatient care for the elderly: a systematic literature review. BMC Geriatr. 2019;19(1):82.

Captieux M, Pearce G, Parke HL, Epiphaniou E, Wild S, Taylor SJC, et al. Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews. BMJ Open. 2018;8(12):e024262.

Taylor SJC, Pinnock H, Epiphaniou E, Pearce G, Parke HL, Schwappach A, et al. A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic Review of Self-Management Support for long-term conditions. Southampton (UK): NIHR Journals Library; 2014.

Werfalli MM, Kalula SZ, Manning K, Levitt NS. Does social support effect knowledge and diabetes self-management practices in older persons with Type 2 diabetes attending primary care clinics in Cape Town, South Africa? PLoS One. 2020;15(3):e0230173.

Onyango JT, Namatovu JF, Besigye IK, Kaddumukasa M, Mbalinda SN. The relationship between perceived social support from family and diabetes self-management among patients in Uganda. Pan Afr Med J. 2022;41:279.

El-Radad HM, Sayed Ahmed HA, Eldahshan NA. The relationship between self-care activities, social support, and glycemic control in primary healthcare patients with type 2 diabetes. Diabetol Int. 2022;14(1):65-75.

Economic Survey. Kenya National Bureau of Statistics, 2023. Available at: https://www.knbs.or.ke/download/economic-survey-2023/. Accessed on 03 December 2023.

Kenya Master Health Facility. List: Find all the health facilities in Kenya, 2023. Available at: https://kmhfl.health.go.ke/#/gis. Accessed on 03 December 2023.

Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013;35(2):121-6.

Waari G, Mutai J, Gikunju J. Medication adherence and factors associated with poor adherence among type 2 diabetes mellitus patients on follow-up at Kenyatta National Hospital, Kenya. Pan Afr Med J. 2018;29:82.

Sweet study. Reliability Tests and Reliability analysis statistics | BUSI 240 - Organizational Behavior I, 2023. Available from: https://www.sweetstudy.com/notebank/libertyuniversity/busi240organizationalbehaviori/reliabilitytestsandreliabilityanalysisstatistics-docx. Accessed on 03 December 2023.

Catherine NLA, Lever R, Marcellus L, Tallon C, Sheehan D, MacMillan H, et al. Retaining participants in community-based health research: a case example on standardized planning and reporting. Trials. 2020;21(1):393.

Adonteng-Kissi B, Moyle W, Grealish L. Informal care of older adults with chronic life-limiting illness in Africa: An integrative review. Int Soc Work. 2022;65:127-41.

Sperber NR, Boucher NA, Delgado R, Shepherd-Banigan ME, McKenna K, Moore M, et al. Including Family Caregivers In Seriously Ill Veterans' Care: A Mixed-Methods Study. Health Aff (Millwood). 2019;38(6):957-63.

Baptista DR, Wiens A, Pontarolo R, Regis L, Reis WC, Correr CJ. The chronic care model for type 2 diabetes: a systematic review. Diabetol Metab Syndr. 2016;8:7.

Raj M, Stephenson AL, DePuccio MJ, Sullivan EE, Tarver W, Fleuren B, Thomas SC, et al. Conceptual Framework for Integrating Family Caregivers Into the Health Care Team: A Scoping Review. Med Care Res Rev. 2023;80(2):131-44.

Sharma N, Chakrabarti S, Grover S. Gender differences in caregiving among family - caregivers of people with mental illnesses. World J Psychiatry. 2016;6(1):7-17.

Leslie M, Gray RP, Eales J, Fast J, Magnaye A, Khayatzadeh-Mahani A. The care capacity goals of family carers and the role of technology in achieving them. BMC Geriatr. 2020;20(1):52.

Mayston R, Lloyd-Sherlock P, Gallardo S, Wang H, Huang Y, Montes de Oca V, etal. A journey without maps-Understanding the costs of caring for dependent older people in Nigeria, China, Mexico and Peru. PLoS One. 2017;12(8):e0182360.

Makunga B, Schenck R, Roman N, Spolander G. Illiteracy among Caregivers: Implications for Children's Educational and Social Development. South Afr J Soc Work Soc Dev. 2017;29.

Khazaeipour Z, Rezaei-Motlagh F, Ahmadipour E, Azarnia-Ghavam M, Mirzababaei A, Salimi N, et al. Burden of care in primary caregivers of individuals with spinal cord injury in Iran: its association with sociodemographic factors. Spinal Cord. 2017;55(6):595-600.

Miller TA, Dimatteo MR. Importance of family/social support and impact on adherence to diabetic therapy. Diabetes Metab Syndr Obes. 2013;6:421-6.

Sunny A, Mateti UV, Kellarai A, Shetty S, Rafikahmed SR, Sirimalla S, et al. Knowledge, attitude, and practice on insulin administration among diabetic patients and their caregivers – Cross-sectional study. Clin Epidemiol Glob Health. 2021;12:10086.

George NC, Radman D, Zomahoun HTV, Boivin A, Ahmed S. Linkages between health systems and communities for chronic care: a scoping review protocol. BMJ Open. 2022;12(8):e060430.

Kurpas D, Petrazzuoli F, Szwamel K, Randall-Smith J, Blahova B, Dumitra G, et al. The pros and cons of the implementation of a chronic care model in European rural primary care: the points of view of European rural general practitioners. Rural Remote Health. 2021;21(3):6509.

Schulman-Green D, Feder SL, Dionne-Odom JN, Batten J, En Long VJ, Harris Y, et al. Family Caregiver Support of Patient Self-Management During Chronic, Life-Limiting Illness: A Qualitative Metasynthesis. J Fam Nurs. 2021;27(1):55-72.

Kadirvelu A, Sadasivan S, Ng SH. Social support in type II diabetes care: a case of too little, too late. Diabetes Metab Syndr Obes. 2012;5:407-17.

Downloads

Published

2024-01-23

How to Cite

Kiarie, J. N., Mambo, S. N., & Kamundi, G. K. (2024). A Quasi-experimental study on the effectiveness of primary caregiver social support capacity on self-management practices of clients living with type II diabetes in Machakos county, Kenya. International Journal Of Community Medicine And Public Health, 11(2), 601–613. https://doi.org/10.18203/2394-6040.ijcmph20240034

Issue

Section

Original Research Articles