A quality improvement project to improve diabetes self-management and patient satisfaction in a low-resourced central Kenyan hospital

Abstract

Background: There is limited evidence about effective strategies for promoting culturally congruent diabetes education in low-resourced primary-care settings. Objectives: This project, conducted in Central Kenya, examined the effect of an intervention on provider practices and patients’ knowledge of diabetes self-care management. Methods: The intervention consisted of short (30-minute) sessions that offered providers evidenced-based, culturally con- gruent diabetes education and teaching materials to use with patients. A checklist was used to assess providers’ diabetes care practices at baseline and post intervention. Data from semi-structured patient interviews assessed patients’ diabetes knowledge at baseline and post intervention. Providers and patients also completed post-intervention satisfaction surveys. Results: Six providers and 74 patients participated in the project. Statistical analysis was completed using SPSS. Significant increases were noted in patients’ post-intervention overall diabetes knowledge score (p=.05) and the foot care knowledge subscale (p=.02). No significant differences were noted between patients’ baseline and post-intervention scores in the gen- eral diabetes (p=.86) or nutrition knowledge (p=.32) subscales. Conclusion: These findings suggest supporting providers with culturally congruent tools and resources about diabetes care guidelines can improve knowledge of self-care practices in patients with diabetes. Keywords: Type II diabetes mellitus; foot care; diabetes self-care; diabetes education; culturally congruent; Swahili; Kikuyu; central Kenya.