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Clinical Care/Education
Knowledge, Attitude, and Practice of Iranian Internists Regarding Diabetes: A Cross Sectional Study
Mahtab Niroomand, Seyedeh Najmeh Ghasemi, Hamidreza Karimi-Sari, Mohammad Hossein Khosravi
Diabetes Metab J. 2017;41(3):179-186.   Published online June 2, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.3.179
  • 3,602 View
  • 46 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDFPubReader   
Background

A number of studies investigated the general practitioners' and family physicians' knowledge, attitude, and practice (KAP) on diabetes. However, studies on internists' KAP on diabetes management are limited. This study aimed to investigate the Iranian internists' KAP on diabetes mellitus and its management.

Methods

A cross-sectional study was conducted on a random sample of internists who participated in the 26th annual congress of internists in Tehran, Iran. The level of KAP and affecting factor was evaluated by a validated instrument.

Results

One-hundred internists with the mean age of 41.98±9.26 years were evaluated. Totally, the physicians possessed 66.29%±19.5%, 50.44%±19.39%, and 64.5%±15.3% of the scores in KAP, respectively. The time since graduation in general medicine had significant negative correlation with their knowledge and practice, that was along with the subjects' age (P<0.05). The KAP level had not significant difference between subjects participated in a continuing medical education (CME) program during the last year compared to subjects did not participated (P>0.05). Attitude, and practice scores were significantly higher in physicians who were working at diabetes clinic (P<0.05), and attitude was more in physicians working at teaching hospitals compared to those who were not working (57.82 vs. 47.72, P=0.020).

Conclusion

According to our results, subjects' age and time since graduation in general medicine and specialty were inversely correlated by knowledge and practice. So internists with older age seems to be in priority for educational programs. And holding CME programs in current forms seems to be not suitable to increase the KAP regarding diabetes.

Citations

Citations to this article as recorded by  
  • Primary care providers' knowledge, attitudes, and practices related to prediabetes in China: A cross-sectional study
    Linhua Pi, Jianru Yan, Dongxue Fei, Ying Zheng, Xiajie Shi, Zhen Wang, Zhiguang Zhou
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Knowledge of physicians regarding the management of Type two Diabetes in a primary care setting: the impact of online continuous medical education
    Zahra Emami, Azam Kouhkan, Alireza Khajavi, Mohammad E. Khamseh
    BMC Medical Education.2020;[Epub]     CrossRef
Comparison of Attitudes Regarding Quality of Life between Insulin-Treated Subjects with Diabetes Mellitus and Healthy Populations
Fariba Hashemi Hefz Abad, Maryam Shabany Hamedan
Diabetes Metab J. 2011;35(4):397-403.   Published online August 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.4.397
  • 53,185 View
  • 33 Download
  • 4 Crossref
AbstractAbstract PDFPubReader   
Background

Diabetes mellitus is a chronic disease and one of the main causes of mortality in developing countries. The main objective of treating all chronic diseases, of course, is to improve well-being and attain a satisfactory quality of life (QOL). The major goal of this study is comparison of attitude toward QOL in insulin-dependent subjects with diabetes mellitus and healthy subjects.

Methods

In this study, insulin-dependent subjects with diabetes mellitus and healthy subjects were gathered via convenience sampling. The subjects were asked to complete the Hanestad & Albrektsen Attitude to Quality of Life Questionnaire. The questionnaire evaluates five quality of life dimensions-physical, social, mental-emotional, behavioral-activity, and economic-using a scoring system similar to the Likert scale. The Wilcoxon test was used to compare scores between the two groups.

Results

The mean total score on attitude toward QOL in the healthy control group was 53.8, and it in the insulin-dependent subjects with diabetes mellitus group was 35.9. The mean total score of attitude toward QOL in the physical dimension, mental-emotional and feelings of well-being dimension, and behavioral-activity dimension were significantly higher in the healthy population than they were in diabetes mellitus groups. Such a difference was not seen in the social and economic dimensions.

Conclusion

Since the attitudes of insulin-dependent subjects with diabetes mellitus toward QOL are used as an index of individual and societal health levels, it appears that this group may benefit from education and professional counseling to improve their QOLs.

Citations

Citations to this article as recorded by  
  • Health-Related Quality of Life and its Determinants Amongst Women With Diabetes Mellitus: A Cross-Sectional Analysis
    Alireza Didarloo, Mohammad Alizadeh
    Nursing and Midwifery Studies.2016;[Epub]     CrossRef
  • Relationship between self-reported weight change, educational status, and health-related quality of life in patients with diabetes in Luxembourg
    Anastase Tchicaya, Nathalie Lorentz, Stefaan Demarest, Jean Beissel, Daniel R. Wagner
    Health and Quality of Life Outcomes.2015;[Epub]     CrossRef
  • Quality of life in people with diabetes: a systematic review of studies in Iran
    Aliasghar A Kiadaliri, Baharak Najafi, Maryam Mirmalek-Sani
    Journal of Diabetes & Metabolic Disorders.2013;[Epub]     CrossRef
  • Heavy burden of non-communicable diseases at early age and gender disparities in an adult population of Burkina Faso: world health survey
    Malgorzata Miszkurka, Slim Haddad, Étienne V Langlois, Ellen E Freeman, Seni Kouanda, Maria Victoria Zunzunegui
    BMC Public Health.2012;[Epub]     CrossRef
A Study on Resistance in Type 2 Diabetic Patient Against Commencement of Insulin Treatment.
Sun Hwa Hong, Mi Jin Kim, Sung Gab Noh, Dae Won Suh, Suk Jung Youn, Kwan Woo Lee, Ho Chae Lee, Yang Soo Chung, Hong Ryang Chung, Hyuk Sang Kwon, Bong Yun Cha, Ho Young Son, Kun Ho Yoon
Korean Diabetes J. 2008;32(3):269-279.   Published online June 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.3.269
  • 2,361 View
  • 48 Download
  • 8 Crossref
AbstractAbstract PDF
BACKGROUND
To achieve tight glycemic control in the poorly controlled type 2 diabetic patients with oral hypoglycemic agent, it maybe beneficial to initiate insulin treatment at the early stage. Many patients with type 2 diabetes are often reluctant to begin insulin therapy despite poor glycemic control with oral hypoglycemic agents, this little known phenomenon, often termed 'psychological insulin resistance (PIR)'. This study investigates psychological insulin resistance in Korean patients with type 2 diabetes. METHOD: This study examined a total of 76 type 2 diabetic patients with poor glycemic control during period of April to July 2006. Through questionnaire and telephone survey, total 24 questions were asked about various attitudes on insulin therapy including psychological barriers and patients' acceptance of this treatment. Subjects were asked to allocate points in 5-point scale (from 5 points for 'very true' to 1 point for 'very untrue'). RESULTS: The means of psychological rejection, injection-related anxiety and fear of insulin side effects such as hypoglycemia and weight gain were 3.65 +/- 0.92, 3.17 +/- 0.98 and 2.8 +/- 1.02, respectively. Unwillingness was common in insulin therapy, 67% of patient rejected or was unwilling to take insulin. Main reasons of patients most frequently endorsed beginning insulin indicate that disease is worsening, permanence (once you start insulin you can never quit) and sense of personal failure. Furthermore, study indicates that patients' reasons for avoiding insulin therapy were mainly psychological rejection, which extended far beyond a simple injection related anxiety. CONCLUSION: PIR was psychological reluctance rather than injection related anxiety. To overcome these psychological barriers to insulin treatment, it is necessary to address appropriate diabetes education including training and counseling with excellent interactive communications between patients and clinicians.

Citations

Citations to this article as recorded by  
  • Using Motivational Interviewing to Overcome Psychological Insulin Resistance
    Sung-Chul Lim
    The Journal of Korean Diabetes.2023; 24(4): 227.     CrossRef
  • Psychological Insulin Resistance: Key Factors and Intervention
    Yeon Jeong Jang
    The Journal of Korean Diabetes.2021; 22(3): 192.     CrossRef
  • Factors influencing psychological insulin resistance in type 2 diabetes patients
    Ji Hyeon Yu, Hye Young Kim, Sung Reul Kim, Eun Ko, Heung Yong Jin
    International Journal of Nursing Practice.2019;[Epub]     CrossRef
  • Development of a Psychological Insulin Resistance Scale for Korean Patients with Diabetes
    Youngshin Song, Younghee Jeon, Jeonghwa Cho, Bohyun Kim
    Journal of Korean Academy of Nursing.2016; 46(6): 813.     CrossRef
  • Patients' perspectives on taking insulin in diabetes - Perspectives of convergence
    Youngshin Song, Eunkyong Ah
    Journal of Digital Convergence.2016; 14(12): 283.     CrossRef
  • Concept Analysis for Psychological Insulin Resistance in Korean People with Diabetes
    Youngshin Song
    Journal of Korean Academy of Nursing.2016; 46(3): 443.     CrossRef
  • New Insulin Injection Recommendations
    Min Jeong Gu
    The Journal of Korean Diabetes.2016; 17(4): 261.     CrossRef
  • Glucose, Blood Pressure, and Lipid Control in Korean Adults with Diagnosed Diabetes
    Sun-Joo Boo
    Korean Journal of Adult Nursing.2012; 24(4): 406.     CrossRef

Diabetes Metab J : Diabetes & Metabolism Journal