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Sim, Wang, Noh, Lee, and Kwon: Diabetes Education Compliance and Knowledge among Diabetes Patients: Analysis of Patients Who Refuse Diabetes Education at an Academic Medical Center
Original Articles & Case Reports

J Korean Diabetes 2014;15(1):51-56.

Published online: 10 January 2014

DOI: https://doi.org/10.4093/jkd.2014.15.1.51

Diabetes Education Compliance and Knowledge among Diabetes Patients: Analysis of Patients Who Refuse Diabetes Education at an Academic Medical Center

Kang Hee Sim1, Bo Ram Wang2, Jin-Won Noh3, Moon Kyu Lee4, Young Dae Kwon5

1Diabetes Education Unit, Samsung Medical Center, Seoul

2Catholic Institute for Healthcare Management, the Catholic University of Korea, Seoul

3Department of Healthcare Management at Eulji University, Seongnam

4Department of Internal Medicine, Samsung Medical Center, Seoul

5Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, the Catholic University of Korea, Seoul, Korea

Copyright © 2014 Korean Diabetes Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

By determining the reasons why patients with diabetes did not take diabetes educationand by analyzingthe characteristics of these patients, this study aimed to provide baseline data to improvediabetes education participation rates.

Methods

A survey was conducted in 56 patients who had been hospitalized for diabetes treatment and who had refused to take the prescribed diabetes education. The reasons for refusing diabetes education and the level of diabetes knowledge were evaluated. Medical records were also reviewed to determine the subjects’ hemoglobin A1c test results.

Results

The most common reason for rejecting diabetes education was ‘previous experiencewith diabetes education.’ The subjects also refused diabetes educations due to cost and an impression that they already have sufficient diabetes knowledge. The patients who refused the education due to expenses were among the lower income group, and 80 percent of patients who had received diabetes educationin the past declined the education because of their previous experience.

Conclusion

In order to increase the participation rates of diabetes education, it is important that patients recognize the significance of ongoing diabetes education. Furthermore, to eliminate the cost problems, national efforts are required such as promoting National Health Insurance coverage to includediabetes education as well as expanding the patients’ opportunities for receiving qualified diabetes education with systematic and standardized education materials for free. (J Korean Diabetes 2014;15:51–56)

Keywords: Diabetes education, Compliance, Knowledge, Diabetes

References

1. Tahrani AA, Bailey CJ, Del Prato S, Barnett AH. Management of type 2 diabetes: new and future developments in treatment. Lancet. 2011; 378:182–97.
crossref
2. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. The Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) 2008 [Internet]. Cheongwon: Ministry of Health and Welfare;c2012. [cited 2013 Mar 03]. Available from:. https://knhanes.cdc.go.kr.
3. Korean Diabetes Association, Korea Centers for Disease Control and Prevention. Diabetes Fact sheet in Korea 2012. Seoul: Korean Diabetes Association;2012.
4. Park HJ, Kwon SN. The effect of self-monitoring of blood glucose in non-insulin-treated patients with type 2 diabetes. Nurs sci. 2010; 22:32–41.
5. Lee HY, Suh YO. The effect of a diabetes education. J Korean Acad Adult Nurs. 1993; 5:44–55.
6. Lee SL, Kim YL, Lee SJ, Cho YK, Choi YK, Chun CH, Chang YK. Effects of diabetes education on diabetic management in non-insulindependent diabetics mellitus patients. J Korean Diet Assoc. 2004; 10:300–8.
7. Korean Diabetes Association, Health Insurance Review and Assesment Service. Diabetes in Korea 2007. Seoul: SIKR Publishing;2007.
8. Park YS. Medical center diabetes education in Korea. J Korean Diabetes Assoc. 1991; 15:293–9.
9. Sim KH, Hwang MS. Effect of self-monitoring of blood glucose based diabetes self-management education on glycemic control in type 2 diabetes. J Korean Acad Soc Nurs Educ. 2013; 19:127–36.
crossref
10. Kim TK, Kang YE, Kim JM, Hong WJ, Kim KS, Kim HJ, Kim YK, Ku BJ. Effects of diabetic camp in type 2 diabetic patients. Korean J Med. 2012; 83:210–5.
crossref
11. Kim HS. Effects of internet diabetic education on glycosylated hemoglobin and self-care in type 2 diabetic patients over one year. J Korean Acad Fundam Nurs. 2006; 13:376–81.
12. Korean Diabetes Association. Treatment guideline for diabetes. J Korean Diabetes. 2011; 12(suppl 1):40–9.
13. Graziani C, Rosenthal MP, Diamond JJ. Diabetes education program use and patient-perceived barriers to attendance. Fam Med. 1999; 31:358–63.
14. Maine Department of Health and Human Services. Diabetes self-management education barrier study. Augusta: Maine Department of Health and Human Services;2006.
15. Kim JH, Chang SA. Effect of diabetes education program on glycemic control and self management for patients with type 2 diabetes mellitus. Korean Diabetes J. 2009; 33:518–25.
crossref
16. American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care. 2003; 26(Suppl 1):S33–50.
17. Chang H, Kwon YD, Yoon SS. Impact of health insurance type on health care utilization in patients with acute cerebral infarction. J Korean Neurol Assoc. 2011; 29:9–15.
18. Medical Times. Poor education for diabetes patientswarning sign of complication prevention [Internet]. Seoul: Medical Times;c2003. -2012 [cited 2013 Jan 5]. Available from:. http://www.medicaltimes.com/Users3/News/newsView.html?ID=34136&nSection=4&nStart=0&subMenu=news&subNum=4.

Table 1.
General characteristics of subjects
  Variables No. (%) / Mean ± SD
Age, yr   60.1 ± 12.3
Sex Male 22 (39.3)
  Female 34 (60.7)
Education Not a high school graduate 25 (44.6)
  High school graduate 14 (25.0)
  Bachelor's degree or higher 17 (30.4)
Occupation Yes 17 (30.4)
  No 19 (33.9)
  Housewife 20 (35.7)
Marital status Married 51 (91.1)
  Single/divorced/widowed/separated 5 (8.9)
Average monthly household income (unit:10,000 Korean won ＜ 200 29 (51.8)
  200–499 16 (28.6)
  ≥ 500 11 (19.6)
Total   56 (100.0)
Table 2.
Diabetes-related characteristics of subjects
  Variables No. (%) / Mean ± SD
Duration of diseases, yr   14 6 ± 8.7
Family history Yes 29 (51.8)
No 27 (48.2)
Treatment Oral medication 19 (33.9)
Insulin 15 (26.8)
Oral medication + insulin 22 (39.3)
Experience of diabetes educations Yes 42 (75.0)
No 14 (25.0)
Hemoglobin A1c ＜ 6.5% 3 (5.4)
≥ 6.5% 53 (94.6)
Diabetes-related knowledge level Good 7 (12.5)
Fair 13 (23.2)
Poor 36 (64.3)
Total   56 (100.0)
Table 3.
Reasons for rejecting diabetes educations (multiple responses)
  No. (%)
Previous experience of diabetes educations 29 (39.2)
Economic burden 11 (14.9)
Hold enough diabetes-related knowledge 11 (14.9)
Poor health 7 (9.5)
Others 16 (21.5)
Total 74 a (100.0)

a Non-respondent (n = 10) were excluded.

Table 4.
Reasons for rejecting diabetes education according to subjects’ characteristics
    Previous experience of diabetes educations Economic burden Hold enough diabetes-related knowledge Poor health Others
Yes No Yes No Yes No Yes No Yes No
Average monthly ＜ 200 14 (58.3) 10 (41.7) 11 (45.8) 13 (54.2) 5 (20.8) 19 (79.2) 3 (12.5) 21 (87.5) 7 (29.2) 17 (70.8)
household income 200–499 6 (42.9) 8 (57.1) 0 (.0) 14 (100.0) 3 (21.4) 11 (78.6) 4 (28.6) 10 (71.4) 6 (42.9) 8 (57.1)
(unit:10,000 Korean won) ≥ 500 9 (90.0) 1 (10.0) 0 (.0) 10 (100.0) 3 (30.0) 7 (70.0) 0 (.0) 10 (100.0) 3 (30.0) 7 (70.0)
X2 (P value)   5.51 (0.064) 14.27 (0.001) 0.36 (0.835) 3.99 (.136) 0.81 (0.667)
Experience of diabetes Yes 28 (80.0) 7 (20.0) 8 (22.9) 27 (77.1) 8 (22.9) 27 (77.1) 2 (5.7) 33 (94.3) 8 (22.9) 27 (77.1)
educations No 1 (7.7) 12 (92.3) 3 (23.1) 10 (76.9) 3 (23.1) 10 (76.9) 5 (38.5) 8 (61.5) 8 (61.5) 5 (38.5)
X2 (P value)   20.72 (＜ 0.001) 0.00 (1.000) 0.00 (1.000) 8.16 (0.011) 6.38 (0.018)
Diabetes-related Good 5 (83.3) 1 (16.7) 0 (0.0) 6 (100.0) 2 (33.3) 4 (66.7) 0 (0.0) 6 (100.0) 3 (50.0) 3 (50.0)
knowledge level Fair 9 (90.0) 1 (10.0) 3 (30.0) 7 (70.0) 3 (30.3) 7 (70.0) 1 (10.0) 9 (90.0) 3 (30.0) 3 (70.0)
  Poor 15 (46.9) 17 (53.1) 8 (25.0) 24 (75.0) 6 (18.8) 26 (81.3) 6 (18.8) 26 (81.3) 10 (31.3) 22 (68.8)
2 (P value) X   7.43 (0.024) 2.15 (0.342) 0.97 (0.617) 1.64 (0.441) 0.86 (0.650)
Total   29 19 11 37 11 37 7 41 16 32
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