Thesis:

Influence of psychological factors on self-management of type 2 diabetes mellitus among adult patients in Lamu hospital, Kenya

Type 2 diabetes mellitus’ global prevalence is scaling up, with approximately 537 million people affected (IDF, 2021). This growing epidemic poses significant public health challenges, especially in resource-constrained regions. The study investigated the aftermath of psychological attributes on the condition’s personal-care behaviors in adult patients at Lamu hospital, Kenya. The study’s objectives were to assess the emotional distress, investigate one’s ability and belief, explore seeking connection networks as a coping strategy, and investigate diabetes related-distress’ influence on personal care behaviors in adult patients in Lamu hospital, Kenya. The study involved 265 participants from the diabetes outpatient clinic and medical wards. Participants were selected based on a confirmed T2DM diagnosis and their willingness to participate. Those with severe medical conditions were excluded. The study was guided by the Roy adaptation model (RAM) and social cognitive theory (SCT). It utilized a quantitative, cross-sectional design. A customized and validated questionnaire, covering aspects such as emotional distress, self-efficacy, seeking social support as a coping mechanism, and socio-demographic data, was used. Expert opinion, pilot testing, and Cronbach’s alpha verified the reliability and validity of the data collection tool. Data analysis was carried out using SPSS and other inferential statistical methods, such as chi-square tests, to evaluate the association of psychological and demographic factors. The ethical considerations were safeguarded. Findings indicated a high prevalence of emotional distress among participants, with over half (51%) reporting that diabetes consumed significant mental and physical energy. Chi-square analyses revealed that gender significantly influenced self-efficacy in maintaining a meal plan at social events (χ² = 6.91, p = 0.009), with females reporting lower confidence. Age differences in exercise self-efficacy were also significant (χ² = 12.32, p = 0.006), with individuals aged 31– 56 years reporting higher confidence. Duration of diabetes significantly impacted medication adherence self-efficacy (χ² = 22.62, p < 0.0001), where patients with 1–6 years of diabetes reported greater confidence. However, education level did not significantly affect self-efficacy in blood sugar monitoring (χ² = 4.16, p = 0.245). Around 70% of patients relied on social support as a key coping strategy. Emotional distress frequently interfered with personal care practices, affecting medication adherence, dietary adjustments, physical activity, and blood sugar monitoring. The study concludes that emotional distress significantly undermines the selfmanagement of type 2 diabetes mellitus (T2DM), with low self-efficacy and reliance on social support playing key roles. To improve diabetes care, healthcare providers should focus on interventions that address emotional distress, such as counselling and stress management programs, while also boosting patient self-efficacy through tailored education. Strengthening social support networks, both in families and communities, could help ease the emotional burden. Future research should explore the long-term effects of emotional support interventions and examine how different forms of social support impact patient adherence to diabetes management practices.