RESUMO
Introduction: Promoting positive life style is a strategy for delaying and reducing the incidence of diabetes complications. Objective: To determine the perception of educators about the quality of education services provided to diabetic patients at the health centers in Khartoum State. Methods: A qualitative descriptive study carried out among 22 educators working at governmental and non-governmental health centers. Mini focus groups of discussion were moderated by a qualified social researcher and a trained note taker. The guiding questions included general information and several questions about education services for diabetic patients. Ethical clearance was obtained from relevant ethical committees. Informed consent was obtained from educators. Content analysis of data was carried and organized in to themes. The themes were organized according to the dimensions of quality of care, structure, process and outcome. Results: All educators were females. Their ages were between 25-55 years. The majority were holders of a university degree with different basic disciplines. The working duration ranged between 3 to 25 years. Ten of them were working in governmental health centers and 12 in non-governmental ones. Few educators were trained on diabetes education (structural quality care). Most of them agreed on the lack of diabetes education materials and specific education program (structural quality care). The majority agreed on the absence of team work and their role is to weight the patients. Most of educators educate individuals rather than groups (process quality care). The majority was not satisfied with education services at the health centers and most of educators reflected the poor knowledge and negative behaviour of the diabetic patients (outcome quality care). Conclusions: Diabetes education services at primary health care are insufficient. Most of educators were not certified educators. Education services lack team work and strategic plans. Diabetic patients have poor knowledge and behaviour regarding diabetes management.
RESUMO
Introduction: Diabetes mellitus needs medical care and education. Adherence of the diabetic patients to education information provided at primary care level have been scantly documeneted. Objective: To measure the adherence of diabetic patients to education information provided at health centers. Methods: A cross sectional study was carried out in 25 governmental health centers (Gov.HCs) and 15 non-governmental health centers (Non-Gov.HCs). Study population was 419 adult diabetic males /females known beneficiaries of the services in the study centers. Patients were interviewed by structured questionnaire. Descriptive statistic presented the patients profile, as well as the education information received by the patients and the levels of patients’ adherence. Fisher exact test at 95% confidence level used to test differences in education information services. Adherence of patients to education information was measured by three points Likert scale. Chi square test used to test the difference in adherence. Ethical clearance and written consent were obtained. Results: The mean age was 55.2±10.2 years. Males and females were 44.6% and 55.4% respectively. Education accounted to 76.4%. Family income above 1000 Sudanese Geneh (SDG) accounted to 64.2%. Doctors provided education information about physical activities to 64.6% and 46.2% patients in Gov.HCs and Non-Gov.HCs respectively, P-value 0.014. Diet plan received by 73.6% and 55.8% of patients in Gov.HCs and Non-Gov.HCs respectively, P-value 0.013. Information on how to measure blood glucose at home received by 48.2% and 25.0% of patients in Gov.HCs and Non-Gov.HCs respectively, P-value 0.002. Very few patients received information from educators, 0.2% and 3.4% of patients in Gov.HCs and Non-Gov.HCs respectively. Foot care education information provided to 25.3% of patients. Adherence of diabetic patients to education information provided was adequate but does not significantly differ between the types of the health centers Conclusions: Education information services were significantly high in Gov.HCs. Adherence of diabetic education information was adequate.