Diabetes and Diabetic Retinopathy: Knowledge, Attitude, Practice (Kap ) among Diabetic Patients in A Tertiary Eye Care Centre

Abstract

Introduction: Diabetic retinopathy is becoming an increasingly important cause of visual impairment in India. Many diabetic patients who come to our centre have undetected, advanced diabetic retinopathy. If diabetic retinopathy had been detected earlier in these patients, irreversible visual impairment could have been prevented. Aim:To document Knowledge, Attitude and Practice (KAP) patterns of diabetic patients regarding diabetes and diabetic retinopathy, to determine association between them, and to identify barriers to compliance with follow up and treatment regimes. Materials and Methods:This was a hospital-based, cross-sectional study, conducted at the Department of Ophthalmology at Christian Medical College, Vellore, Tamil Nadu, India, over a six-month period from June 2013 to November 2013. Two hundred and eighty eight diabetic patients, who fulfilled the eligibility criteria, were included in the study. KAP of patients was assessed using a 45-point, verbally administered questionnaire. Patients were placed in different categories, such as, 'good/ poor' knowledge, 'positive/negative' attitude and 'good/poor' practice. Data were analysed using Chi-square test and binary logistic regression, as appropriate. The proportion of patients with 'good/poor' knowledge, 'positive/negative' attitude and 'good/poor' practice, and the association between KAP were studied. Barriers to compliance with follow up/treatment regimes were identified. Results:Out of the 288 patients in the study, 42% had good knowledge about diabetes, but only 4.5% had good knowledge about retinopathy. Good knowledge about diabetes was significantly associated with positive attitude towards diabetes and good practice patterns regarding retinopathy; awareness of retinopathy was also significantly associated with good practice. A total of 61.1% of patients did not have periodic eye examination; most common barrier identified was lack of awareness about the necessity for this (38.5%). Conclusion:Good knowledge about the disease was significantly associated with positive attitude and good practice patterns. Knowledge about diabetic retinopathy was poor among the patients in our study. Lack of awareness concerning the need for screening for retinopathy was a major barrier to regular screening. There is an urgent need to educate diabetic patients about this potentially blinding complication of diabetes.

<p>Does a diabetic retinopathy educational program raise awareness among elderly diabetic patients?</p>

“…Regarding mean score of knowledge of the studied population; 5.34±1.0 in pre-test, which indicated poor knowledge, improved in post-test to 16.66±1.8, this result was similar to that of Srinivasan NK et al, 16 who observed that only 4.5% of studied sample had good knowledge about retinopathy. Also, Geethadevi M et al 30 found that 60.8% had no knowledge of diabetic retinopathy and Panigrahi S et al 31 reported that 69.0% of the study population had poor knowledge of diabetic retinopathy.…”

“…A few studies have been conducted regarding the knowledge and awareness about DR among the diabetic population. 16 This is the first study carried out on knowledge, attitude, and practice regarding DR in Assuit university hospital. So, the current study has been conducted to determine the level of knowledge, attitude, reported practice, and to identify the impact of an educational program on a diabetic population.…”

A study of knowledge, attitude and practice in diabetic retinopathy among patients attending a primary health care centre

“…16 Mahesh G et al and Srinivasan N K et al, also found a statistically significant association between awareness of diabetic retinopathy and good practice patterns regarding retinopathy in their studies. 19,20 In primary health centres, physicians can play a major role in creating awareness and imparting knowledge about diabetic retinopathy. Data from our study also reflects this.…”

Awareness of diabetic retinopathy and barriers for eye screening among adults with type 2 diabetes mellitus attending tertiary care teaching hospital, Davanagere, Karnataka

“…Similar reasons were given by patients in studies done in Vellore [1] and Jordan. [11] As no similar studies were previously done in our setting, this provides information toward an understanding of health seeking behavior of diabetics regarding one of the major causes of blindness in this populace.…”

“…[9] This awareness was low as compared to studies done in Vellore (71.9%) [1] , Nepal (63.3%), [10] and Jordan (98.3%). [11] Majority of the patients 83.3% believed that individuals with controlled diabetes will have no eye problem which is higher as compared to the findings done in Bagalkot (68%) [2] and Malaysia (51.1%).…”