DISSERTATION ON

A STUDY TO ASSESS THE

KNOWLEDGE ON MANGEMENT OF
DIABETES MELLCITUS AMONG
DIABETIC PATIENTS ADMITTED IN
SELECTED
HOSPITALS
IN
FARIDABAD
BY
Miss. Arti Memoria
Miss. Tenzin Saldon
Miss. Tiljy.K.K
Miss. Shakarani
Miss. Usha Rani
Miss. Susheela Devi
Miss. Meenakshi
Miss. Renu
Mr. Vinaya Chandran

Post Basic BS.c Nursing

Batch
2011- 2013
FLORENCE
SCHOOL AND COLLEGE OF NURSING
DAYALPUR(FARIDABAD)
PANDIT BHAGWAT DAYAL SHARMA
UNIVERSITY OF SCIENCE
ROHTAK
MAY 2013

A STUDY TO ASSESS THE KNOWLEDGE

ON
MANGEMENT OF DIABETES
MELLITUS
AMONG DIABETIC PATIENT ADMITTED
IN
SELECTED HOSPITAL IN FARIDABAD
Approved by the Dissertation Committee on
May 2013
Professor in Nursing Research Mr. Sujith.A
R.N R.M M.sc (N)
Principal
Florence College of Nursing

Research Guide Miss Sonia John

Wise Principal
Florence College of Nursing

Dayalpur (Faridabad)

Dissertation submitted as a partial

Fulfillment of
requirement for the
degree of Bachelor of Science in Nursing,
Pandit Bhagwat Dayal Sharma University
Rohtak
A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE ON
MANAGEMENT OF DIABETES MELLITUS AMONG DIABETIC
PATIENTS ADMITTED IN SELECTED HOSPITAL IN
FARIDABAD WITH A VIEW TO DEVELOP AN INFORMATION
BOOKLET
By:
Miss. Arti Memoria
Miss.Tenzin Saldon
Miss.Tiljy.K.K
Miss.Shaka Rani
Miss.Usha Rani
Miss.Susheela Devi
Miss. Meenakshi

PROJECT REPORT
SUBMITTED AS PARTIAL FULFILLMENT OF THE
REQUIREMENT FOR THE PCBSC NURSING AFFILIATED TO
PANDIT DAYAL SHARMA UNIVERSITY OF HEALTH
SCIENCES IN ROHTAK

PANDIT BHAGWAT DAYAL SHARMA UNIVERSITY OF

HEALTH SCIENCES IN ROHTAK

DECLARATION BY THE CANDIDATE

We hereby declare that this dissertation entitled as A

descriptive study to assess the knowledge on management of
Diabetes Mellitus among diabetic patients admitted in selected
hospital in Faridabad with a view to develop
an information
By:
Booklet is a bonafide and a genuine research work carried out
Miss.Arti
Memoria of
by us under the guidance of Ms. Sonia
John Department
Mental Health Nursing.
Miss.Tenzin Saldon
Miss.Tiljy.K.K
Certified that this project done by the following
Candidates.
Date:
Place :

Miss.Shaka Rani
Signature
of the Candidates
Miss.Usha
Rani
Miss.Susheela Devi
Miss. Meenakshi

CERTIFICATE BY THE GUIDE

This is to certify that the dissertation entitled as A

descriptive study to assess the knowledge on management of
Diabetes Mellitus among diabetic patients admitted in selected
hospital in Faridabad with a view to develop an information
Booklet is a bonafide and a genuine research work carried out
by Miss.Arti Memoria, Miss.Tenzin Saldon, Miss.Tiljy.K.K,
Miss.Shaka Rani, Miss. Usha Rani, Miss.Susheela Devi, Miss.

Meenakshi,

Miss.Renu,

Mr.

Vinaya

Chandran

In

partial

fulfillment of the requirement for the PCBSE students.

Date:
Place :
Signature of the Guide
Ms. Sonia John
Department of Mental Health
Nursing.

ENDORSEMENT BY THE H.O.D PRINCIPAL/HEAD OF THE

INSTITUTION

This is to certify that the dissertation entitled as A descriptive

study to assess the knowledge on management of Diabetes
Mellitus among diabetic patients admitted in selected hospital
in Faridabad with a view to develop an information Booklet is

a bonafide research work carried out by Miss.Arti Memoria,

Miss.Tenzin Saldon, Miss.Tiljy.K.K, Miss.Shaka Rani, Miss.Usha
Rani, Miss. Susheeladevi, Miss. Meenakshi, Miss.Renu, Mr. Vinaya
Chandran In partial fulfillment of the requirement for the

PCBSE. Under the guidance of Miss. Soniya John Department

of Mental Health Nursing, Faridabad College of Nursing,
Faridabad.

Seal and Signature of the H.O.D

Date:
Place :

Seal and Signature of the Principal

Date:
Place :

ACKNOWLEDGEMENT
O Give thanks to the Lord for He is good!
For His mercy endures forever
- Psalms 107:1

Drops of ocean makes an ocean. Although bricks give the structure

of house, proper foundation make it strong. The satisfaction and pleasure
that accompany the successful completion of any task, would be
incomplete with all maintaining the people who have made it possible &
whose constant guidance & encouragement reward any effort with
successfully

First of all, we extend our sincere in debt to Florence College of

Nursing for providing an opportunity to be in the student of this
esteemed institution to conduct study.

We

would

like

to

convey our

heartful

gratitude

to

Sujith

Aravindakshan, Principal, Florence and college of nursing for his

guidance & suggestion for the study successfully.

We express our esteemed thanks to the Vice Principal. Miss Soniya

John for the guidance and contribution to support the project work.

We thank to our staff who had been with us & being with us & who
had been the source of inspiration throughout this course of study

We extended our thanks to Florence College Library staff who

granted special permission and helps us in referring the books &
Journals.

We express our heartfelt gratitude and thanks to our parents,

friends and Colleagues for their constant support and prayers.

RESEARCH ABSTRACT

A descriptive study to assess the knowledge on management of Diabetes

Mellitus among diabetic patients admitted in selected hospital in Faridabad
with a view to develop an information Booklet.

OBJECTIVES

To

assess

the

existing

knowledge

level

of

diabetic

patients

on

management of Diabetes Mellitus.

To find association between the knowledge scores with selected

demographic variables.
To develop an infoamtion Booklet on management of Diabetes Mellitus

BACKGROUND
Diabetes is a major health problems being faced by modern society of
today all over the world and India is predicted to have the most number of
people with Diabetes Mellitus by the year 2015. Once one

has develop

Diabetes, it cannot be cured but fortunately enough can be managed very well
and quality of life can be improved under wellness programme involving diet,
exercise, and medicine.

METHODS

The study was conducted in the month of May 2013 at selected hospital in
Faridabad. an administrative approval was obtained from concerned authority
in Faridabad.

A descriptive study with a sample size consisting of 40 diabetic patients.

Purposive sampling method was used to select the sample respondents. The
tool used in collection of demographic data on diabetic patients comprised of
10 items.

Structure self administered knowledge questionnaire consist of 35 statements

on management of Diabetes Mellitus. The Diabetes Mellitus management
comprised of diet, medication, exercise, foot care and complication.

RESULTS
The result indicate that majority of the respondents (32.5%) were between 4150 years of age group. Majority of respondents (70%) were male. Majority of
respondents (57.5%) were belong to Hindu religion. Majority of respondents
(50%) were belongs to joint family. Majority of respondents (65%) were married.
35% of respondents were educated upto high school. Majority of respondents
(35%) are private employee. Majority of the respondents (52.5%) has a history
of Diabetic Mellitus. Majority of the respondents (40%) were received
information from electronic media. Among the sample 29 (72.5%) had
inadequate knowledge, 9 (22.5%) had moderately adequate knowledge and 2
(5%) had adequate knowledge. Demographic variable such as age, sex, religion
type of family, marital status, monthly income of the family, source of
information were found to be non significant at 0.05 level.

Demographic

variables such as educational status, occupation, family history of Diabetic

Mellitus were found to be significant 0.05 level.

Interpretation and conclusion

The study reflects that there is lack of knowledge even in the educated
population. So thereby, an information Booklet is developed on management of

Diabetes Mellitus to impart knowledge in health promotional behavior

regarding management of Diabetes Mellitus.

TABLE OF CONTENTS

CHAPTER NO.
1
2
3
4
5
6
7
8
9
10

TITLE
INTRODUCTION
OBJECTIVES
REVIEW OF LITERATURE
METHODOLOGY
DATA ANALYSIS
DISCUSSION
CONCLUSION
SUMMERY
BIBLIOGRAPHY
ANNEXURES

PAGE NO.
1-4
5-10
11-16
17-24
25-54
55-57
58-60
61-63
64-66
67-91

LIST OF TABLES

TABLE
NO.
1
2
3
4
5
6
7
8
9

TITLE OF THE TABLES

Classification
Classification
Classification
Classification
Classification
Classification
Classification
Classification
Classification

10

Diabetes Mellitus
Classification of Respondents by source of

47

11

information
Frequency and percentage distribution of

49

of
of
of
of
of
of
of
of
of

Respondents
Respondents
Respondents
Respondents
Respondents
Respondents
Respondents
Respondents
Respondents

by
by
by
by
by
by
by
by
by

age group
sex
religion
type of family
marital status
educational status
occupation
monthly income
family history of

PAGE NO.
29
31
33
35
37
39
41
43
45

Respondents according to pre test knowledge level

12

on management of Diabetes Mellitus

Classification of Respondents on diet, medication,

51

13.

exercise, foot care and complication

Data on association of knowledge on management of

52-53

Diabetes Mellitus among diabetic patients with their

selected demographic variables.

LIST OF FIGURES

FIGURE
NO.
1
2
3
4
5
6
7
8
9
10

FIGURES

PAGE NO.

Conceptual frame work of the study

Schematic representation of research design
Classification of Respondents by age group
Classification of Respondents by sex
Classification of Respondents by religion
Classification of Respondents by type of family
Classification of Respondents by marital status
Classification of Respondents by educational status
Classification of Respondents by occupation
Classification of Respondents by monthly income of

10
18
30
32
34
36
38
40
42
44

11

the family
Classification of Respondents by family history of

46

12

Diabetes Mellitus
Classification of Respondents by source of

48

13.

information
Frequency and percentage distribution of

50

Respondents according to pre test knowledge level

on management of Diabetes Mellitus

LIST OF ANNEXURES

SL NO.
TITLE
1
Certificate of content validity
2
Lists of experts consulted for the content

PAGE NO.
67
68

validity of the tool

3

Structured self administrated knowledge

questionnaire tool-English and Hindi version

Answers and scoring key

69-90
91

INTRODUCTION

Ants die in Sugar

- Malawin proverb

The word Diabetes was coined by Aretacus of separated. The word taken from Greek
diabainein, and literally means passing through or Siphon, a reference to one of
diabetes major symptoms of excessive urine discharge. The word became diabetes
from the English adoption of the medieval Latin diabetes. In 1965 Thomas Willis added
Mellitus to the name (Greek mel-honey) when he noted that a diabetics urine and
blood has a sweet taste. In 1776it was confirmed the sweet taste was because of an
excess of sugar in the blood. The ancient Chinese tested for Diabetes by observing
whether ants were attracted to a person is urine and called the ailment Sweet urine
disease

Diabetes Mellitus is a chronic progressive disease characterized by the bodys

inability to metabolize carbohydrates, fats and proteins leading to hyperglycemia (high
blood glucose level). The management of Diabetes is one of the most important
subjects

in

clinical

practice

in

Indian

context,

increasing

urbanization,

industrialization and changing life style seem to be contributing to increasing

prevalence of Diabetes.

Medical management for clients with Diabetes Mellitus includes restoring and
maintaining blood glucose levels to as near normal as possible by balancing diet,
exercise and the use of oral hypoglycemic agents or insulin in general, when Diabetes
Mellitus is successfully managed clients avoid the complication of hypoglycemia and
hyperglycemia.

Initial as well as ongoing client education is vital in helping the client manage
this chronic condition. Interventions must be individualized to the clients goals, age,
life. Style, nutritional needs, malnutrition activity level, occupation, type of Diabetes
Mellitus and ability to independently perform the skills required by the management
plan.

1.

NEED FOR STUDY

Diabetic mellitus is a chronic system disease related to abnormal insulin

production, impaired insulin utilization or both. Diabetes Mellitus is a serious health
problem throughout the work and its prevalence is increasing rapidly

W.H.O:-

The world health organization (WHO) has estimated that there will be 350
million people with Diabetes is the world by 2012. WHO develop a program for

worldwide Diabetes Mellitus is increasing rapidly in China and India and other
countries, where the standard of living is increasing in association with their increase
in obesity. Diabetes Mellitus increasing not only in the Western world as it has been for
many years, but also in Mid Eastern countries for reasons there are unclear.

WORLDWIDE:-

0.6 million males and 0.54 million females with diagnosed Diabetes in enlarged
and Wales in 2008, and over half (60 and 53% respectively) where aged 50-74 years.
Because the population in ageing the members male and females with diagnosed.
Diabetes is projected to use to 0.84 million (37%) and 0.67 million (24%) respectively,
in specific prevalence. From 2004-2008 the increases were 24% in 0-24 years old
males, 18% in 24-29 years old men, 15% in 50-74 years old men and 14% in men
aged 75 years. In female, the increases were 17, 2018 and 12% respectively, if
prevalence increase by 10% from 2008-2023, the number of males with the diagnosis
is projected to rise by 36% to 0.74 million, given a 20% increase prevalence, the
number of female is projected to rise to 1.9 million (78% increase) and 8.7 million
(67% increase) respectively in 2013.

The estimated Diabetes prevalence for 2010 in 285 million and is

expected to affect 438 million people by 2023.

2.
According to International Diabetes Federation (IDF) estimated that in 2010,
the five countries with the largest number of people with diabetic are India,
China the United States, Russia and Brazil. The IDF also reported that in
2010, the five countries with the highest Diabetes prevalence in the adult
population all Norway, the UAE, Saudi Arabia and Bahrain. Low and middle
income countries for the greatest burden of Diabetes.

According to ADA and CDC, total ADC 23.8 million (7.8%, CDC 24 (8%).
Undiagnosed 5.7 million, Pre Diabetes 57 million, New case per years 1.6
million is previous over 20 years of age. Prevalence under 20 years age-186,000
or 0.22%. This equals about in every 400-600 children with Diabetes Mellitus.
Prevalence in person aged 20 years and older 23.5 million (or) 10.7% of all
people in this age group. Prevalence in person aged 20 years and older 12.2
million (or) 23.1% of all people in this group. Prevalence in men aged 20 years
and older 12 million (or) 11.2% prevalence in women age 20 years and older
11.5 million or 10.2% Non-Hispanic white 14.9 million (or) 19.8% NonHispanic blacks 3.7 million or 14% of this group. American Indians and
Alaskan natives 14.2%

Adjusted for age over 20 years for patient of the Indian Health service
16.5% (Total), 60% (Alaskan) and 29.3% (Southern) (Arizona) of these
population have Diabetes. Adjusting again for age 20 (or) above 6.6% of nonHispanic whites 7.5% of Asian Americans. 10.4% of Hispanics and 11.8% of
non-Hispanic blacks have Diabetes Mellitus.

INDIA:Further, evidence for the rise in prevalence of Diabetes case from

Chennai as the prevalence. Diabetes has rises to 11.6% in the same Urban
area which had a prevalence 8.2% five year in 2008. A study from Guwahati
reported a prevalence of 8.2%. A study done in Kerala showed very high
prevalence of 16.3% of 15.2% in 2009, the prevalence of undiagnosed Diabetes
was 4.3% which was more than double that of diagnosed cases.
3.
A study done in Mumbai, in 2010 reported a prevalence of 4.5%
according to WHO criteria, the national urban Diabetes survey was a

population based study conducted in sic large cities from different region of
India, the prevalence was the highest in Hyderabad (16.6%) followed by
Chennai (13.5%), Bangalore (12.4%) Kolkatta (11.7%), New Delhi (11.6%) and
Mumbai (9.3%) A recent study from rural Maharastra showed a high prevalence
of 4.3%. The prevalence of self reported Diabetes was 5.6& in this study
population.

In Karnataka, the Hindu edition of 2008, February 18 reported that over

30 million population in India has Diabetes Mellitus. Every person sustain
after 40 years in unfortunately being attributed to old age.
The overall prevalence of type 1 diabetes in Karnal district is 10.20/100,000 population,
with a higher prevalence in urban (26.6/100,000) as compared to rural areas
(4.27/100,000). Karnal city, with a population of 222017, has a relatively high
prevalence of type 1 diabetes (31.9/100,000). The prevalence in men is higher
(11.56/100,000) than in women (8.6/100,000).
In the 5 to 16 years age group, the prevalence is 22.22/100,000, while in the 0-5 years
age group, prevalence is 3.82/100,000.

Based on the above Review of literature and findings the researcher

found that there is a need to educate the Diabetes Mellitus patients regarding
management of Diabetes to promote the health and prevent the diabetic
complications.

4.

OBJECTIVES

STATEMENT OF THE PROBLEM

A descriptive study to assess the knowledge on management of Diabetes

Mellitus among diabetic patients admitted in selected hospital in Faridabad
with a view to develop an information.

OBJECTIVES

To assess the existing knowledge level of diabetic patients regarding

management of Diabetes Mellitus.

To find an association between the knowledge store with selected

demographic variables.

To develop an information Booklet an management of Diabetes Mellitus

OPERATIONAL DEFINITIONS

Assessment

:- It

refers

to

management

knowledge
of

Diabetes

of

diabetic

patient

by

using

refers

to

on

structured

questionnaire.
Knowledge

:- In

this

study

knowledge

the

level

of

understanding of patients regarding management of

Diabetes Mellitus
Management of

:- It refers to the diet, medication, exercise and foot care

Diabetes Mellitus.

5.
Diabetic patients

:- Refers to persons whose blood sugar levels higher than

normal.

Information
Booklet

:- Refers to a Booklet of contents prepared by an

investigator and validated by experts. It contains
information regarding meaning and management of
Diabetes Mellitus which will be provided to the
subjects for self reading and gaining information.

ASSUMPTION:

1. Diabetic patients may have inadequate knowledge on management of

Diabetes Mellitus.
2. Knowledge may vary with selected demographic variables.

HYPOTHESIS:

H1 There will be a significant association between knowledge scores and

selected demographic variables.

DELIMITATION

The study is delimited to 40 sample

Delimited to assessment of knowledge aspect only

Delimited to selected hospital patients only

6.
CONCEPTUAL FRAMEWORK
A conceptual framework is a group of concepts and a set of proportions
that spell out the relationship between them.
Conceptual framework deals with abstractions (concepts) that are
assembled by virtue of their relevance to a common theme. Conceptual
framework play several inter-related roles in the process of science. It serves as
a spring board for the generation of researcher hypothesis and can provide and
important context for scientific research.
It is the process of mixing from an abstract idea to a concrete proposal.
It helps investigator to organize their thinking observation interpretation and
goal direction.
The conceptual framework represents a less formal attempt of organizing
a phenomena. Conceptual models deals with concepts that are used as
building blocks and provide a conceptual perspective regarding inter-related
phenomena which are closely structured.
A conceptual frame work is a network of intra-related concepts that
provide a structure for organizing and describing the phenomenon of interest
research studies are based on a theoretical conceptual framework that facilities
to visualizing the problem and places the variable in a logical context.

The present study was aimed at assessing knowledge on management of

Diabetes Mellitus among diabetic patients in a selected hospital, Faridabad
with a view to prepare an information booklet on management of Diabetes
Mellitus. The conceptual frame work for present study is based on modified
Penders Health promotion Model (1980s) reframed by S. Saddle River, N.J.
Prentile Hall 2002. The model consists of 3 steps.
1. Individual characteristic and experience.
7.
2. Behaviour specific cognition and effect.
3. Behaviour outcome.

IN THE PRESENT STUDY INDIVIDUAL CHARACTERISTICS

Refers to personal, biological, psychological, social, cultural factors and

prior related behavior.

BEHAVOUR SPECIFIC COGNITION AND EFFECT:-

Refers to motivational significances for acquiring and maintaining health

promoting behaviours. These are critical care for intervention because they can
be modified through nursing intervention. They include perceived benefit of
action, perceived barrier to action actively related effect.

BEHAVOIUR OUTCOME:It refers toward attaining positive health outcome for the old age people
those who are effected Diabetic Mellitus. The investigator has modified the
health promotional model for the present study.

THE INDIVIDUAL CHARACTERISTIC AND EXPERIENCE:-

Refers to demographic variables and study variables.

BEHAVOUR SPECIFIC COGNITIVE AND EFFECTS:-

Refers to knowledge on management of Diabetic Mellitus among diabetes

patients.

8.

BEHAVIOUR OUTCOME :-

The student investigator assessed the knowledge on management of Diabetic

Mellitus among people by using structured questionnaire.

9.

10.

REVIEW OF LITERATURE

Review of Literature is a key step in research process. A through Literature

review focusing on prior research provides a foundation on which to base the
knowledge. Hence a survey of literature becomes a vital part in any research
separated. It will help to identify what is known and unknown about a problem.
It broadens the understanding and gives insight in to the problem under
study?
1. Studies related to diabetes mellitus.
2. Studies related to knowledge of diabetic patients regarding management
of diabetes mellitus.

I. STUDIES RELATED TO DIABETES MELLITUS:A study was conducted on life style risk factors and new onset Diabetes
Mellitus in adults. The objective of the study was to determine how life style
factors assessed in combination, relate to new-onset Diabetes in a broad and
relatively unselected population of adults. The sample include low risk life style
group were defined by physical activity level above the median, dietary score
(higher fiber intake and poly unsaturated to saturated fat ratio, lower trans-felt
intake and lower mean glycemic index) in the top 2 quintiles, never smoked or
farmer smoker more than 20 years ago or far fewer than 5 pack years; alcohol
use; body mass index less than 25 and waist circumference of 88cm for women
or 92cm for men. The finding shows that during 34539 person years, 337 new
cases of drug treated Diabetes Mellitus occurred (9.8 per 100 person years).
After adjustment for age, sex, race, education level, and annual income, each
life style factor was independently associated with incident Diabetes over all the

rate of incident Diabetes was 35% lower (relative risk, 0.65; 95% confidence
interval 0.59, 0.71) for each 1 additional life style factor in the low risk group.

11.

A study was conducted on time trends in the prevalence of Diabetes Mellitus

(Ten years analysis from India on 19,072 subjects with Diabetes). The objective
of the study was to assess the time trends in the prevalence of Diabetes on the
following parameters, age, group, sex and individual with freshly diagnosed
Diabetes versus known Diabetes the sample include person time can be
estimated for each patient when a patient changed from diabetic free to diabetic
patient. This can be captured for each patient from the variable onset of first
diagnoses as a diabetic patient the result shows that there is an increasing
trend in the number of individuals in the young particularly the 18-34 years
group. The number of women with Diabetes tended to increase over the 10
years period.

A study was conducted on Diabetes risk factors Diabetes and Diabetes care,
across sectional mail study. Self completed survey and retrospective chart
review were used the objective of the study was to comprehensively describe
Diabetes-related risk factors and quality of care. The sample include ninety
seven patients with Diabetes and 495 with other diseases. In the mail study 84
with Diabetes in the self completed survey and 101 diabetic patient chart
reviews. The finding showed that most residents without Diabetes had recently
had their blood pressure and cholesterol checked 60.4% were trying to control
their weight and 73.9% were exercise regularly. Those with Diabetes reported a
greater uptake of healthy living messages and had a mean HbAIC of 7.3% total
cholesterol of 5.0 mmol L(-1):12.9% had a diastolic blood pressure greater than
or equal to 85 mmHg foot checks were infrequent (18%)

II. STUDIES

RELATED

TO

KNOWLEDGE

OF

DIABETIC

PATIENTS

REGARDING MANAGEMENT OF DIABETES MELLITUS.

A study was conducted on glycemic control. The purpose of the study was
glycemic control are important components of management to prevent and
delay the complications of Diabetes. 46 patients who participated in this study
were randomly assigned to either an in person or a teleconference approach the
12.
participants were middle aged adults, both men and women with type I or type
II Diabetes.
Variables examined including glycemic control as measured by glycated
hemoglobin and psychological variable, psychological measures were assessed
using validated instruments such as problem areas in diabetic scale, the
Diabetes quality of life scale to determine. Whether there were difference in
patients quality and satisfaction with life with Diabetes. The findings showed
that significant improvement (PL.001) in metabolic control in both groups, as
demonstrated by decreases in glycated Hemoglobin level after the programme.
However, there were no significance between group difference, suggesting that
both approaches are acceptable methods for teaching patients.

A study was conducted on preventing of diabetic foot, ulcer recurrence in

high risk patients. Use of temperature monitoring as a self assessment tool in
this physician blinded randomized 1.5 month, multi centre trial, 173 subjects
with a previous history of diabetic foot ulceration were assigned to standard
therapy, structured foot examination or enhanced therapy group. Each group
received therapeutic foot wear, diabetic foot education and regular foot care
subjects in the enhanced therapy group used an infrared thermometer to
measure temperatures on six foot sites each day the temperature difference
greater than 4 degrees F (greater than 2.2 degrees c) between left and right

corresponding cities triggered patients to contact the study nurse and reduce
activity until temperature normalized the findings show that enhanced therapy
group had fewer foot ulcers than the standard therapy and structured foot
examination groups (enhanced therapy 8.5 Vs standard therapy 29.3%,
P=0.0046 and enhanced therapy Vs structured foot examination groups were
4.37 and 4.71 times more likely to develop ulcer than patients in the enhanced
therapy group14.
A study was conducted on quality evidence for life style management and
glycemic control in adults. A quasi experimental study was used to evaluating
life style (diet and or physical activity) modification and life style control date
13.
source included bibliographic data base, manual reference search and contract
with study others. The kindly show that search strategy generated 4,572
citations. The majority of citations were not relevant to the study objective in
this retrospective study morbidity obese with Diabetes Mellitus treated with a
very low carbohydrate diet15.
A study was conducted on beliefs and practices among people with Diabetes
Mellitus. A structures question knowledge, beliefs and practices regarding
Diabetes was administered to 199 persons with Diabetes (92.5%) mean age
(SD) was 53 (11) years. Mean deviation of Diabetes (SD) was 8 (7) years in men
and 9 (6) years in women men had a significantly better knowledge score that
women (P=0.02) there was no significant difference in the beliefs an practices
scores. Score were classed as good (60%) in only 13.6% of participants for
knowledge, 17.6%.

for beliefs and 11.2% for practices, about 38* of the

participants had recovered education on diabetes care16.

A study was conducted on exercise on Diabetes Mellitus. The patients none

of whom were regular exercises, were randomized to on of four groups-aerobic
exercise, resistance training combination of both or none. Overall researches
saw improvements in blood sugar control in all the patients who worked out
compared with controls patients in the aerobic group bad a reduction of 51% in
their separate n weight training group had a 38% reduction compared with
control. Access all 3 exercise groups date suggested that working out could
improve blood pressure/triglyceride and cholesterol levels in the changes
among groups. Exercising also led to modest weight loss even though patients
were put on diets especially designed to maintain weight and reduction in belly
fat17

A study was conducted on exercise on Diabetes Mellitus. It is estimated that

No. of people with Diabetes in the world will double in coming years from 171
million in 2000 to 366 million in 2030, cardiovascular disease accounts for

14.
more than 70% total mortality among patients with type 2 Diabetes. The
association of physical activity physical fitness, and changes in the life style
with the risk of type 2 Diabetes has been assessed by number of prospective
studies and clinical trials in the past decade. Several studies have also
evaluated the joint associations of physical activity, body mass index and
glucose levels with the risk of type 2 Diabetes these studies showed that
moderate or high levels of physical activity or physical fitness and changes in
the life style can prevent type 2 Diabetes18.

A study was conducted on complications of diabetes Mellitus, long term

complications due to diabetes continue to be a major problem for patients with
this disease. Most common complication were peripheral neuropathy (68%) and

problems related to eyes (43%) lower extremity ulcer as a consequences of this

disease was also found to a common complication. Thus this study showed
that early detection and effective control of Diabetes can be expected to reduce
the incident of Diabetes related complications. Furthermore prevention and
proper management of foot ulcers will reduce risk of amputation in these
patients19.
A study was conducted on developed of a Diabetes diet related quality of life
style. The objective of the study was to assess the reliability and validity of
diabetic diet related quality of the scale. Which is a measure of the influence of
diet therapy on patients quality of life. The sample include patient with
Diabetes (N-236) who were being treated on an outpatient basis were asked to
complete the self administered DDRQOL instrument. The factor validity,
convergent and discriminant validity. Internal consistency and reproducibility
of the DDRQOL scale were then assessed. The result shows that the following
seven subscales were adopted for the DDRQOL `satisfaction with diet burden of
diet therapy perceived merits of diet therapy general perception of diet
restriction of social function vitality and mental health. As hypothesized the
DDRQOL scale was associated C each of the SF-36 subscales, C convergent &
discriminate validity being generally exhibited

20

15.
A study was conducted on exercise prescription. For patients with diabetes and
pre-diabetes. Diabetes Mellitus and pre-diabetic conditions such as impaired
fasting glucose and impaired glucose-tolerance (Igt) are rapidly increasing in
prevalence exercise training often in combination with other life style
strategies as beneficial effect on preventing concept of Diabetes and improve
glycemic control in those with pre-diabetes in addition exercise training
improve cardiovascular risk profile, body composition and cardio-respiratory
fitness, all strongly related to better health outcomes based on the evidence it

is recommended that patients with Diabetes or pre-diabetes accumulate a

minimum of 210 min/week of moderate-intensity exercise or 125 min/week of
vigorous-intensity exercise within no more than two consecutive days without
training. The finding showed that two or more resistance training section per
weeks (2-4 sets of 8-10 repetitions) should be included in the total 210 or 125
min of moderate or vigorous exercise respectively21.

16.
METHODOLOGY

Methodology indicates the general patterns for organizing the procedure

to gather valid and reliable data for investigations. This chapter deals with the

methodology and procedure adopted by the researcher for the conduction of the
study. It presents in detail about the research approach, research design, the
settling, population, sample and sampling technique, instrument used for data
collection, data collection procedure and plan for data analysis.

RESEARCH APPROACH:-

The research approach indicates the procedure for conducting the study.
It guides the researcher what to research, whom to analyse and interpret the
results in view of the nature of the problem selected for the study and the
objectives to be accomplished a descriptive research approach was considered
as appropriate for the study.

RESEARCH DESIGN:-

Research design refers to the researchers over the plan for obtaining
answers to the research questions and it spells out the strategies that the
researcher adopt to develop information that is accurate, and interpretable. The
present study assess the knowledge on management of Diabetes Mellitus
among diabetic patients. Research design selected for the study was descriptive
design.

Variables under study :-

A variable is a characteristic or quality that various from one person or object

to another. A variable is anything that can change or anything that is liable to
vary.

17.

DEMOGRAPHIC VARIABLES :

Demographic

variables

under

the

study

are

age,

sex,

religion,

educational status, occupational status, income, type of family, marital status

and family history of Diabetes Mellitus.

SETTING OF THE STUDY :-

The setting is the location where the study is conducted. The current study was
conducted in Apoorva Hospital Faridabad.

POPULATION :A population is a group whose members possess specific attribution that a

researcher

is interested in studying. The target population of this study is

patients with Diabetes Mellitus.

Accessible population of this study is patients with Diabetes Mellitus in

Apoorva Hospital Faridabad.

SAMPLE : -

Sample refers to submit of a population that is selected to participate in a

particular study. It is a subset of the population which represents the entire
population. The sample size chosen for this study is 40 patients with Diabetes
mellitus in Apoorva Hospital Faridabad.

SAMPLING TECHNIQUE:-

Sampling defined as the process of selecting a group of people or the elements

for the conduction of the study.
Purposive sampling technique was used to select the samples.

19.
SAMPLING CRITERIA :-

1. Inclusive criteria :
1. The patients who are diagnosed as either type I or type II Diabetes
2.
3.
4.
5.
6.

Mellitus
Patient age group between 35-55 years
Those who are willing to participate in the study.
Patients who are available at the period of study
Patients who can read and write English & Hindi
Patients of both gender.

2. Exclusive Criteria :1. The patients who are having complications

2. Patients who received information on management of Diabetes
Mellitus.
DEVELOPMENT OF INSTRUMENT:

Structural knowledge questionnaire was selected on the basis of the

objectives of the study, as it was considered to be the most appropriate
instrument to elicit responses from the subjects.
The instrument is a vehicle that could best obtain data pertinent to the
study and at the same time add to the body of general knowledge in the
discipline.

The tool was developed based on review of literature, opinion on

the subject experts and in discussion with the guide and personal experience
in clinical setting.

20.
DESCRIPTION OF THE INSTRUMENTS:The tool is divided into section I and II

Section I : demographic data :

Socio demographic data contain 10 items on age, sex, religion, type of family,
marital status, educational status, occupational status, income, family history
of Diabetes Mellitus and source of information on knowledge regarding
management of Diabetes Mellitus.

Section II :-

This section consisted of 35 items regarding management of Diabetes

Mellitus. The items were developed as to cover the following groups.

General questions related to management of Diabetes Mellitus.

Diet
Medication
Exercise
Foot care
Complication

For each questionnaire four opinion were given and only one correct answer, for
each correct answer, the score was 1. If answer was wrong the score was given
as o. the highest score was 35.

>27 Score (>75% is adequate knowledge)

18-26 Score (50-75% is adequate knowledge)
>17 Score (>50% is adequate knowledge)

21.

TESTING OF THE TOOL

Content Validity

Validity refers to the degree to which an instrument measures what is

supposed

to measure content validity of the tool and give their valuable

suggestions. The suggestions of experts were incorporated in the tool and

information Booklet was further modified and finalized with experts opinion
with consolation of guide after content validation, tools were given language
expert to translate them to Hindi Language.

RELIABILITY OF THE TOOL:

Reliability is the degree of consistency that the instrument of the procedure

demonstrated whatever is measuring, it does so consistently.

The tool was administered to 5 patient with Diabetes Mellitus after

getting formal permission from the hospital in order to establish reliability.

PILOT STUDY :

Pilot study is the trail run of the methodology planned for the major project,
the purpose of the study is two fold, to make improvement in the research
projects and to detect problems that must be solved before the major study is
attempted.

22.
The purpose of pilot study was as follows:-

Find out feasibility of conducting the final study.

Determine the methods of statistical analysis.

A pilot study was conducted on 10 sample in the month of May 2011 at

Vardaan Hospital

Faridabad. they were selected for the pilot study by

purposive sampling technique. Subject for they were selected for the pilot study
by purposive sampling technique. Subject for the pilot study possessed the
same characteristics as that of samples for main study. After the data
collection, the data were analyzed and it was found feasible to conduct main
study.

DATA COLLECTION PROCEDURE:-

A formal permission from medical superintendent from hospital was obtained

prior to the starting of the study, the study

was conducted in Vardaan

hospital, Medical Surgical department. The data collection was done in month
of March 2013 and data collected from 35 patients with diabetes mellitus. The
objective and nature of the study was explained to the patients. Confidentiality
was assured to all the patients to get their co-operation through the process of
data collection. A questionnaire was administered which is compressed of two
sections. Demographic variables and standardized tool for assessing the
knowledge regarding management of Diabetes mellitus among diabetic patients.

PLAN FOR DATA ANALYSIS :-

Analysis is the systematic organization and synthesis of research data and

testing of research hypothesis using these data. The data obtained was
analyzed in terms of the objectives of the study by using descriptive and
inferential statistics, the master data sheet was prepared with response given
by subjects. The plan for data analysis was follows:
23.

SECTION I : DESCRIPTION OF BASE LINE VARIABLES.

Section II : Description of Knowledge scores of sample by using frequency,

percentage mean and standard Deviation (SD).

Section III : Association between knowledge score and selected base line
variables.

CONCLUSION :-

This chapter gives a brief description of the methodology adopted for the study
which includes the research approach, design, setting, population, sample
sampling

technique, development and description of tool pilot study, data

collection, procedure and plan for data analysis.

24.

DATA ANALYSIS
Statistical Analysis is a method of rendering quantities information
meaning and intelligently statistical procedure enable the researcher to reduce
summarize, evaluate, interpret and communicate numeric information.

This chapter deals analysis and interpretation of data collected from 40

peoples regarding management of Diabetes Mellitus. Keeping in view the
objective of descriptive study which was adopted to assess the knowledge
regarding management of Diabetes Mellitus among diabetic patients admitted
is selected hospital Faridabad.

The data was collected from the respondents before giving information
booklet. The collected information was organized, tabulated, analyzed and
interpreted using descriptive and inferential statistics. Analysis was

done

based on the objectives and assumptions of the study.

OBJECTIVE OF THE STUDY :-

1. To asses the existing knowledge level of diabetic patient on management

of Diabetes Mellitus.

2. To find an association between the knowledge score with selected

demographic variables.
3. To develop an information Booklet on management of Diabetes Mellitus.

25.
PRESENTATION OF THE DATA:-

To begin with the data were entering in master data sheet tabulation

and

stoical processing. The data are analyzing and interpreting using descriptive
and inferential statistics. The data were presented on following headings.

Section I : Description of baseline variables.

Section II : Description of knowledge score of sample by using frequency,

percentage mean and standard deviation (SD)

Section III : Association between knowledge score and selected baseline

variables.

ANALYSIS OF THE DEMOGRAPHICAL VARIABLES:-

Analysis of the demographic characteristic of the respondents such as age, sex,

religion, Type of family, marital status, educational status, occupational status,
monthly income, family history of Diabetes Mellitus and source of information.

The selection deals with description of socio demographic variables or

samples characteristics 40 samples from selected hospital based on the sample
criteria. The data on the sample characteristics were analyzing using
descriptive statistics and presented in terms of frequency percentage depicted
with diagram.

26.

SECTION A DEMOGRAPHIC TABLE

Sl No

Characteristic

Category

s
Age

30-40 years

10

25

41 50 years

13

32.5

51-60 years

12

30

Sex

61 & above
Male

5
28

12.5
70

Religion

Female
Hindu

12
23

30
57.5

Muslim

12

30

Christian

12.5

Others
Nuclear

0
18

0
45

Joint

20

Extent
Married

2
26

5
65

Unmarried

20

Widow/Widower

10

Educational

Divorce/Separated
Primary

2
10

5
25

Status

Secondary

12

30

High School

14

25

P.U.C

Graduate & above

2
3.

4.

5.

6.

Type of family

Marital Status

7.

8.

Occupation

House wife

10

25

Private employee

14

35

Self employee

13

32.5

Retired

7.5

Monthly Income

27.
Rs.1000

12.5

of the family

Rs.1000 2000

10

25

Rs.2001-3000

10

25

15
21

37.5
52.5

Family history

Rs.>3000
Yes

10

of D.M
Source if

No.
Electronic media

19
6

47.5
40

information

Printed media

10

Health professional

10

25

Family members /

10

25

relatives / friends

28.

DESCRIPTION OF SAMPLES ACCORDING TO THE AGE GROUP

Table I (a)

Sl No
1
2
3
4

Age Group
30-40 years
41 50 years
53-60 years
61 & above
Total

N=40

F
10
13
12
5
40

%
25
3.2.5
30
12.5
100

Table 1 (1) indicates the majority of subject belongs to 41-51 years that is
about 32.5% of subject in this study

29.

30.

DESCRIPTION OF SIMPLE ACCORDING TO SEX

Table 1 (b)

Sl No
1
2

Religion
Male
Female
Total

N=40

Frequency
28
12
40

Percentage
70
30
100

Table 1 (b) indicates distribution of subject according to sex. In the total

samples about 70% are male and 30% are female.

31.

32.

DESCRIPTION OF SIMPLE ACCORDING TO RELIGION

Table 1 I

Sl No
1
2
3
4

N=40

Religion
Hindu
Muslim
Christian
Others
Total

Frequency
23
12
5
0
40

Percentage
57.5
30
12.5
0
100

Table 1 I indicates distribution of subject according to religion. In this

study 57.5% of the subject are Hindu, 30% belongs to Muslim and 12.5%
of belongs of Christian

33.

34.

DESCRIPTION OF SIMPLE ACCORDING TO FAMILY

Table 1 (d)

Sl No
1
2
3

Religion
Nuclear
Joint
Extend
Total

N=40

Frequency
18
20
2
40

Percentage
45
50
5
100

Table 1 (d) indicates distribution of subject according of family. In this

study sample , 30% belongs to Muslim and 12.5% of belongs of Christian

35.

36.

DESCRIPTION OF SIMPLE ACCORDING TO MARITAL STATUS

Table 1 (e)

Sl No
1
2
3
4

Type of family
Married
Unmarried
Widow/Widower
Divorce/Separated
Total

N=40

Frequency
26
2
8
4
40

Percentage
65%
5%
20%
10%
100

Table 1(e) indicates distribution of subject according of Marital Status. In the

total subjects 65% are married 20% are unmarried. 10% are widow/widower
and 5% are divorce / separated.

37.

38.

DESCRIPTION OF SIMPLE ACCORDING TO EDUCATIONAL

STATUS

Table I (f)

N=40

Sl No

Educational

Frequency

Percentage

1
2
3
4
5

Status
Primary
Secondary
High School
PUC
Graduate & above
Total

10
12
14
2
2
40

25
30
35
5
5
100

Table 1 (f) indicates the distribution of subject according to educational

Status. In this sample about 25% are primary, 30% secondary, 35% are
high school, 5% are PUC and 5% are graduate and above.

39.

40.

DESCRIPTION OF SIMPLE ACCORDING TO OCCUPATION

STATUS

Table I (g)

N=40

Sl No

Educational

Frequency

Percentage

1
2
3
4

Status
House wife
Primary Employee
Self Employee
Retired
Total

10
14
13
3
40

2.5
42.5
32.5
7.5
100

Table 1 (g) indicates the distribution of subject according to occupation.

Above 25% of samples are house wives 42.5%, sample are private
employee, 32.5% are self employee and 7.5 are retired.

41.

42.

FIG No. 10 Column diagram representing distribution of

samples according to monthly income of the family.

44.

DISTRIBUTION OF SAMPLE ACCORDING TO FAMILY HISTORY OF

DIABETETS MELLITUS

Table I (i)

Sl.
No.

Family History of Diabetes

Frequency

Percentage (%)

Mellitus

Yes

21

52.5

No

19

47.5

Total

40

100

Table 1(i) indicates distribution of sample according to family history of

Diabetes Mellitus. About 52.5% or samples have family history of Diabetes
Mellitus. And 47.5% do have family history of Diabetes Mellitus.

FIG NO. 11 Column diagram representing distribution of subjects according to family

history of Diabetes Mellitus.

45.

46.

DISTRIBUTION OF SAMPLE ACCORDING TO SOURCE OF

INFORMATION REGARDING DIABETES MELLIITUS

Table I (j)

Sl.

Source of information

Frequency

Percentage(%)

16

40

10

10

25

relatives/

10

25

Total :

40

100

No.
1

Electronics media

Printed media

Health professional

Family

members

friends

Table 1(j) indicates distribution of sample according to source of

information regarding Diabetes Mellitus. About 40% samples got
information from electronic media 10% from printed media 25% from
health members relates/friends.

FIG No. 12 Cone diagram representing distribution of subjects according to the

source of information.

47.

48.

SECTION II
FREQUENCY AND PERCENTAGE DISTRIBUTION OF
RESPONDENTS ACCORDING TO PRE TEST KNOWLEDGE
LEVEL OF MANAGEMENT OF DIABETES MELLITUS
Respondents
Knowledge level

Category

Number

Percentage(%)

Adequate

>75%

51-75%

22.9

<50%

29

72.5

Total

40

100

Knowledge

Moderate
Knowledge

Inadequate
Knowledge

CONCLUSION
The above table shows the majority of respondents (72.5%) had
inadequate knowledge, 9 respondents (22.5%) had moderate knowledge,
and 2 respondents (5%) had adequate knowledge in pre test knowledge
level on management of Diabetes Mellitus.

FIG NO. 13 Column diagram representing frequency and percentage distribution

of respondents according to pretest knowledge on management diabetes
mellitus.
49.

50.

SECTION-III
Classification o respondents on diet, medication exercise and
complications.

N-40

Respondents knowledge(%)
S.No.

Knowledge

Statements

Mean

Mean %

S.D.

Aspects
1

Diet

2.52

36

15.57

Medication

10

2.48

24.8

15.26

Exercise

0.75

18.75

4.62

Foot care

10

2.48

24.8

15.26

Complication

0.75

18.75

4.62

51.

SECTION IV
DATA ON ASSOCIATION OF KNOWLEDGE ON MANAGEMENT OF DIABETES MELLITUS
AMONG DIABETIC PATIENTS WITH THEIR SELECTED DEMOGRAPHIC VARIABLES

SL
.
N
O

DEMOGRAPH
IC
VARIABLES

RESPONDENTS KNOWLEDGE

CATEGO
RY

INADEWQUA
TE
n
%
1

Age

Sex

Religion

Type of family

ADEQUAT
E
n
%

50

40

10

10

41-50
years

69.23

23.08

7.69

13

51-60
years

10

83.33

16.67

12

100

22

78.57

17.86

3.57

28

Female

58.33

33.33

8.34

12

Hindu

18

78.26

17.39

4.35

23

Muslim

66.67

25

8.33

12

Christian

60

40

Others

Nuclear

11

61.11

33.33

5.56

12

Joint

17

85

10

&

Male

D
f

P
V
A
L
U
E

5.33
NS

0.
0
5

0.
0
5

0.
0
5

TOTA
L

30-40
years

61
above
2

MODERAT
E
n
%

X2
VALU
E

1.75
NS

2.05
NS

Extended

50

50

3.95
NS

0.
0
5

52.
VARIABLES

Marital
status

Educational
status

Occupation

Monthly
income of
the family

Family
history of
Diabetic
Mellitus
Source of
information

10

Married
Unmarried
Widow/
Widower
Divorce /
Separated
Primary
Secondary
High school
PUC
Graduate &
above
House wife
Private
employee
Self
employee
Retired

19
1
6

73.08
50
75

5
1
2

19.23
50
25

2
0
0

7.69
0
0

26
2
8

75

25

10
10
9
0
0

100
83.33
64.29
0
0

0
2
5
1
1

0
16.67
35.71
50
50

0
0
0
1
1

0
0
0
50
50

10
12
14
2

10
9

100
65.29

0
4

0
28.57

0
1

0
7.14

10
14

10

76.92

15.38

7.7

13

100

<1000
1001-2000
2001-3000
>3000
Yes
No

5
9
8
7
11
18

100
90
80
46.67
68.75
94.74

0
1
2
6
5
1

0
10
20
40
31.25
5.26

0
0
0
0
0
0

0
0
0
13.33
0
0

5
10
10
15
21
19

Electronic
media
Printed
media
Health
profession

11

68.75

31.25

16

32

50

25

25

70

20

10

10

2.65
NS

0.05

27.12*

0.05

15.12*

0.05

12.26
NS

0.05

9.05*

0.05

8.09
NS

0.05

Family
Professional

90

53.

10

10

NS = Not significant at 0.05 level of significance

* = Significant

Table 13, depicts the association between demographic variables and knowledge of Diabetic
patients. The results shows educational status, occupation, family history of Diabetes Mellitus
were found to be significant at 0.05 level. Other demographic variables such as age, sex, religion,
type of family, marital status, monthly income of the family, source of information were found to
be non significant at 0.05 level.

54.

DISCUSSION
The primary aim of the study is to assess the knowledge regarding management of
Diabetes Mellitus among diabetic patients in Apoorva hospital at Faridabad with a view
to develop information booklet (on management of Diabetes Millitus). The study was also

focused to determine the association between the knowledge on management of Diabetes

Mellitus with their demographic variables.

A self administered knowledge questionnaire on management of Diabetes Mellitus on

knowledge level was selected for the study on the basis of the objectives. The research
design adopted for this study was descriptive study design. Purposive sampling
technique was used to select 40 samples. The obtained data were entered into the
master sheet for tabulation and statistical processing. The finding of the study are
discussed in terms or objectives. The analysis of data was organized and presented the
following aspects.

1. FINDINGS RELATED TO BASELINE VARIABLES OF DIABETIC

PATIENTS

Majority of the Respondents (32.5%) were between 41-50 years of age group.

Majority of Respondents (70%) were male.

Majority of Respondents (57.5%) were belongs to Hindu religion.

Majority of Respondents (50%) were belongs to joint family.

Majority of Respondents (65%) were married.

35% of Respondents were educated upto high school.

Majority of Respondents (35%) are private employee.

Majority of Respondents (52.5%) has the history o Diabetes Mellitus.

Majority of Respondents (40%) were received information from electronic media.

55.

2. KNOWLEDGE AMONG DIABETIC PATIENTS RAGARDING MANAGEMENT OF

DIABETES MELLITUS
The first objective of the study was to assess the existing knowledge level of diabetic
patients. The finding revealed that the overall mean score of knowledge was 13.25.
Among the sample 29(72.5%) had inadequate knowledge. 9(22.5%) has moderately
adequate knowledge and 2(5%) had inadequate knowledge. The highest mean percentage
of knowledge score was in the area of basic concept of foot care (46.2%). The least mean
percentage knowledge score was in the area of complication (7.3%).
The knowledge score for diet was 36%, 24.8% was for medication and 18.75% was for
exercise. This findings shows that peoples are having more knowledge in foot care and
very less knowledge in complication.

A study was conducted on knowledge of Diabetes, its treatment and complication among
diabetic patients. A cross sectional survey using structured questionnaire, the number
of sample is 101. The result shows that 90 patients had Type II Diabetes and 11 had
Type 1 Diabetes of the 101 patients. 51 thought the Diabetes to be incurable, 50
patients did not know the risk factors involved in the development of Diabetes. The study
confirms that patient knowledge about the treatment and complication o preventive
aspects. There is a definite need to empower patients with the knowledge required to
help the obtain maximum benefit from their treatment for Diabetes. 22

3. ASSOCIATION

BETWEEN

DEMOGRAPHIC

VARIABLES

AND

KNOWLEDGE OF DIABETIC PATIENTS

Demographic variable such as age, sex, religion, type of family, marital status,
monthly income of the family, source of information were found to be non significant at
0.05 level. Hence the research hypothesis, H1 There will be a significant association

between knowledge level and demographic variables is found to be non significant. So

H1 is rejected.
56.
Demographic variables such as occupation, family history of Diabetes Mellitus,
educational status were found to be significant at 0.05 level. Hence the research
hypothesis, H1 There will be a significant association between knowledge scores and
demographic variables is found to be significant. So H1 is accepted.

A study was conducted on disease knowledge among Diabetes Mellitus patients

attending primary care. Cross sectional study was used to assess the knowledge. The
objective of the study was to assess knowledge among a patient population. Structured
knowledge questionnaire was applied to 50 samples with Diabetes Mellitus. There was
no association between appropriate metabolic control among patients and disease
knowledge. Demographic characteristics such as occupation, age, and education are
associated with changes in degree of knowledge.23

57.

CONCLUSION
The study was conducted to assess the knowledge level on management of Diabetes
Mellitus among diabetic patients, those who are admitted in selected hospitals at
Faridabad. In the present study 40 diabetic patients are respondents were selected by
using convenience sampling method procedure.
The research approach adapted to the present study is a descriptive design with a
view to assess the knowledge level on management of Diabetes Mellitus among diabetic
patients. The data were collected by using self administered questionnaire. The data was
interpreted by suitable statistical methods.
The present study assessed the level of knowledge among diabetic patients those
who are admitted in selected hospitals and it was found that 75.5% of diabetic patients
were having inadequate knowledge, 22.5% of diabetic patients were having moderate
knowledge level 5% of diabetic patients were having adequate knowledge.

NURSING IMPLICATIONS
The findings of the study have implications on the field of nursing practice, nursing
education, nursing research and nursing administration.

NURUSING PRACTICE :

Several implications can be drawn from the present study for nursing practice.

1. Education programmes conducted by the nursing personnels in the hospital helps

in creating positive attitude towards management of Diabetes Mellitus.

2. The nurse plays an important role in health promotion and managing Diabetes
Mellitus.
58.
3. Education programmes with effective teaching strategies with informational
booklets motivate people to follow healthy practice in day to day life, involving
changes in life style.

4. Every nurse should make use of this result to update the knowledge to help the
diabetic patients those who are admitted in the hospital to increase there
knowledge on management of Diabetic Mellitus by means of health education.

NURUSING EDUCATION :

1. The nursing curriculum should consist of knowledge related to health information

by using different methods of teaching.

2. Nursing students should be made aware of their role in health promotion and
disease prevention in the present and future years, which may help in achieving
the goal of health for all.

3. Nurse at post graduate level have to develop there skill in assessing the patients
knowledge on management of Diabetes Mellitus and preparing health teaching
material according to the needs of diabetic patients.

NURSING RESEARCH :

1. Various methods may be used to strengthen the knowledge of the people by the
investigator which should be publishing for the benefits of diabetic patients those
who are admitted in the selected hospital.
59.
2. There is a need of extensive and intensive research in this area, so that strategies
for educating nurse in managing Diabetes Mellitus can be develop.

3. She should also encourage and depute nurses to participate in such programmes
conducted by any other voluntary organization.

4. Necessary administrative support should be provided to conduct health education

in any setting. The knowledge of the nurses may be updated through inservice
education an refresher courses regarding different methods of management of
Diabetes Mellitus. A Hospital policy should be adopted to provide health education
or written information on management on Diabetes Mellitus.

60.
SUMMARY

SUMMARY OF THE STUDY :

The primary aim of the study was to assess the knowledge on management of
Diabetes Mellitus among diabetic patients in selected hospitals at Faridabad.

OBJECTIVES :

1)

To assess the existing knowledge level of diabetic patients on management of

Diabetes Mellitus.

2)

To find an association between the knowledge score with selected demographic

variables.

3)

To develop an information Booklet on management of Diabetes Mellitus.

Hypothesis :

H1 : There will be a significant association between scores and selected demographic

variables.

The students selected conceptual frame work for the study was based on modified
Penders health promotion model 2002.

In this study, the review of literature is presented under following heading

Studies related to Diabetes Mellitus.

Studies related to knowledge of diabetic patients regarding management of

Diabetes Mellitus.
61.

Review of literature helped the students to develop the conceptual frame work, criteria
for assessing knowledge on management of Diabetes Mellitus among diabetic patients.
The study design consisted of a descriptive approach with the descriptive survey design.
The study population is 35-65 years of adults from selected hospitals in Faridabad.
Purposive sampling method was adopted. The study consisted of 40 samples.

The tool developed and used for data collection was structured knowledge questioners on
10 items related to demographic variables of adult and selection to consist of 35 items
related to management of Diabetes Mellitus diabetic patient in selected hospitals at
Faridabad.

Content validity of tool was established by 5 experts. The main study was conducted in
the month of May in selected hospitals at Faridabad. Structured knowledge questioner
schedule of demographic variables and knowledge on management of Diabetes Mellitus
in 35-65 years of adult were assessed.

The data gathered were analysed and interpreted according to the objectives. Descriptive
statistics were used. Mean median and standard deviation with graphical presentation of
data. Inferential statistics was used to test hypothesis at 0.05 level significance. Chisquare test was applied for finding association of knowledge on management of Diabetes
Mellitus with selected demographic variables respectively.

The result shows that 29 (72.5%) were having inadequate knowledge, 9(22.5%) were
having moderate knowledge and 2 (5%) were having adequate knowledge.

The finding of the present study regarding the aspects of diet the mean score was
2.52(36%), in medication the mean score was 2.48(24.8%), in exercise the mean score
was 0.75 (18.75%), in foot care the mean score was 2.48 (24.8%), in complication the
mean score was 0.75(18.75%).
62.
Association between demographic variables like occupation, education, family history of
Diabetes Mellitus is found to be significant. And there exist a non-significant association

with other selected demographic variables such as age, religion, type of family, marital
status, monthly income, source of information.

Thus the student researchers found it satisfactory is assessing, knowledge on

management of Diabetes Mellitus among diabetic patients in selected hospitals with the
help of structured knowledge questioner method. Further recommendation has been
stated expecting for an improved study with wider generalization.

63.
BIBLIOGRAPHY

1)

Eshwaramurthy Chockalingam, Bitter facts of diabetes and blood sugar

history:2006 available from VRL-eshwar@pacific.et s.g.

2)

Lukkmann and souensen of medical surgical nursing, nursing care of client with
endocrine disorders of pancreas.

3)

Burner and Saouddharths Text Book of medical surgical nursing, Assessment

and management of patients with diabetes mellitus.

4)

Spring house mastering medical surgical nursing, Endocrine disorders.

5)

Luckmann, H.Ivery Rs, Tailer P, http//www,cdc.goy/ accdphp/ dddt/ fact.htm

6)

International diabetes federation (2009), diabetes fact and figures, Retrived

april7, 2009 from www.idf.org

7)

Centers for disease control and prevention (2008) national diabetes fact sheets
retrived april 2008 from http//www.cdc.gov.accdphp/ddt/fact.htm

8)

All

India

diabetes

control

association

national

http//www.govt/ind/diabetes/min.nib.pubmed

diabetic

fact

sheets.

9)

Edwin, Padin, Richard P, life science division http://www.ncbi.nib/ gov.pubmed1760815

10)

Long term benefits from lifestyle interventions for diabetes prevention, time to
expand the efforts, fuomilehtal etal diabetes care 2011.34

S10-S14

64.
11)

Ramachandra. A. Snehalatha, high prevalence of diabetes and impaired glucose

tolerance India diabetologia 2009-44-1101

12)

Diabetic risk factor, diabetes and diabetes care. Health.2008.pudmed, Simens D,

dsworkster @ gmail.com

13)

Nile, wizhaoy, life sciences division, glycemic control in diabetic patients,

http://www.ncvi.nib,gov/pubmed/21605212

14)

Lavery L.A, Higgins K.R., Department of surgery Lavery@swmail.org. Preventing

diabetic foot ulcer recurrence in high(Diabetes care 2009)

15)

Wusf, Jian YM, Cheng.K.C., A slf management intervention to improve quality (J

chin nurse,2011)-pub med result.

16)

R.K. Hibbab, J, K, Roshd, Belifs and practice among diabetic patients,

hitahab@gmal.com

17)

Belvine Perry, Florida, Judge in the sacey Anothony trial reprimanding law

18)

HUG, lakka, TA,K pipelainen to, Tuoilento J Diabetes unit department of health
promotion and chronic disease prevention, national public health institutes
mannerherimintie-166, FIN-0030, Heisinki-Finland

19)

Mmay field JA, Reiber, GE, Saandar LJ

Janisse-D, Pogach-LM, Preventive footcare in people with biabetes care

20)

King H, Global burden of diabetes 1995-2025 prevalence numerical estimates

and projections diabetes care 21-1414-1431, 2008.

65.
21)

Hordern, MD, Dunstan D.W. prim JB center of cliniucal research excellence in

metabolic and cardio vascular disease.

22)

Bruce D.G., Davis W.A., Diabetes education and knowledge in patients with
Diabetes. The Fremantale Diabetes study J. Diabetes comp 2007: 17:82-9

23)

Anana. Solis ESP, maritnez vazqwz Department de medicina familiar maxico

albemar @ correo . unqm. Mx

66.

ANNEXURE I
CERTIFICATE OF CONTENT VALIDITY

This is to certify that the tool developed by Miss. Arti Memoria, Miss. Tenzin Saldon,
Miss. Tiljy.K.K, Miss. Shakarani, Miss. Usharani, Miss. Susheela Devi, Miss. Meenakshi,
Miss. Renu, Mr. Vinaya Chandran final year PCBSB Nursing student of Florence College
of Nursing Faridabad is validated by undersigned and can proceed with this tool and
conduct the main study for dissertation entitled a descriptive study to assess the

knowledge on management of Diabetes Mellitus among diabetic patients admitted

in selected hospital in Faridabad with a view to develop an information Booklet.

Date:
Place :
Signature of the experts

Name and designation

67.

ANNEXURE II

LIST OF CONTENT VALIDATORS OF THE TOOL

Mr. SUJITH ARAVINDAKSHAN

Principal of Florence college of Nursing
Faridabad

Miss. SONIYA JOHN

Vice-Principal
Florence college of Nursing
Faridabad

Dr. RAMESH CHANDER

Deputy Civil Surgeon
B.K. Hospital
Faridabad

68.

Annexure III

Self Administered Knowledge Qustionair on Management of

Diabetes Mellitus
Section A

Demographic Profile

Introduction :-

Dear participant, every question has alternative response. Select the

correct answers among the option and place a tick () mark in the
appropriate box provided will be kept in confidential.

1. Age in years.
a) 30-40
b) 41-50
c) 51-60

d) 61 & above
2. Gender
a) Male
b) Female

69.

3. Religion
a) Hindu
b) Muslim
c) Christian
d) Others
4. Type of family
a) Nuclear
b) Joint
c) Extended
5. Marital Status
a) Married
b) Unmarried
c) Widow/Widower
d) Divorce/Separate
6. Educational status
a) Primary
b) Secondary
c) High School
d) PUC
e) Graduate and above

7. Occupational Status
a) Housewife

70.

b)
c)
d)
e)

Private Employee
Self employee
Retired
Agriculture

8. Monthly income of the Family _____________Rs.

9. Family history of Diabetes mellitus, Yes/No
If yes specify the types.
a) Insulin dependent Diabetes Mellitus/Type 1
b) Non insulin dependent diabetes Mellitus / Type II
10.

Duration of illness ____________________ years _______ month.

11.

Source information on knowledge regarding management of

Diabetes Mellitus.
a) Electronic media (T.V. Radio, Internet)
b) Printed Media (News Paper, Magazine, Book)
c) Health professional (Doctor, Nurse)
d) Family Members/ relatives/ friends.

71.

Section B
Introduction:-

 Dear participant, every question has 3 alternative response, select

the correct answer among the options
Management of Diabetes Mellitus
Diet
1. Recommended diet for Diabetes Mellitus are
a) Fat rich diet
b) Carbohydrate rich diet
c) Low carbohydrate diet
[
2. Artificial sweetness helps to
a) Increase blood glucose
b) Reduce blood glucose level
c) Increase insulin level
3. Bitter guard will help to
a) Reduce blood glucose level
b) Increase blood glucose level
c) Decrease insulin level
4. Diabetic patient should avoid
a) Banana
b) Lemon
c) AmIa

[
[
]

]
]

[
[
[

]
]
]

[
[
[

]
]
]

[
[
[

]
]
]

72.

5. The diabetic patient should avoid vegetable like

a) Cabbage, drumstick
[
b) Cauliflower, cucumber
[
c) Carrot, beet root
[
6. Tube are rich in
a) Protein
[
b) Carbohydrates
[
c) Fat
[
7. Diabetes Mellitus patients should eat

]
]
]
]
]
]

a) Full meals per day

b) Small and frequent meals per day
c) 2 small meal per day

[
[
[

]
]
]

[
[
[

]
]
]

[
[
[

]
]
]

[
[
[

]
]
]

[
[
[

]
]
]

[
[
[

]
]
]

[
[

]
]

Medication
8. Oral hypoglycemic agents are effective in
a) People with type 2 Diabetes Mellitus
b) People with type 1 Diabetes Mellitus
c) People with gestational Diabetes Mellitus
9. Insulin help to
a) Increase the blood glucose level
b) Maintain blood glucose level
c) Decrease the electrolyte level

73.

10. One of the Diabetes Mellitus oral medication

side effects is
a) Increase blood glucose level
b) Decrease blood glucose level
c) Increase sodium level
11. One of the sites for insulin injection is
a) Thighs
b) Legs
c) Palm
12. The route of administering insulin injection is
a) Subcutaneous
b) Intravenous
c) Intramuscular
13. The insulin must be stored in
a) Hot temperature
b) Cold temperature

c) Room temperature
14. The angle of insertion of insulin syringe in
Obese patient is
a) 90o angle
b) 45o angle
c) 30o angle

[
[
[

]
]
]

74.

15. Before administering insulin injection, the

Diabetic patient should
a) Shake the medicine
[
b) Do not shake the insulin
[
c) Shake and warm the medicine
[
16. The diabetic patient is advised to rotate the
Insulin injection site to
a) Prevent the loss of subcutaneous fat
[
b) Increase the subcutaneous fate
[
c) Reduce the patient comfort
[
17. One of the side effects of insulin injection site is
a) Redness
[
b) Vomiting
[
c) Headache
[

]
]
]

]
]
]
]
]
]

Exercise
18. A diabetic patient should do exercise at least
a) 30-45 minutes/day
b) 1 hour/day
c) 2-3 hours/day

[
[
[

]
]
]

19. A Diabetes Patient should do exercise

a) Once in a week
b) Twice in a day

[
[

]
]

c) Twice in a week

75.

20. One of the best aerobic exercises for Diabetic Patient is

a) Running
[
]
b) Jogging
[
]
c) Brisk walking
[
]
21. Importance of exercise in person with Diabetes Mellitus is
a) Lower blood glucose and triglycerides level
[
]
b) Increase blood glucose and triglycerides level [
]
c) Decrease insulin level
[
]
Foot Care

22. Diabetic Patient should wash their feet with

a) Mild soap with leak warm water
b) Soap with hot water
c) Soap with cold water
23. Diabetic Patient should wear shoes as
a) Loose fitting
b) Tight fitting
c) Correct size
24. Diabetic Patient should not put lotion on
a) Top of the feet
b) Between the toes
c) Bottom of the feet

[
[

[
]
]

[
[
[

]
]
]

[
[
[

]
]
]

[
[

]
]

76.

25. Diabetic Patient should keep their feet

a) Always dry and clear
b) Moist and clean

c) Moist

26. Diabetic Patient should examine their shoes daily for

a) Any colour changes
[
]
b) Size of the shoes
[
]
c) Any irritating objects (nails)
[
]
27. Diabetic Patient should wear
a) White colour socks
[
]
b) Red colour socks
[
]
c) Yellow colour socks
[
]
28. Diabetic patient should cut short the toe nails straight across
with
a) Scissor
b) Blade
c) Nail cutter
29. Diabetic Patient should not walk with
a) Wearing shocks
b) Comfortable shoes
c) Bared foot

[
[
[

]
]
]

[
[
[

]
]
]

77.

30. Diabetic Patient should avoid applying of

a) Heating pads
[
]
b) Warm socks
[
]
c) Extra covering
[
]
31. Diabetic Patient should avoid application of lotion which contains
a) Alcohol
[
]
b) Iodine
[
]
c) Dettol
[
]
Complications

32. Decreased blood sugar can be managed by

a) Immediate intake of spicy food
[
b) Immediate intake of salt
[
c) Immediate intake of sweet
[
33. Diabetes Mellitus patient should cheek their eyes
a) One in a year
[
b) Once in a month
[
c) Twice in a year
[
34. Diabetic foot can be prevented by
a) Use of antibiotics
[
b) Proper foot care and hygiene
[
c) Exercise
[

]
]
]
]
]
]
]
]
]

78.

35. While sitting tangling of legs should be avoided to

a) Promote bid circulation
[
b) Prevent bid circulation
[
c) Promote comfort
[

]
]
]

79.

SECTION-A

: , .
() .

1. .
) 30-40
) 41-50
) 51-60
) 61

2.
)
)
3.
)
)
)
)
80.

4.
)
)
)

5.
)
)
) /
) /

6.
)
)
)
)
)

81.

7.
)
)
)
)
)
8. _____________ .
9. , /
.
) / 1
) /
10. ____________________ _______ .
11. .
) ( , )
) (, , )
) (, )
) / / .

82.

SECTION-B
: -

, , 3

1.
)
)
)
2.
)
)
)
3.
)
)
)

83.

4.
)
)

) AMIA
5.
) ,
) ,
) ,
6.
)
)
)
7.
)
)
) 2

84.

8.
) 2
) 1
)
9.
)
)

)
10.
)
)
)
11.
)
)
)
12.
)
)
) Intramuscular

85.
13.
)
)
)
14.

) 90o
) 45o
) 30o
15. ,

)

)
)
16.

)
)
)

86.
17.
)
)
)

18.
) 30-45 /
) 1 /
) 2-3 /
19.
)
)
)
20.
)
)
)

21.
)
)
87.
)
)
22.
)
)
)
23.
)
)
)
24.
)
)
)
25.
)
)
)

88.
26.

)
)
) ()
27.
)
)
)
28.

)
)
)
29.
)
)
) Bared
30.
)
)
)
89.
31.
)
)
)

32.
)

)
)
33.
)
)
)
34.
)
)
)
35. tangling
)
)
)
90.

Annexure IV
Answer And Scores Key

ITEM NO
1
2
3
4
5
6
7
8
9
10
11

CORRECT RESPONSES
C
A
A
A
C
B
B
A
B
B
A

SCORES
1
1
1
1
1
1
1
1
1
1
1

12
13
14
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35

A
B
A
C
A
A
B
C
A
A
C
B
A
C
A
A
C
A
B
C
A
B
A

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

Total

91.