The impact of lifestyle intervention on the motivation of Type 1 diabetic patients at Kalafong Hospital

Abstract

6.5 million people have been diagnosed with diabetes in South Africa. Despite current medical interventions, the number of newly diagnosed individuals continues to rise. Lifestyle intervention has been widely used to improve the treatment outcomes of type 2 diabetic patients. This study aimed at evaluating the effect of lifestyle intervention on Type 1 diabetic patients within the context of Kalafong Hospital, a public hospital in South Africa. The study took place within Kalafong Hospital and looked specifically at lifestyle intervention, as lifestyle itself is a crucial part in the management of diabetes. The observations that the majority of patients receiving treatment from the Diabetes Clinic at Kalafong Hospital (found through observation and by looking at the diabetic clinic patient database) showed continued elevated blood sugar, despite pharmaceutical care. The finding that patients were observed as passive recipients of care and the knowledge that, in 2007 alone, 20 139 citizens died as a result of diabetes, led the researcher to investigate whether lifestyle intervention could improve the motivation of Type 1 diabetic patients (Burden of Disease Research Unit, 2010:4). Various studies agree that lifestyle intervention can improve the management of diabetes. Few studies, however, consider whether lifestyle intervention can improve the management of Type 1 diabetes within the South African context. The idea behind the study was to provide lifestyle intervention within a group setting, in order to gain the benefit of both lifestyle intervention and the therapeutic effects of groups. The goal of the study was to determine the impact of lifestyle intervention on the motivation of Type 1 diabetic patients at Kalafong Hospital. The problem statement and hypothesis that guided the study were as follows: i) Type 1 diabetic patients exposed to lifestyle intervention should experience a sustained increased motivation to adhere to a proper diet and exercise routine that continues even after the termination of the lifestyle intervention and ii) when exposed to lifestyle intervention, Type 1 diabetic patients will show a reduced HbA1c which will be sustained over a three-month period. Quantitative applied research was conducted using a true experimental design. The population for the study was Type 1 diabetic patients aged between 18 and 40 who attended the Diabetic Clinic at Kalafong Hospital. The study used stratified random sampling to generate a sample. Thirty-eight respondents diagnosed with Type 1 diabetes were selected for the study. Respondents underwent six lifestyle intervention sessions/groups. Blood tests were completed by respondents before the intervention and three months after termination of the intervention. A questionnaire was completed by the respondents before the intervention and three months after termination of the intervention. The questionnaires were analysed through the use of the following non-parametric tests: Wilcoxon Signed Rank Test, Mann-Whitney U Test and the McNemar Test. Significant findings were analysed further and discussed. Significant findings included the questions pertaining to: management; time spent managing diabetes; perceived self-efficacy; goals and goal setting; feelings about diabetes and reported sources of support. The HbA1c blood results were analysed using SPSS (Statistical Package for the Social Sciences). The results were analysed using a univariate analysis and a T-test. The conclusions of this study indicate that the lifestyle intervention, despite improving health literacy, had no significant effect on the motivation of Type 1 diabetic patients. Even from the biopsychosocial perspective, the intervention failed to significantly affect either the biological, psychological or social aspects of the respondents. The recommendations offered by the study can be used by social workers within healthcare, to guide future research and to assist in the planning for lifestyle intervention programmes within healthcare settings.