Citation
Subramaniam, Umma Devi
(2016)
Competencies of diabetes educators in facilitating self-management and its associated factors among diabetic patients in Malaysia.
Masters thesis, Universiti Putra Malaysia.
Abstract
Introduction : Diabetes Mellitus is emerging as an epidemic of the 21st century and
threatens to overwhelm the health care system in the near future. There were nearly
1.5 million adults affected by the disease and there is an increment of about 3.3% in
the prevalence of diabetes over the last decade in Malaysia. Self-management of
diabetes among diabetic patients can be achieved through diabetes education provided
by competent diabetes educators.
Objectives : The aim of the study was to determine the diabetes educators’
competencies to facilitate self- management and its associated factors among diabetic
patients in Malaysia. The specific objectives of this study were to determine the sociodemographic,
service and training factors of diabetic educators, their knowledge on
the five domains of competencies on the clinical understanding of diabetes
management (Domain I), culturally-competent supportive care across the lifespan
(Domain II), teaching and learning skills (Domian III), diabetes self-management
practices (Domain IV), and health promotion and other programs (Domain V), and the
challenges faced by them in counselling diabetic patients.
Methodology : This was a cross-sectional study using a self-assessment questionnaire
adapted from American Association of Diabetes Educators Guidelines (2013) with
445 diabetes educators randomly selected using simple random sampling in Primary
and Secondary Healthcare Centres from five states in Malaysia. The reliability and
validity of the questionnaire were done. Mean and standarad deviation were used to
compute the competencies of diabetes educators’ on the five domains of competencies.
Their level of competency was determined as Level 1 (low competency), Level 2
(moderate competency) and Level 3 (high competency). The study also described the
challenges faced by the diabetes educators in their daily job. To test the significant association between the independent variables (socio-demographic, service and
training factors factors) and dependent variable (level of competency), a Pearson
Correlation test of association was used. Multiple linear regression was used to predict
the variables of diabetes educators’ competency.
Results : The findings of the study showed that mean value for the competency of the
diabetes educators is 3.11± 0.44. The mean values for the Domain I was 3.35 ± 0.55,
Domain II was 3.37 ± 0.54, Domain III was 2.69 ± 0.59, Domain IV was 3.21 ± 0.50
and Domain V was 2.91 ± 0.70. In terms of association between the independent and
dependent variables, that there was a weak and negative association between age and
competency. There was also weak and significantly positive association between the
number of years as diabetes educator and competency. There were significant
associations between gender, ethnicity, job position, academic qualification and type
of post-basic course attended and their level of competency. The overall mean for the
challenges faced by diabetes educators was at moderate level. Predictors of diabetes
educators’ competency were gender, ethnicity, academic qualification and number of
years as diabetes educators.
Conclusion : The overall competency of the Malaysian diabetes educators was high
at Level 3. Their competency was associated positively with gender, number of years
as diabetes educators and type of post-basic course attended and negatively associated
with age, ethnicity, job position and academic qualification. They were satisfied as
their role was recognised by their superiors and they were given the empowerment to
carry out the relevant programs related to the patients’ diabetes control.
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