Project – Assessment of Knowledge, Attitude, and Practice (KAP) Regarding Diabetes Management Among Patients in Ikeja Primary Health Care Center

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia resulting from defects in insulin secretion, insulin action, or both (American Diabetes Association [ADA], 2023). Globally, diabetes affects over 537 million adults, and type 2 diabetes mellitus (T2DM) accounts for more than 90% of these cases (International Diabetes Federation [IDF], 2022). The disease is associated with severe complications, including cardiovascular diseases, neuropathy, nephropathy, retinopathy, and increased mortality, which place a significant burden on healthcare systems, especially in low- and middle-income countries (Saeedi et al., 2019).

In Nigeria, the prevalence of diabetes is steadily rising, with estimates indicating that approximately 5.77 million adults live with the disease (IDF, 2022). Urban areas such as Lagos State, which include densely populated communities like Ikeja, face unique challenges in diabetes management due to high population density, lifestyle changes, increased consumption of processed foods, sedentary behavior, and limited adherence to treatment protocols (Uloko et al., 2012).

Effective management of diabetes requires not only clinical interventions but also patient-centered strategies that consider individuals’ knowledge, attitudes, and practices (KAP) regarding the disease. Knowledge refers to awareness about diabetes, its causes, symptoms, complications, and treatment options. Attitude involves beliefs, feelings, and perceptions towards diabetes and its management, while practice encompasses behaviors such as adherence to medication, dietary modifications, physical activity, and regular monitoring of blood glucose (Al-Qazaz et al., 2011).

Several studies have shown that inadequate knowledge and negative attitudes toward diabetes can lead to poor self-management, resulting in uncontrolled blood glucose levels and higher rates of complications (Shrivastava et al., 2013). Conversely, patients with high levels of knowledge, positive attitudes, and consistent self-care practices often achieve better glycemic control and improved quality of life (Zainudin et al., 2016). Despite this, there is limited research in Nigeria that specifically assesses KAP among patients receiving care at primary health centers, where the majority of diabetes management occurs for low- and middle-income populations.

Understanding the KAP of patients in Ikeja Primary Health Care Center is particularly important because primary health care centers serve as the first point of contact for most patients. These centers provide preventive, curative, and educational services, yet gaps in patient knowledge and practices can compromise diabetes control. This study aims to assess patients’ knowledge, attitudes, and practices regarding diabetes management in Ikeja, Lagos State, providing insights for healthcare providers and policymakers to design targeted interventions.

1.2 Statement of the Problem

Diabetes mellitus continues to pose a major health challenge in Nigeria, with an increasing burden of type 2 diabetes among adults in urban areas. Despite the availability of primary health care services, many patients exhibit poor glycemic control due to inadequate knowledge, negative attitudes, and suboptimal self-management practices (Uloko et al., 2012). This situation is exacerbated in densely populated urban centers like Ikeja, where lifestyle factors, cultural beliefs, and limited health literacy contribute to poor diabetes management.

Several studies indicate that patients’ knowledge and attitudes significantly influence their adherence to treatment regimens, lifestyle modifications, and routine check-ups (Shrivastava et al., 2013). However, there is limited empirical data on the KAP of patients receiving care at Ikeja Primary Health Care Center, which makes it difficult to identify gaps and design effective educational and behavioral interventions. Without adequate understanding of patients’ knowledge, attitudes, and practices, healthcare providers cannot fully support patients in managing their diabetes, increasing the risk of complications and healthcare costs.

Therefore, this study seeks to assess the knowledge, attitudes, and practices of patients regarding diabetes management at Ikeja Primary Health Care Center. By evaluating these factors, the study aims to identify gaps and areas for improvement in patient education, healthcare delivery, and self-care practices, ultimately contributing to better diabetes outcomes in urban Nigerian communities.

1.3 Research Objectives

The main objective of this study is to assess the knowledge, attitude, and practice (KAP) regarding diabetes management among patients in Ikeja Primary Health Care Center. The specific objectives are:

1. To evaluate the level of knowledge of patients regarding diabetes, its complications, and management strategies.
2. To examine patients’ attitudes toward diabetes and its management.
3. To assess the self-management practices of patients regarding diabetes.
4. To identify the relationship between patients’ knowledge, attitudes, and practices in diabetes management.

1.4 Research Questions

1. What is the level of knowledge of patients regarding diabetes, its complications, and management strategies at Ikeja Primary Health Care Center?
2. What are the attitudes of patients toward diabetes and its management?
3. What self-management practices do patients adopt in controlling their diabetes?
4. Is there a relationship between patients’ knowledge, attitudes, and practices regarding diabetes management?

1.5 Research Hypothesis

The study will test the following hypothesis at a 0.05 significance level:

H₀: There is no significant relationship between patients’ knowledge, attitudes, and practices regarding diabetes management at Ikeja Primary Health Care Center.

H₁: There is a significant relationship between patients’ knowledge, attitudes, and practices regarding diabetes management at Ikeja Primary Health Care Center.

1.6 Significance of the Study

The study is significant in the following ways:

1. Healthcare Improvement: By identifying gaps in knowledge, attitude, and practice, healthcare providers can develop targeted educational programs and counseling sessions to improve diabetes management.
2. Policy Development: The findings will inform policymakers and health administrators on areas that require intervention in primary health care centers to enhance patient outcomes.
3. Community Awareness: The study will raise awareness about the importance of proper knowledge and positive attitudes in managing diabetes, encouraging better self-care practices.
4. Academic Contribution: The study adds to the literature on diabetes management in Nigeria, particularly in urban primary health care settings, and provides a basis for future research.

1.7 Scope of the Study

This study will focus on adult patients diagnosed with type 2 diabetes mellitus who are receiving care at Ikeja Primary Health Care Center, Lagos State. The study will assess patients’ knowledge, attitudes, and self-management practices, including medication adherence, dietary habits, physical activity, and glucose monitoring. The study will not focus on type 1 diabetes, gestational diabetes, or patients outside Ikeja Primary Health Care Center.

1.8 Definition of Terms

1. Diabetes Mellitus: A chronic condition characterized by elevated blood glucose levels due to defects in insulin secretion or action (ADA, 2023).
2. Type 2 Diabetes Mellitus (T2DM): A form of diabetes usually affecting adults, often associated with insulin resistance and lifestyle-related factors (IDF, 2022).
3. Knowledge: Awareness and understanding of diabetes, including causes, symptoms, complications, and management strategies.
4. Attitude: Patients’ feelings, beliefs, and perceptions about diabetes and its management.
5. Practice: Patients’ actual behaviors in managing diabetes, such as medication adherence, diet control, exercise, and monitoring blood glucose.
6. Primary Health Care Center: A health facility providing preventive, promotive, and curative services to local communities, serving as the first point of contact for patients.
7. Self-Management: The ability of patients to manage symptoms, treatment, and lifestyle modifications related to diabetes.
8. KAP Study: A research approach assessing Knowledge, Attitude, and Practice toward a specific health condition.

Project – Assessment of Knowledge, Attitude, and Practice (KAP) Regarding Diabetes Management Among Patients in Ikeja Primary Health Care Center