What Are the Experiences and Training Needs of Home-Based Carers in Dealing With Diabetes in a Rural Village in South Africa? An Explorative Study

Abstract

Type 2 Diabetes Mellitus is a difficult chronic condition associated with morbidity, mortality and loss of quality of life. In Sub-Saharan African countries, HBC (Home-Based Carers) play an important role in the care of people diagnosed with chronic illnesses like diabetes. However, home-based carers seem to lack knowledge to care of people with diabetes because they have not been not formally trained. The aim of this study is to explore and describe the practices, knowledge and learning needs of Home-Based Carers (HBCs) of people with diabetes. A qualitative explorative approach was taken, holding interviews with 15 HBCs at the 4 clinics in the Ga-Dikgale village. The purposive sampling method was used to select participants for this study. Four themes are described: activities performed by HBCs during the care of diabetes patients, existing structures and sources of information for HBCs on the management of diabetic patients, challenges experienced by HBCs during the provision of care to diabetes patients and the learning needs of HBCs, based on how they want their training to be organised. HBCs execute various activities during the care of PWD (patients with diabetes) including providing nutritional advice, medication support, helping with household chores, accompanying patients to healthcare services and dressing their wounds. However, they lack knowledge of issues related to the care of PWD, which makes their role very difficult and challenging.

What Is the Impact of a Context-Specific Training Program for Home-Based Carers? An Evaluation Study

“…Specific learning outcomes relevant to meet their job-related needs were developed based on the gaps between what the HBCs know, what they need to know, and their learning needs, as indicated during the situational analysis. The following modules were included in the training based on the HBCs’ training needs identified during training needs analysis: (1) Basic knowledge and classification related to diabetes mellitus which covers the concepts used for diabetes mellitus and care, normal regulation of blood glucose, types of diabetes mellitus, clinical differences between diabetes type 1 and type 2, signs and symptoms of diabetes mellitus, and risk factors of diabetes mellitus; (2) prevention and control of diabetes, which include early detection of diabetes by the FINDRISK tool, healthy diets, healthy food guide pyramid, plate model, role of physical activity in the prevention of diabetes, physical activities for diabetic patients, benefits of losing weight, avoidance of alcohol, and avoidance of tobacco use; and (3) management and prevention of complications by HBCs that covers the measures by HBCs to manage diabetes mellitus, the role of HBCs in assisting adherence to diabetic treatment, knowledge of glucose testing, assisting diabetic patients in treatment, complications of diabetes mellitus, hypoglycaemia, signs and symptoms, causes and prevention, diabetic foot problems, prevention of foot ulcer, amputation and wound dressing, and management and care of complications by HBCs [ 18 ]. The subject matter included was based on the previously developed material about T2DM and the research articles.…”