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@#Background: Primary care doctors are responsible to provide smoking cessation intervention (SCI) to smokers in a community. This study aimed to assess the SCI practice among primary care doctors themselves and its associated factors. Methods: This cross-sectional study was conducted from July to October 2016. All the 140 doctors in 12 public primary care clinics in Kuala Lumpur were invited to participate in this study. However, only 122 doctors (females, 82.8%) completed the self-administered questionnaire that assessed their demography, clinical experience, SCI practice and its barriers, self-efficacy in delivering and knowledge on smoking and SCI. Results: Only 42.6% of the doctors had good SCI practice. Almost all doctors assessed the smoking status of their patients (98.4%) and advised them to quit (98.4%). However, lesser proportions of the doctors followed up the practice of patients (50.0%), taught smokers on various methods of quit smoking (46.70%) and discussed about the barriers and resources to quit prior to the quit date (27.9%). Less than one-fourth of the doctors were confident in providing SCI. Although 69.7% had previous training in SCI, many felt they had inadequate knowledge (56.6%) and skills (47.5%). Only 11.5% of doctors thought their previous training was enough. Having higher level of knowledge on smoking and SCI was significantly associated with good SCI practice [adjusted Odds Ratio (95% Confidence Intervals): 1.21 (1.02, 1.43), p=0.026]. Conclusion: The SCI practiced by the primary care doctors in this study was sub-standard, particularly in assisting smokers to quit and arranging follow up. Low self-efficacy in providing SCI was also common. These inadequacies may be due to poor knowledge and skills, which needs to be improved through effective clinical training.
RESUMO
@#Performing self-care activities can be challenging but it is important for favourable outcomes of type 2 diabetes mellitus (T2DM). It may be influenced by psychological problems. Therefore, this study examined the level of self-care activities and the presence of psychological problems among patients with T2DM. The association between these activities and the psychological problems was assessed too. This cross-sectional study was conducted at a public health clinic in Sabah. Data was collected between July and September 2017 using a validated self-administered questionnaire which include the depression, anxiety and stress scale-21 (DASS-21) and the summary of diabetes self-care activities (SDSCA) questionnaire. About 91% of 331 participants took diabetes medications in ≥6 days per week. They followed a healthful eating plan, inspected feet and exercised 30 minutes a day in 5.0 (IQR 4.0), 4.0 (IQR 7.0) and 1.0 (IQR 4.0) days per week respectively. Among owners of glucometer, the median (IQR) of monitoring blood glucose was 1.0 (1.0) days per week. The participants with depression, anxiety and stress were 4.5%, 8.8% and 5.7% respectively. Following a healthful eating plan (p<0.001) was found to be significantly associated with anxiety; those with anxiety practised this activity in fewer days than those without anxiety. Generally, self-care activities were poorly practiced by the participants, except for taking diabetes medications. Thus, the patients should be encouraged to improve their self-care activities. Psychological problems were also found to be uncommon. However, anxiety symptoms should not be ignored as it may negatively affect their adherence to healthy diet.
RESUMO
Introduction: Social support and self-efficacy are factorsthat influence patients’ health behaviour. However, therelationship between these two factors among patients withType 2 Diabetes Mellitus (T2DM) has not been adequatelyexplored. This study aims to report social support and selfefficacy of Malaysian T2DM patients, and their correlations.Methods: This cross-sectional questionnaire study involved329 patients with T2DM who received their follow up at apublic primary care clinic. Patients were selected viasystematic random sampling. Patients self-completedlocally adapted versions of the Medical Outcomes Study(MOS) Social Support Survey and Diabetic Management SelfEfficacy Scale (DMSES). The scores of both tools wereanalysed to determine the association and correlationbetween social support and self-efficacy.Results: The mean score for overall social support was72.7±21.40 score range (0-100). “Affectionate support” wasrated the highest averaged mean score at 78.31±23.71 (scorerange: 0-100). The mean DMSES score was 147.6±35.5(score range :0-200), of which “medications” subscale wasrated the highest with averaged mean scores 9.07±1.67(score range: 0-10). Overall social support and self-efficacywere found to be weakly correlated (r=0.197, p<0.001).However, all subscales of social support were moderatelycorrelated with “medications” subscale of self-efficacy.Conclusion: Social support is significantly associated withpatients’ self-efficacy in handling their own medications.