Self-care behaviours and associated factors among type 2 diabetes patients in Ghana: A systematic review

Abstract

Introduction: Diabetes remains an emerging public health challenge in Ghana. The control of cardio‑metabolic risk factors among type 2 diabetes patients in the country is suboptimal, leading to massive healthcare costs. This systematic review examined the extent of adherence to self-care behaviours and associated factors among type 2 diabetes patients in Ghana.Methods: PubMed, PsycINFO, Scopus, and Google scholar were used to identify quantitative observational studies published between 1990 and June 2022. Studies exclusive to type 2 diabetes patients ≥18 years of age in a Ghanaian setting were included in this review. Findings of primary studies were analysed using narrative synthesis.Results: Eleven (11) studies, presenting data on a total of 2,503 type 2 diabetes patients, were included. All the studies were published in the last decade (2015-2021) and a majority (45.5%) of them were from the Greater Accra Region. The mean number of days (per week) participants adhered to a self‐care behaviour were in the ranges of 3.9–4.4 for diet, 4.2–4.8 for physical activity, 0.5–2.2 for self-monitoring of blood glucose (SMBG), and 2.9–5.0 for foot care. Adherence rates for medication were in the range of 33.5–84.5%. Patient-related factors, sociodemographic/economic-related factors, condition-related factors, and healthcare system-related factors were associated with the practice of self-care behaviours.Conclusion: Adherence to self-care behaviours among type 2 diabetes patients in Ghana remains an ongoing challenge, with significant variations in adherence among patients with different characteristics. Public health interventions are needed to address the variations in adherence to self-care behaviours among type 2 diabetes patients.

Prevalence of diabetes and associated risk factors in Ga Mashie, Accra, Ghana – the CARE Diabetes community-based survey

“…This is supported by the work of Suglo et al which found that people are knowledgeable of what constitutes a healthy diet and what foods are suitable for people living with diabetes in Ga Mashie (33); nonetheless, a healthy diet was perceived as expensive, with cost as a major barrier to consumption of healthy food (33). Furthermore, the adherence to self-care behaviours among people living with diabetes is also a challenge as demonstrated by Opoku et al, where the mean number of days per week adherence to dietary recommendations was 3.9-4.4 days/week; and where only 2.7% of people living with diabetes adhere daily to these recommendations (34).…”

“…Consistent self-care among individuals living with diabetes presents notable challenges, reflecting varied adherence levels to medication and care recommendations (34). Barriers to effective self-management are likely to include limited knowledge about diabetes dietary strategies, financial constraints, treatment non-compliance, restricted access to glucometers, inadequate social support, and prolonged waiting times at healthcare facilities (43).…”

Understanding Physical Activity Behavior in Ghanaian Adults with Type 2 Diabetes: A Qualitative Descriptive Study

“…Such patients usually rely on alternative sources of treatment, such as spiritual healing. Mistrust of biomedical forms of treatment coupled with strong beliefs in spiritual or herbal treatment prevents some patients from accessing hospital healthcare [ 6 , 49 ]. Therefore, the findings should be interpreted in the context of the variety of patients with T2DM.…”

“…A self-care regimen is a priority approach in diabetes management due to its positive impact on diabetes outcomes [ 5 ]. The findings of a systematic review on self-care behavior in Ghanaians with T2DM show that adherence to a self-care regimen is suboptimal [ 6 ]. Physical activity (PA) is an essential component of a self-care regimen [ 7 ].…”