DIABETES A LEADING CAUSES OF DEATH IN NIGERIA, HOW NURSES THROUGH EDUCATION AND HEALTH PROMOTION COULD INCREASE DIABETES AWARENESS AMONG NIGERIANS

Abstract

Diabetes is a non-communicable disease that has attained great significance in the sub-Saharan region, with Nigeria being the most affected. Many persons with the condition suffer a reduced life expectancy and quality of life. Diabetes places an extra burden on the individuals and families affected, especially for the majority of patients unable to access quality health care. The study is on diabetes a leading causes of death in Nigeria, how nurses through education and health promotion could increase diabetes awareness among Nigerians. The total population for the study is 200 staff of selected health center in Akwa Ibom State. The researcher used questionnaires as the instrument for the data collection. Descriptive Survey research design was adopted for this study. A total of 133 respondents made up nurses, lab technician, senior staff and junior staff was used for the study. The data collected were presented in tables and analyzed using simple percentages and frequencies.

 

 

 

CHAPTER ONE

INTRODUCTION

• Background of the study

Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body’s cells do not respond properly to insulin, or both. Patients with high blood sugar will typically experience polyuria (frequent urination), they will become increasingly thirsty (polydipsia) and hungry (polyphagia). There is no cure for diabetes. People with diabetes need to manage their disease to stay healthy.  (www.medicalnewstoday.com) It is a metabolic disease in which the body’s inability to produce any or enough insulin causes elevated levels of glucose in the blood. Persons with diabetes have too much sugar in their blood. This problem can start when a person is young (Type 1 diabetes) or older (Type 2 diabetes). Type 1 diabetes is usually more serious, this can only be control by insulin (drug/Injection).  Diabetes is a serious complex condition which can affect the entire body. Diabetes requires daily self care and if complications develop, diabetes can have a significant impact on quality of life and can reduce life expectancy. While there is currently no cure for diabetes, you can live an enjoyable life by learning about the condition and effectively managing it. Diabetes is a noncommunicable disease that has attained great significance in the sub-Saharan region, with Nigeria being the most affected. Many persons with the condition suffer a reduced life expectancy and quality of life. Diabetes places an extra burden on the individuals and families affected, especially for the majority of patients unable to access quality health care. There are no nurses who specialize in diabetes care in Nigeria all nurses are trained to provide basic care for patients at all tiers of care. Nurses are responsible for bedside urine tests, point-of-care blood glucose determinations, basic nutritional advice, education for insulin self-injection, and insulin administration for patients with cognitive dysfunction or who are otherwise unable to self-inject. (www.omicsonline.org)Some of these nurses have been exposed to informal or ad-hoc diabetes training sponsored by a nongovernmental organization (NGO) or multinational pharmaceutical company. Awareness of various aspects of Diabetes Mellitus (DM) is essential for the prevention, management and control of the disease. However, several studies have consistently shown that awareness of DM in the general population is low. Diabetes Mellitus (DM) has emerged as one of the most challenging public health problems in the 21^stcentury. It currently affects over 366 million people worldwide and this figure is likely to double by 2030. The greatest burden of this condition is felt in low and middle-income countries, and these nations account for about 80% of all cases of diabetes. In sub-Saharan Africa alone, there are about 12 million people suffering from this condition and there are projections that this number will reach 18 million by 2030, making the region the one with the fastest growing rates of diabetes mellitus in the world.  Public health problem would impose substantial challenges on the healthcare systems as well as on the economy of most developing nations in the near future. This is because a significant proportion of individuals who suffer from the condition in these countries are within the reproductive age. These are the same individuals who are expected to drive the economic machinery in these nations so as to achieve the agreed millennium development goals. When the disease affects these individuals, and if not properly controlled, it may lead to lifelong complications, which are generally associated with increased morbidity and mortality. For instance, poorly controlled DM can cause damage to eyes (leading to blindness), kidneys (leading to renal failure), and nerves (leading to impotence and foot disorders/possibly amputation) as well as increased risk of heart disease, stroke, and poor blood supply to the limbs. Most of these complications are not only irreversible, but there are also costly to manage as they generally require management in specialized centers with sophisticated infrastructure and equipment, well trained staff and potent medications, which are all scarce in Nigeria. Since most of these specialized centers are not available in many Nigeria settings, patient education becomes a central component in the prevention and control of this disease in Nigeria. Such education should lead to diet modification, increased physical exercise and lifestyle changes including the promotion of weight loss. These educational programs should help people assess their risks of diabetes, motivate them to seek proper treatment and care and inspire them to take charge of their disease. In addition, it should enable early detection and treatment of complications as well as enhanced early referrals of cases to specialized centers for management and follow-up. Although the importance of educational programs in the prevention and control of DM is well recognized, there are concerns whether these programs are achieving the desired goal of increasing awareness of DM in developing countries. Indeed, several studies have consistently shown that awareness of the DM in the general population seems to be low. For example, Ulvi et al., showed that a significant number of people in rural area had little or no knowledge of DM, and even the few who claimed to be aware of the condition only knew it by the name “sugar” and had never heard the term “Diabetes Mellitus. Similarly, others have shown that many people are still ignorant about several aspects of the disease as well as approaches that are necessary for the prevention and control of DM. Self-management skills are an essential part of diabetes care and with the help and support of nursing staff the condition can be managed to help people stay healthy and prevent complications. Diabetes Nigeria should provide resources for health care professionals to increase the provision and uptake of diabetes self-management education. Making lifestyle changes can often help people with type 2 diabetes and those with an elevated risk of diabetes. A poor diet leading to weight gain, a lack of physical activity as well as high cholesterol and high blood pressure are risk factors for diabetes combined with smoking and excessive alcohol consumption. Maintaining a balanced diet, losing weight, undertaking regular physical exercise, limiting alcohol consumption and giving up smoking are all ways to reduce the risk of developing type 2 diabetes. Type 1 diabetes cannot be prevented, but people with type 1 diabetes can take steps to prevent or delay the development of complications by keeping their blood glucose level at the target level. They should also regularly meet with a health care professional to check for any signs of complications so they can receive treatment as early as possible. Exercise can contribute to weight loss, increase insulin sensitivity and help to reduce high cholesterol and blood pressure. Diet is also an important factor in preventing diabetes. Excessive consumption of saturated fats, simple carbohydrates (such as found in white bread), sugar and salt can all contribute to the development of diabetes. Diabetes Specialist Nurses (DSNs) are crucial in providing good patient care and promoting self-care management. DSNs work wholly in diabetes care and may be employed in a variety of care settings. A DSN is often the first point of contact for people, referring them to other specialist services. DSN’s will also provide training, education and support to non-specialist health care professionals including nurses in primary, secondary and community settings and care homes. All nursing staff has an important role and clear responsibilities when treating people with diabetes. Nurses from across the nursing spectrum including occupational health nurses, nurses working in public health and school nurses are likely to come into contact with people who have diabetes or are having tests to diagnose diabetes. Practice nurses have a particularly vital role as they are often the people who carry out the annual diabetes and foot check. Practice nurses in particular play a clinical role in screening, maintaining and supporting people with diabetes.

1.2 SSTATEMENT OF THE PROBLEM

Diabetes Mellitus (DM) has emerged as one of the most challenging public health problems in the 21^stcentury. It currently affects over 366 million people worldwide and this figure is likely to double by 2030. The greatest burden of this condition is felt in low and middle-income countries, and these nations account for about 80% of all cases of diabetes. It is in view of this that the researcher intends to the impact of diabetes a leading causes of death in Nigeria, how nurses through education and health promotion could increase diabetes awareness among Nigeria.

1.3OBJECTIVE OF THE STUDY 

The main objective of this study is diabetes a leading causes of death in Nigeria, how nurses through education and health promotion could increase diabetes awareness among Nigeria.  But for the successful completion of the study; the researcher intends to achieve the following sub-objectives;

1. To investigate the causes of diabetes in Nigeria
2. To ascertain the extent of diabetes awareness carryout by Nigeria Government
3. To investigate the role of health practitioners in reducing the adverse effect of diabetes
4. To suggest possible solution to the identified problem.

1.4 RESEARCH HYPOTHESES

For the successful completion of the study, the following research hypotheses were formulated by the researcher;

H₀: health practitioners do not play any role in reducing the adverse effect of diabetes

H₁: health practitioners do not play any role in reducing the adverse effect of diabetes

H₀²: there are no diabetes awareness programs carried out by the government own medical centers in the rural communities

H₂: there are diabetes awareness programs carried out by the government own medical centers in the rural communities

1.5 SIGNIFICANCE OF THE STUDY

It is believed that at the completion of the study, the findings will be of benefit to ministry of health. The study educates nurses on how to educate, prevent and manage diabetes. The study will also be of great benefit to the researchers who intends to embark on research on similar topics as it will serve as a guide. Finally, the study will be of great importance to academia’s, lecturers, teachers, students and the general public.

1.6  SCOPE AND LIMITATION OF THE STUDY

The scope of the study covers diabetes a leading causes of death in Nigeria, how nurses through education and health promotion could increase diabetes awareness among Nigeria. The researcher encounters some constrain which limited the scope of the study;

1. a) AVAILABILITY OF RESEARCH MATERIAL: The research material available to the researcher is insufficient, thereby limiting the study
2. b) TIME: The time frame allocated to the study does not enhance wider coverage as the researcher has to combine other academic activities and examinations with the study.
3. c) Organizational privacy: Limited Access to the selected auditing firm makes it difficult to get all the necessary and required information concerning the activities.

1.7 DEFINITION OF TERMS

DIABETES: Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body’s cells do not respond properly to insulin, or both. Patients with high blood sugar will typically experience polyuria (frequent urination), they will become increasingly thirsty (polydipsia) and hungry (polyphagia).

CAUSES: A person or thing that acts, happens, or exists in such a way that some specific thing happens as a result; the producer of an effect

NURSES: Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life.

EDUCATE: Give intellectual, moral, and social instruction to (someone), typically at a school or university.

PROMOTE: Support or actively encourage (a cause, venture, etc.); further the progress of

AWARENESS: Awareness is the ability to directly know and perceive, to feel, or to be cognizant of events. More broadly, it is the state of being conscious of something.

1.8 ORGANIZATION OF THE STUDY

This research work is organized in five chapters, for easy understanding, as follows

Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study. Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature. Chapter three deals on the research design and methodology adopted in the study. Chapter four concentrate on the data collection and analysis and presentation of finding.  Chapter five gives summary, conclusion, and recommendations made of the study

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