Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
For authors, the manuscripts can be uploaded online through an easily navigable portal, on other hand, reviewers appreciate the systematic handling of all manuscripts. The way JCDR has emerged as an effective medium for publishing wide array of observations in Indian context, I wish the editorial team success in their endeavour"



Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




Dr Mohan Z Mani

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I wish all success to your journal and look forward to sending you any suitable similar article in future"



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Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
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I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




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Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2010 | Month : August | Volume : 4 | Issue : 4 | Page : 2798 - 2803

Social and Psychological Evaluations of Diabetic Patients Towards Disease Management: A Cross Sectional-Study at a University Health Center in Malaysia

AL-HADDAD M , MOHAMED IBRAHIM M I , HASSALI M A, SULAIMAN SYED S A, MAARUP N

*(PhD), Lecturer & Researcher,** (PhD) Professor of Social Pharmacy,Discipline of Social and Administrative Pharmacy, ,***( Pharm D ), Dean of School of Pharmaceutical Sciences, ****(PhD) Lecturer & Researcher,Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang,( Malaysia). ***** (MD )Health Center, Universiti Sains Malaysia, 11800 Penang,( Malaysia)

Correspondence Address :
Mahmoud Al-Haddad : PhD
Lecturer & Researcher
Discipline of Social and Administrative Pharmacy,School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, (Malaysia)
Email: dr_mahmoud77@hotmail.com
Tel: +6 012 5534547

Abstract

Objectives: This study aims to explore the social and psychological behaviours among diabetic patients regarding diabetes and its treatment at a University Health Center in Malaysia.
Setting: Health Center of Universiti Sains Malaysia
Methods: A cross sectional study design was used to explore the patients’ social and psychological domains of diabetes and its treatment by using a Diabetes Care Profile (DCP) questionnaire. All questions used were based on a 5-point Likert scale and appropriate statistical tests were conducted at a significant level of less than 0.05.
Results: The patients showed good level of diabetes understanding, care ability, importance of care, positive attitudes, self care adherence and long term benefits. In addition, they showed a low impact of diabetes on their social and personal lives and low negative attitudes. Adherence to a good diet was seen as the most difficult behaviour to change among diabetic patients. Patients with fewer years with diabetes scored significantly better than those with more years with diabetes, in most of the domains of this study.
Conclusion: A majority of the patients showed a good level of understanding about diabetes and its treatment. Difficulty in controlling diet was the major problem which was identified by most of the respondents. Therefore, these study findings could be used to develop better counseling and educational programs for diabetic patients based on their needs.

Keywords

diabetes, Malaysia, social, behaviour, attitude, psychological

Introduction
Apart from engaging evidence-based treatment regimens for diabetes patients, successful treatment outcomes can only be achieved if behavioural issues relating to disease management are taken into account. Some behavioural issues such as healthy dieting and personal engagement in physical activity are important for a diabetic patient in order to achieve good glycaemic control (1), (2). One major obstacle is the lack of seriousness on the management of the disease by either the patient or the healthcare providers. Furthermore, lack of understanding or the ability to remember all the information given by the healthcare provider and the social isolation due to disease suffering are a few obstacles identified, which will negatively have an impact on the adherence of patients living with diabetes (3).

Sources of self management knowledge are very important in the management of diabetes. Many patients derive their information from sources other than healthcare professionals, which significantly affect their healthcare practices.

Patients with internal psychological barriers (health beliefs and self efficacy), internal physical barriers (co-morbidities) and external psychological barriers (environment) are shown to perform less self disease management activities regardless of their sex, age and diabetes knowledge (4). Lifestyle factors related to eating behaviours, understanding of diabetes, controlling problems, obesity and physical activities play important roles in the prevention and treatment of diabetes. The relationship between the knowledge of diabetic patients about the disease and their self-management practices and ambulatory preventive care were evaluated in Minnesota (5). A significant positive correlation between knowledge and self-management practices was found.

In real life, there are many confounders, as discussed earlier, which could tremendously have an effect on the patients’ beliefs and their behaviours. Therefore, without understanding the patients’ knowledge, it would be difficult to assess what their attitudes are and what the main barriers to adherence are; it would be difficult for healthcare providers and educators to properly develop strategies to help diabetic patients. Thus, this study aims to explore the social and psychological behaviours of diabetic patients regarding diabetes and its treatment at a University Health Center in Malaysia.

Methodology
Study Design

A cross sectional study design was used to explore the patients’ social and psychological parameters regarding diabetes and its treatment by using a Diabetes Care Profile questionnaire (DCP).

Study Population and Sample
All patients with type 2 diabetes who visited the Universiti Sains Malaysia (USM) Health Center, who were able to read and write in the Malaysian national language and gave verbal informed consent were eligible for this study.

Questionnaire Design
DCP is an instrument which has been developed to measure the social and psychological factors which are related to diabetes and its treatment (6). Evidence of its reliability and validity has been proven by two different studies (7), (6). The DCP questionnaire was translated into the Malaysian national language and it was reviewed and validated by an expert committee. A pilot study was conducted to finalize the final draft of the questionnaire. The questionnaire contained 11 sections. Section 1 was about the patients’ demographics, which was followed by their understanding of diabetes. The other sections were about control problems scale; social and personal factors; the patients’ positive attitude toward diabetes; negative attitude; care ability; importance of care and self-care adherence; diet adherence evaluation and finally, long term care benefits. All variables in the DCP were measured by using a 5-point Likert scale.

Patients’ Recruitment And Data Collection Procedure
The list and contact numbers of all diabetic patients at USM were taken from the Health Center. Then, the patients were randomly contacted and specific dates and times were set to meet them. During the interview, the patients were informed about the study and verbal informed consent was taken from each of them. They were given an average of 30 minutes to complete the questionnaire.

Data Analysis
Cronbach's Alpha was calculated to measure the reliability of the questionnaire. Mann Whitney and One-Way ANOVA tests were used wherever appropriate. All analyses were conducted by using an SPSS software package version 12 at a significance level of less than 0.05.

Results

A total of 135 patients successfully completed the questionnaire. Cronbach's Alpha results showed high reliability with coefficients of 0.937, 0.859, 0.749, 0.853, 0.931, 0.732, 0.863 and 0.973 for understanding diabetes care, social and personal factors, positive attitudes, negative attitudes, self-care ability, the importance of care, healthcare adherence, diet adherence and long term care benefits, respectively.
(Table/Fig 1) summarizes all of the respondents’ demographics. It was found that males represented almost two thirds of the respondents (65.9%). A majority of the respondents were Malay (82.2%) and were in the age group of 55-59 (40.74%).
The results showed that the patients had a good level of understanding about diabetes and its treatment (mean = 3.19±0.55) (Table/Fig 2). In addition, the patients showed that diabetes had a lower impact on their social and personal life (mean = 2.39±0.80), where they had enough time to spend with their family andfriends and had the ability to eat the type and quantity of food that they wanted to eat. The patients showed high levels of positive attitudes (mean = 3.42±0.80) since they believed that they are able to control the disease and it would not affect their life. The levels of negative attitudes were lower than tha of the positive attitudes (mean = 2.91±0.73). The patients showed a good level of confidence that they can handle the disease and that they were able to control the disease and their feelings towards the disease (mean = 3.69±0.68). Importance of care was the highest score to which the patients responded in this study (mean = 4.24±0.60), where they believed that it is important to keep their sugar levels and weight in control. Perceived importance of care only was not enough and thus, the patients had to show that they had already kept their sugar levels and weight under control, which was found in this study, where their mean answer to self-care adherence was 3.90±0.87. The patients showed that they had difficulties in diet adherence (mean = 2.59±1.10), where they didn’t frequently follow a scheduled meal plan. On the other hand, the patients perceived that diabetes control would result in long term care benefits (4.16±0.72).

When the patients’ responses were compared based on race, Malays reported significant higher responses to the importance of care as compared to the Indians (p=0.035). On the other hand, the levels of diabetes care understanding were significantly higher in patients who were living with diabetes for less than one year as compared to those living with diabetes for 1-2 years and 3-5 years (p=0.008 and 0.016, respectively). When the social and personal impacts of diabetes were compared, patients suffering with diabetes for less than one year showed a significantly lower impact of diabetes on their social and personal life as compared to those living with diabetes for 3-5 years and those living with diabetes for more than 5 years (p=0.032 and 0.001, respectively). In addition, positive attitudes were significantly higher in patients living with diabetes for less than 1 year as compared to those living with diabetes for more than 5 years (p=0.024). Patients with low educational levels showed a significantly higher impact of diabetes on their social and personal lives as compared to patients with graduate degrees (p=0.031). Finally, patients with a monthly income of more than RM4000 showed a significantly lower impact of diabetes on their social and personal life as compared to those with a monthly income of less than RM1000 and RM1001-1500 (p=0.012 and 0.027, respectively).

Discussion

Studies have suggested that lifestyle changes are very effective in preventing or delaying the development of diabetes mellitus (8), (9). Therefore, proper behavioural changes are essential for the better management of chronic diseases. Lack of adherence is common in the management of chronic diseases which result from many causes such as the chronic nature of the disease, complexity of the treatment and life style changes. The patients in this study showed an average good level of understanding regarding diabetes and its treatment. The current findings are similar to another study which was conducted in Malaysia, which found that diabetic patients had a better knowledge of diabetes than healthy respondents (10). In the present study, patients living with diabetes for a period of less than one year showed significantly higher scores of understanding as compared to those patients who lived with diabetes for much more time. This shows that those who are newly diagnosed with diabetes are more enthusiastic to search and know about the disease as compared to the patients who lived for a longer period with diabetes. The knowledge and understanding of any chronic disease should be higher in patients who have been with the disease for a longer period, but advancement in technology and the easy availability of the internet may have facilitated the search about any disease which may played a big role in increasing the understanding and knowledge for those who were recently diagnosed with any disease. In addition, patients who are newly diagnosed with any disease keep on asking many questions about this disease which increases their level of knowledge about that disease. The impact of diabetes on the patients’ social and personal life was quite low in this study. The patients disagreed that diabetes was a reason which was keeping them from: having enough money, meeting their household and other responsibilities, traveling as they wanted, having good relationships with others, having their own life schedule, spending time with others and having enough time alone. Concurrently, according to the findings of the previous discussion, the patients living with diabetes for less than one year, who showed a significantly higher understanding level as compared to the patients living for a longer period with diabetes, were also found to have a significantly lower impact of diabetes on their social and personal life as compared to those living for a longer period with diabetes. This reflects the impact of understanding on the patients’ social and personal life,which is controversially related, where whenever the understanding level is found to increase, the social and personal impact decreases. In addition, the patients with higher incomes were found to be less affected by diabetes, especially their social and personal lives, where higher incomes made it easy for them to better manage their social and personal lives. Furthermore, patients with higher educational levels showed a significantly lower impact of diabetes on their social and personal lives as compared to those with only a school level of education. This could be explained by the higher knowledge levels and the income of this group as compared to the other groups, especially the patients with only a school level of education.

On the other hand, the patients’ positive attitudes were found to be quite high in the studied group of patients. This could be explained by their higher level of understanding of diabetes and its treatment, as well as the low impact of diabetes on their social and personal lives. Therefore, they have shown significantly higher positive attitudes as compared to the other groups.
Cultural food preferences and family traditions play important roles in behavioural change (11). In this study, diet adherence was quit low, which could be elucidated by the cultural food preferences in Malaysia, since Malaysians normally prefer to eat spicy and sweet food which made it difficult for the patients to adhere to the healthy and non-sweet food.

Conclusion

The patients’ understanding, knowledge, attitude, care ability andlong term care beliefs were high in the studied group of diabetic patients. Patients living with diabetes for less years were more knowledgeable about the disease, they had better attitudes and they were less affected by the disease in their social life as compared to those living for longer years with diabetes. In addition, the patients’ counseling programs should focus on diet adherence, since most patients in this study highlighted difficulties to follow healthy meal plans. Therefore, the findings of this study could be used to better develop educational and counseling programs for patients with diabetes.

Acknowledgement

This educational program was supported by the Secretariat of Healthy Campus, Universiti Sains Malaysia. Our thanks to the Health Center of University Sains Malaysia, School of Pharmaceutical Sciences and National Poison Center.. Special thanks to: Assoc. Prof. Dr. Mohd Baidi Bahari, Dr. Nurulain bt Abdullah Bayanuddin, Mr. Azaharudin b. Awang Ahmad, Ms. Sulastri bt Samsudin, Ms. Asdariah bt Misnan, Che Gayah bt Omar, Che Rubia and Jameaton who contributed greatly for the success of this program.

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Fitzgerald, JT, Davis, WK, Connell, CM, Hess, GE, Funnell, MM & Hiss, RG: Development and Validation of the Diabetes Care Profile. Eval Health Prof. 1996;
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Fitzgerald, JT, Anderson, RM, Gruppen, LD, et al: The Reliability of the Diabetes Care Profile for African Americans. Eval Health Prof. 1998; 21: 52-65.
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Pi-Sunyer, FX: How Effective Are Lifestyle Changes in the Prevention of Type 2 Diabetes Mellitus? Nutrition Reviews. 2007; 65: 101-10.
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The Diabetes Prevention Program Research: The Diabetes Prevention Program (DPP): Description of lifestyle intervention. Diabetes Care. 2002; 25: 2165-71.
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JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com