ABSTRACT
@#Introduction: Good health literacy and knowledge are associated with improved outcomes in diabetes. The purpose of this study was to determine diabetes-specific literacy and knowledge levels, and its associated socio-demographic factors, among adults with type 2 diabetes mellitus (T2DM). Methods: This cross-sectional study was conducted among 196 adults from the Indian, Chinese, and Malay ethnic groups with T2DM who attended a primary care clinic in Seremban, Malaysia. The Literacy Assessment for Diabetes and Diabetes Knowledge Test 2 were used to assess diabetes-specific literacy and knowledge, respectively. Results: The majority of participants (75.0%) had literacy scores that corresponded to Ninth Grade Level but only 3.6% of participants had a good knowledge of diabetes. Literacy scores explained up to 19.8% of the variance in knowledge scores (r=0.445, p<0.01). Indian participants had the lowest literacy and knowledge scores when compared to Chinese and Malays (p<0.05). Participants with higher education had better literacy and knowledge scores (p<0.05). Educational level was more likely than ethnicity to predict both literacy and knowledge scores (p<0.001), while gender and age did not significantly predict either score. The majority of participants could answer general questions about physical activity, diabetes-related complications and healthy eating. Knowledge of diabetes and its relation to specific foods and the effect of diet on glucose control were limited among the participants. Conclusion: Education and ethnicity were associated with literacy and knowledge on diabetes. There existed a deficit of diabetes-related nutrition knowledge among the participants. These findings may help healthcare providers tailor individualised patient educational interventions.
ABSTRACT
@#Introduction: Self-efficacy for eating predicts successful weight loss and maintenance in Type 2 Diabetes Mellitus (T2DM) individuals. The Weight Efficacy Lifestyle (WEL) questionnaire determines self-efficacy for controlling eating. This study aims to validate the Malay-translated version of the WEL questionnaire and to establish the cut-off scores to define the level of eating self-efficacy in Malaysian T2DM individuals. Methods: A total of 334 T2DM individuals, aged 55.0±9.0 years, were recruited from a primary healthcare clinic based on sampling ratio. Medical records were reviewed for eligibility. Inclusion criteria included BMI ≥23kg/m2, and no severe diabetes complications. The WEL questionnaire assessed eating resistance during negative emotions, food availability, social pressure, physical discomfort and positive activities, and was back translated into Malay language. Self-efficacy was rated on a 0-9 scale with higher WEL scores indicating greater self-efficacy to resist eating. Factor analysis established the factor structure of the WEL questionnaire. Inter-item and item-total correlations determined construct validity while internal consistency described the reliability of the structure. Results: A two-factor structure accounting for 49% of variance was obtained, and it had adequate reliability, as indicated by Cronbach’s α of 0.893 and 0.781 respectively. Item-total correlations of r>0.700, p<0.01 and inter-item correlations of r<0.500, p<0.01 demonstrated construct validity. Cut-off scores of ≥44 and ≥32, respectively for factor one and two defined high eating self-efficacies in T2DM individuals. Conclusion: The Malaytranslated version of the WEL questionnaire appears to be a valid and reliable tool to assess self-efficacy for controlling eating behaviour in Malaysian T2DM population.