Development and implementation of a family-centred nutrition and exercise programme for diabetes mellitus patients of Blouberg Municipality, Limpopo Province

Abstract

Background: The increase in diabetes prevalence is often accompanied by comorbidities and complications, which negatively impact on the quality of life of patients. Poor dietary intake and physical inactivity lead to obesity and contribute to diabetes prevalence and poor outcomes. Non-diabetic family members of patients are already at risk of developing diabetes due to a family history of the disease. Therefore, this study was aimed at developing and implementing a family-centred nutrition and exercise diabetes care programme for better outcomes and fewer new cases. Methodology: This study employed a mixed method approach, where convergent parallel design was used where quantitative and qualitative data were collected. For the quantitative strand, 400 subjects participated in the study (i.e., 200 diabetes patients and 200 family members). Diabetes patients were selected using stratified random sampling from rural clinics, while family members were selected using the sampled patients. For the qualitative strand, 17 diabetes patients were purposively sampled, and data saturation was reached. Two set of questionnaires (for patients and family members) were used to collect quantitative data, while one-on-one interviews with patients were used to collect qualitative data. Phase 2 involved development and validation of an intervention program. The validation involved a process where professional experts were used for validation using Delphi technique. Phase 3 included implementation and program evaluation wherein post-implementation quantitative survey was conducted on 100 participants (50 patients and 50 family members), who were purposively sampled from list of those who participated in Phase 1. Quantitative data was analysed using SPSS Software v27.0, while qualitative data analysed using 8 Steps of Tesch’s inductive, descriptive open coding technique. Results: In Phase 1, the results showed that over half of patients (57%), compared to 38% of family members, were obese; and that most patients (75%), compared to 55% of family members, had abdominal obesity. Close to half of patients (45%), compared to 31% of family members, had overall excellent nutrition and exercise diabetes care knowledge. The majority of patients (73%), compared with 25% of family members, had overall positive attitudes towards nutrition and exercise diabetes care. Only 15% of diabetes patients compared with 9% of family members had overall good practice vi related to nutrition and exercise diabetes care. In Phase 3, it was reported that the majority of both patients (84%) and family members (100%), respectively indicated that the organization of the educational intervention was commendable. All patients (100%) and family members (100%) indicated that the health education strategies used stimulated their interest and were very helpful to their learning. Conclusion: A family-centred nutrition and exercise diabetes care programme was developed, implemented and evaluated. Diabetes patients and family members indicated that the intervention was helpful to their learning and met their expectations. Therefore, there is an urgent need for the adoption of the family-centred nutrition and exercise diabetes care programme to achieve healthy eating and increased physical activity. The adoption of healthy eating and physical activity among diabetes patients and their non-diabetic family members will subsequently lead to better diabetes outcomes, and minimizing new cases, respectively.