Background: A well-informed patient with Type 2 diabetes may be more compliant with treatment. This study aims to evaluate the diabetes-related knowledge and socio demographic determinants of patients seen at University of Santo Tomas Hospital through a translated and validated Filipino-DKT questionnaire.

Methods: Standard translation procedure was used to produce the Filipino version of the DKT2. A convenience sample of 112 outpatients with Type 2 diabetes was identified for six months at the University of Santo Tomas Hospital, Philippines. All data were collected using the Filipino-DKT and a demographic questionnaire.

Results: The Filipino-DKT demonstrated an acceptable Cronbach's alpha of 0.70 and an acceptable average inter-item correlation of 0.40 (p<0.001). The test-retest reliability was excellent, with a Pearson coefficient r of 1.00 (p<0.001). Our study demonstrated that of the 112 patients with diabetes who answered the general knowledge test, the majority had average knowledge of 78.64%, while 16.07% had poor knowledge. A total of 55 participants on insulin answered the second part of Filipino-DKT that measures insulin knowledge. Surprisingly, 56% of the subjects on insulin had poor knowledge, and only 7% had good knowledge. Results showed that the majority (56%) had poor knowledge. Participants who reported poor control of their diabetes (HbA1c >7%) also reported lower levels of knowledge about diabetes and insulin use. There was no association between duration of diabetes, family history of diabetes, and type of diabetes with knowledge of diabetes.

Conclusion: The Filipino diabetic knowledge of diabetes is poor and not related to age, sex, and duration of diabetes. Filipino-DKT is an acceptable, reliable, and valid measure of diabetes knowledge used in our clinical practice and research.

Introduction: Patient education is integral in the management of gestational diabetes mellitus (GDM), a common pregnancy complication that may cause adverse perinatal outcomes. This study evaluated the effect of diabetes education on the knowledge and attitude among patients with GDM, comparing pre- vs post-diabetes session scores and determining pregnancy outcomes. Methodology: A one-group pre-test and post-test experimental design study was conducted on 75 patients after one- session diabetes counseling using the Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) and the third version of the Diabetes Attitude Scale (DAS-3). Results: Of the 75 subjects, 84% exhibited adequate knowledge of diabetes. Post-education, a significant increase in the total scores was seen among those less than 35 years of age (p-value: 0.003), both employed and unemployed (p-value: 0.0.026, 0.047, respectively), with a secondary level of education (p-value: 0.014) and multigravid (p-value: 0.015). An overall median positive attitude score of 3.6 was documented. For neonatal outcomes, no adverse events existed. For maternal outcomes, 17.9% had elevated fasting blood glucose while 7.1% had elevated 2-hour post-glucose tolerance test. Conclusion Diabetes education improves patient’s knowledge but not their attitude. Hence, improvement in attitude interventions should be incorporated into the current diabetes education program.
Diabetes, Gestational ; Knowledge ; Attitude

Objectives: Gestational diabetes mellitus (GDM) is a common pregnancy complication with adverse fetal and maternal outcomes. Currently, there are only a few validated tools available that address knowledge in GDM. Recognition of the inconsistencies will provide for an effective learning program to achieve optimal results. This study aimed at validating the “Gestational Diabetes Mellitus Knowledge Questionnaire” (GDMKQ). Methodology: A cross-sectional validation study on GDMKQ among 51 GDM patients aged at least 18 years was conducted in the outpatient clinics of a tertiary hospital. Excluded were those with pre-existing diabetes. The questionnaire was submitted for peer review for translation to Filipino and back-translation. Concurrent validity, internal consistency and test-retest reliability of the questionnaire were undertaken as part of the validation process. Descriptive analysis was used for data elaboration by using SPSS v23. Results: The Filipino version of GDMKQ demonstrated sensible content and face validity. As measured, respondents obtained higher total and domain scores with better knowledge levels of GDM compared to its English version. An overall adequate knowledge was observed among those married and college subgroup as compared to single women and those with secondary level of education. The reliability of the questionnaire was calculated at 0.632 using the Kuder-Richardson 20. The test-retest scores using the Filipino-translated questionnaire has a Pearson correlation coefficient of 0.853 with moderate to good level of agreement with each other, and Cohen’s kappa of 0.564 with an intra-class correlation coefficient of 0.828. Conclusion The Filipino-translated version of GDMKQ is a valid screening tool that assesses a patient’s knowledge of gestational diabetes. Identifying the level of their understanding will enable clinicians to develop an individualized, effective learning program to improve pregnancy outcomes.
Diabetes, Gestational ; Knowledge ; Surveys and Questionnaires

The development of molecular biology help to clearly understand about pathophysiological mechanisms of diabetes mellitus are due to genetic factors and life environment. The diabetes divided up: type 1 diabetes, type 2 diabetes, and other types. In 1999, American Diabetes Association and WHO advanced a new classification, following: type A (type 1 diabetes), type B (type 2 diabetes), type C (MODY - onset in young adult), type D (diabetes at pregnancy and tolerated glucose disorders in pregnancy)
Diabetes Mellitus ; Diabetes Complications ; Molecular Biology ; Knowledge

Introduction: Knowledge, attitude, and practices among diabetes patients have been heavily studied topics in different settings. Organizations catering to diabetic patients such as community clubs play pivotal role in diabetes care and management. Objectives: This research explored the knowledge, attitudes and practices among adults living with Type 2 Diabetes Mellitus in an urban community. The objective of this study was to determine the KAP of DM patients attending a community-based DM Club. Methods: Using the DAS-3 and AACE Knowledge evaluation, this study was particularly interested in knowing the KAP of the patients in the different domains such as Nutrition, Exercise, Self-monitoring, and Treatment. Type 2 DM patients attending the community-based DM club were recruited and KAP questionnaires were administered among the 89 survey respondents. Results: The level of knowledge in each domain of AACE had a mean evaluation score of 50 and above. The results also show that majority of diabetic patients strongly believe in the need for special training in teaching, counselling and behavior change techniques among health care professionals, psycho-social impact of diabetes, and patients’ autonomy. Conclusion This research also emphasizes that a community-based diabetes club may play an important role in diabetes care and management providing patient education which may lead to increased KAP.
Diabetes Mellitus ; Knowledge ; Attitude ; Residence Characteristics

Objective: The objective of this study is to measure the level of knowledge and practice of diabetic foot self-care and determine the factors that affect the level and knowledge and practice of diabetic foot self-care among diabetic patients. Methodology: Three hundred thirty adult diabetic patients at the outpatient clinics were given self-administered questionnaires on knowledge and practice of diabetic foot self-care. The scores were computed based on their answers. A score of >70% was gauged as good, 50 to 70% as satisfactory and <50% as poor. Results: Of the subjects, 82.7% had good foot care knowledge, 22.4% had good foot self-care practice, and 71% had satisfactory practice score. Patients who received diabetes education were twice as likely to have a good knowledge score (OR 2.41, 95% CI, 1.09 to 5.32; p=0.03). Compared to patients who received diabetes care in private clinics, those who attended the charity outpatient clinic were nearly three times as likely to have a good knowledge score (OR 2.8, 95% CI, 1.32 to 5.96; p=0.007). Patients with known diabetes for more than ten years and those with a family history of diabetes were 50% less likely to have good practice scores (OR 0.50, 95% CI, 0.28 to 0.90; p=0.021 and OR 0.49, 95% CI, 0.29 to 0.83; p=0.008, respectively). Conclusion The current state of foot care knowledge in Filipino diabetic respondents is good but the level of foot self-care practice is only satisfactory.
Diabetic Foot ; Diabetes Mellitus ; Knowledge ; Self Care

Introduction: With the increasing prevalence of diabetes mellitus (DM) in the Philippines, Diabetes Self-Management Education (DSME) remains to play a vital role in diabetes care. It is important in optimizing metabolic control, preventing and managing complications, and maximizing quality of life in a cost-effective manner. This study aimed to determine the effect of diabetes education on the knowledge and attitudes of type 2 DM patients. It also aimed to determine the topics that needed more emphasis during education. Methods: A prospective study, which included 75 patients: 38 patients in the education group and 37 patients in the noneducation group, was conducted. A single session diabetes education was given to the patients in the education group. Baseline and follow-up knowledge and attitude scores by using the modified, validated, Filipino versions of American Association of Clinical Endocrinologists (AACE) Knowledge Evaluation Form and Diabetes Attitude Scale–3 (DAS–3), respectively, were compared between the education and non-education groups. The changes in weight and body mass index (BMI) for both groups were also compared. Results: Results showed that on follow-up, there was a significant increase in the mean percentage scores for knowledge in the education group. There was no significant increase in mean frequency of correct answers for questions on precautions prior to exercise, monitoring, nutrition and medication adjustment during ill days. Questions on psychosocial impact, and value of tight glucose control showed significant improvement in the education group, while one question on seriousness of diabetes did not improve significantly. Conclusion Diabetes education generally improved the knowledge and attitudes of patients towards their disease.
Knowledge ; Attitude ; Diabetes Mellitus, Type 2

BACKGROUND: The development of decision support systems for nursing has been limited by difficulties in defining and representing the nursing knowledge base and by a lack of knowledge about how nurses make decisions. However, the current trends suggest that many of the formidable technological and conceptual challenges associated with representing nursing knowledge can be overcome, and that decision support systems developed using knowledge engineering can be used to significantly improve nursing practice. OBJECTIVE: The aim of this study was to develop a diagnostic nursing decision support system for inpatients with type 2 diabetes mellitus, and to elucidate the advantages and disadvantages of applying a knowledge engineering approach to its development. METHODS: To acquire the relevant knowledge, a literature review was used to iteratively establish nursing diagnoses and clinical assessment criteria. Twenty-five NANDA diagnoses and 145 clinical assessment variables were structured into a criteria table used as the knowledge base for a prototype system. To investigate the responses of nurses to knowledge presentation, 27 nurses from inpatient and ambulatory settings and the graduate course of nursing informatics were recruited and a scenario-based preliminary evaluation was performed. RESULTS: A prototype for inpatients with type 2 diabetes mellitus was developed as a Web-based stand-alone system. It automatically generated suggested nursing problem lists based on the input data, and also provided detailed explanatory information for each item on the list. We describe the advantages and disadvantages of the development approach used and discuss the users' impressions of the system.
Diabetes Mellitus, Type 2* ; Diagnosis ; Humans ; Inpatients* ; Knowledge Bases ; Nursing Diagnosis ; Nursing Informatics ; Nursing*

OBJECTIVETo evaluate the validity and reliability of Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB).

METHODSWe selected 460 patients with diabetes in the community, used the scale which was after two rounds of the Delphi method and pilot study. Investigators surveyed the patients by the way of face to face. by draw lots, we selected 25 community diabetes randomly for repeating investigations after one week. The validity analyses included face validity, content validity, construct validity and discriminant validity. The reliability analyses included Cronbach's α coefficient, θ coefficient, Ω coefficient, split-half reliability and test-retest reliability.

RESULTSThis study distributed a total of 460 questionnaires, reclaimed 442, qualified 432. The score of the scale was 254.59 ± 28.90, the scores of the knowledge, attitude, behavior sub-scales were 82.44 ± 11.24, 63.53 ± 5.77 and 108.61 ± 17.55, respectively. It had excellent face validity and content validity. The correlation coefficient was from 0.71 to 0.91 among three sub-scales and the scale, P<0.001. The common factor cumulative variance contribution rate of the scale and three sub-scales was from 57.28% to 67.19%, which achieved more than 50% of the approved standard, there was 25 common factors, 91 items of the total 98 items held factor loading ≥0.40 in its relevant common factor, it had good construct validity. The scores of high group and low group in three sub-scales were: knowledge (91.12 ± 3.62) and (69.96 ± 11.20), attitude (68.75 ± 4.51) and (58.79 ± 4.87), behavior (129.38 ± 8.53) and (89.65 ± 11.34),mean scores of three sub-scales were apparently different, which compared between high score group and low score group, the t value were - 19.45, -16.24 and -30.29, respectively, P<0.001, and it had good discriminant validity. The Cronbach's α coefficient of the scale and three sub-scales was from 0.79 to 0.93, the θ coefficient was from 0.86 to 0.95, the Ω coefficient was from 0.90 to 0.98, split-half reliability was from 0.89 to 0.95.Test-retest reliability of the scale was 0.51;the three sub-scales was from 0.46 to 0.52, P<0.05.

CONCLUSIONThe validity and reliability of the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale are excellent, which is a suitable instrument to evaluate the self-management for patients with diabetes.

OBJECTIVETo develop a brief version scale with good validity and reliability to evaluate self-management knowledge, attitude and behavior (KAB) of diabetes patients in a shorter time.

METHODS20 authority experts who specialized in the field of diabetes clinical and non-communicable disease self-management, and familiar with the relevant content of diabetes self-management were selected. Face to face and Email consultation methods were applied in two rounds delphi expert consultations to choose items from the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB, total scale, 98 items). In the first round of expert consultation, experts were asked to select the core items from every dimension and score the extent of familiarity and basis of judgment. In the second round of expert consultation, the significance of the core items which were selected by experts in first round, were graded. The items which entered into the brief scale were determined by harmonious condition of expert opinions.

RESULTSTwo rounds of consultation reclaimed 16 and 15 responses respectively, Positive coefficients of experts were 80% and 94% respectively, and both authoritative coefficients were 0.90. In the first round of consultation, experts selected 44.3 ± 6.2 items on average, 42 items were selected according to the integrity of the scale for measuring dimension and content at last. In the second round of consultation, experts thought that the 42 items could measure the important contents of each dimension comprehensive and representative, the item importance scores of knowledge, attitude, and behavior subscale were 8.42 ± 1.17, 8.61 ± 1.24, 8.61 ± 1.02 respectively, and the coordination coefficients of the three subscale were 0.36, 0.20, 0.49 (χ(2) were 89.74, 11.13, 96.03, P<0.05). The total coordination coefficient was 0.38 (χ(2) =199.36, P<0.001), which indicated the concentration of experts(')opinion was acceptable, showed the brief scale with good face validity and content validity.

CONCLUSIONThe brief scale could evaluate Diabetes Self-management KAB Scale rapidly and relatively comprehensive in groups or individuals diabetes with good face validity and content validity.