Explorative research on health literacy and self-care management of type 2 diabetes mellitus in Malaysia

Ahmad Azhari, Azrina Ely (2024) Explorative research on health literacy and self-care management of type 2 diabetes mellitus in Malaysia. PhD thesis, University of Nottingham.

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Type 2 diabetes is a chronic metabolic disorder which affects 3.9 million people in Malaysia in 2019. The prevalence of diabetes in the country is expected to rise as a result of unhealthy diet and sedentary lifestyle. As a complex disease, effective pharmacological management is key, in addition to the adoption of healthy self-care behaviours by patients. However, many patients with type 2 diabetes struggled to maintain their glycaemic control and adopt self-care measures due to various reasons which include low health literacy. Low health literacy among diabetes patients may result in poor self-care management and diabetes outcome. Pharmacists play a major role in patient education especially on medication adherence and diabetes self-care as they are easily accessible to the public. The accessibility of pharmacy services to the public may aid diabetes patients with health literacy challenges getting advice and support they need in empowering self-care.

This qualitative study aims to explore newly diagnosed patients’ and pharmacists’ perceptions of the knowledge of diabetes and its management, and what empowers pre-diabetes and newly diagnosed type 2 diabetes patients to practise self-care and how pharmacists interact and communicate with individual patients to promote self-care behaviours in preventing disease progression. A total of 36 participants (22 patients and 14 pharmacists) were recruited online and from two public health clinics. Data were collected using semi-structured interview and focus group discussion via Microsoft Teams and Zoom as well as via telephone calls. NVivo® software was used for data analysis and data obtained were coded and categorised into themes using reflexive thematic analysis. The Health Literacy Questionnaire (HLQ) was used in this study to identify the patients’ strengths and limitations in health literacy. Results from both groups and the HLQ were used to provide a better understanding on patient empowerment to self-care.

This study found that having sufficient access to reliable resources, continuous support from family, peers, and healthcare providers and a good understanding of the condition is important in empowering self-care behaviours. However, most patients in this study lacked the necessary support and access to reliable diabetes information. To address these challenges, pharmacists, being easily accessible and reliable, serve as a valuable source of information and can provide different diabetes services like blood glucose monitoring and patient education using literacy-sensitive techniques. Working together with other healthcare providers is also crucial to offer patients direct care and address the complex needs of diabetes management. Additionally, this study also found that continuing pharmacist’s education on diabetes management and health literacy is essential to enhance communication strategies used for diabetes patients with different levels of health literacy.

This study emphasises the importance of supporting newly diagnosed T2DM and pre-diabetes patients to self-care, highlighting the significant role pharmacists play in assisting these individuals. The findings indicate that with sufficient access to health services, information and support, diabetes patients were empowered to practise self-care. Given the accessibility of pharmacists, especially in the community settings, they could be the big players in supporting other healthcare providers to deliver effective self-care education.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Chai, Jim
Anderson, Claire
Keywords: type 2 diabetes, pharmacists, self-care, health literacy, patient empowerment
Subjects: R Medicine > RS Pharmacy and materia medica
Faculties/Schools: University of Nottingham, Malaysia > Faculty of Science and Engineering — Science > School of Pharmacy
Item ID: 77140
Depositing User: Ahmad Azhari, Azrina
Date Deposited: 09 Mar 2024 04:40
Last Modified: 09 Mar 2024 04:40
URI: https://eprints.nottingham.ac.uk/id/eprint/77140

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