Factors that influence non compliance to prescribed diabetic regimens in the management of diabetes: a case study of Kenyatta National Hospital
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Prior to the research period, observations at the Kenyatta National wards indicated a marked increase in cases of diabetic patients being admitted because of complications of Diabetes Mellitus. The complications were mainly due to the patients’ failure to comply to their prescribed diabetic regimens. The fundamental principal underlying the management of Diabetes Mellitus is the balancing of energy expenditure with nutritional sources of energy under the influence of insulin and other hormonal factors and this gives the base as to why prescribed regimens are used in the control of the disorder. The study investigated the influence of socio-economic, cultural and demographic factors on a patient’s degree of compliance to their prescribed diabetic regimens. Barriers limiting change to these regimens were identified and the diabetic counselling which patients received from the hospital counsellors was assessed. This was because the effectiveness of the counselling services rendered could only be graded as effective when the patients put into practice the advice given. A total of sixty diabetic patients and eight nutrition counsellors participated in the study. Results indicated that regimen compliance by diabetic patients at Kenyatta National Hospital could generally be documented as good. Though nutrition counselling for the diabetics was issued in good time a serious inadequacy in the way it was carried out was noted due to lack of necessary materials to carry out the counselling. The diet sheets issued did not reflect the wide variety of staple foods most communities use in their day-to-day diets in Kenya. It was recommended that diabetic regimen counselling should be decentralised from Kenyatta National Hospital, which is a referral hospital to more easily accessible areas like Health Centres and the District Hospitals. Another recommendation was that more indigenous foods be added to the diet sheets.