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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA.
1 NAME OF THE
CANDIDATE AND
ADDRESS
Mrs. RAINA ANISITA D’SOUZA,
Ist YEAR M.Sc. NURSING STUDENT,
N.D.R.K. COLLEGE OF NURSING,
B.M. ROAD, HASSAN, KARNATAKA.
2 NAME OF THE
INSTITUTION
N.D.R.K. COLLEGE OF NURSING, B.M. ROAD,
HASSAN, KARNATAKA.
3 COURSE OF STUDY
AND SUBJECT
MASTER OF SCIENCE IN NURSING
(COMMUNITY HEALTH NURSING)
4 DATE OF ADMISSION
TO THE COURSE
07/07/2010
5 TITLE OF THE TOPIC “EFFECTIVENESS OF PLANNED TEACHING
PROGRAMME ON KNOWLEDGE OF DIABETES AND
ITS MANAGEMENT AND THE PRACTICE OF
DIABETIC DIET AMONG THE RURAL PEOPLE IN
SELECTED VILLAGES AT HASSAN, KARNATAKA.”
5.
1
STATEMENT OF THE
PROBLEM
“A STUDY TO ASSESS THE EFFECTIVENESS OF
PLANNED TEACHING PROGRAMME ON
KNOWLEDGE OF DIABETES AND ITS MANAGEMENT
AND THE PRACTICE OF DIABETIC DIET AMONG
THE RURAL PEOPLE IN SELECTED VILLAGES AT
HASSAN, KARNATAKA.”
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION.
6. BRIEF RESUME OF THE INTENDED WORK
6.1 INTRODUCTION:
“If I would have listened, if I would have understood diabetes like I understood music,
may be these things wouldn't have happened.”1
Marvin Isley
“Scientific research consists in seeing what everyone else has seen, but thinking what no
one else has thought”.2
The word diabetes is derived from the Greek word meaning to siphon and refers to the
most obvious sign of the disease – marked loss of water by urination. The word mellitus comes
from the Latin word for sweet or honey and thus differentiates diabetes mellitus (sweet urine
disease) from diabetes insipidus (bland urine disease). 3
Scientific progress in our knowledge of diabetes began in the eighteenth century with the
development of the microscope and Langerhans’s descriptions of the islets in the pancreas that
contain beta cells. The “most celebrated diabetes clinician in the world,” at that time, was
Bouchardat of France (1806-1886). He is perhaps the first to associate the pancreas with diabetes. 3
With the discovery of insulin in 1921, certain complacency settled over the diabetes world
– diabetes was “cured”. After a few years, however, it became evident that insulin treatment was
not the final answer. Insulin extended the life span, but within a few years, people with diabetes
began to go blind and die of vascular disease. Thus, the burden is put on the diabetes specialists to
educate the person who has diabetes, his or her family, the public, and other health care
professionals who care for the patients with diabetes in order to accomplish the goal of
normalizing blood glucose levels as much as safely tolerated. 3
Diabetes is not the patient – the person with diabetes is the patient. Diabetes is a disease
that affects every organ and organ system of the body; moreover, it affects and is affected by the
emotions. This requires a cadre of professionals: a team effort of the individual with diabetes, the
family and significant friends, and the family physician, the diabetes specialist, the acute care
nurse, the nurse educator, the dietitian, the psychologist, counselor, social worker, podiatrist,
physical therapist, or exercise specialists. 3
Diabetes has emerged as a major health care problem in India. According to Diabetes Atlas
published by the International Diabetes Federation (IDF), there were an estimated 40 million 2
persons with Diabetes in India in 2007 and this number is predicted to rise to almost 70 million
people by 2025.4
The countries with the largest number of Diabetic people will be India, China and USA by
2030. It is estimated that every fifth person with Diabetes will be an Indian.4
Due to these sheer numbers, the economic burden due to Diabetes in India is amongst the
highest in the world. The real burden of the disease is however due to their associated
complications which lead to increased morbidity and mortality.4
The goal of diabetes therapy should be to safely achieve normal blood glucose levels
around the clock. This goal may only be achieved with adequate education. The parents and adults
as well as the youth must learn to adjust diabetes medication and food intake to control glucose on
a 24 – hour basis. As the family adjusts to the fact that the one who has DM has a chronic
condition and as the individual adjusts to the same fact, methods must be devised to support
understanding, good judgment, self-discipline, and motivation in order to obtain optimum health. 3
We have always believed that control of diabetes has been and is important in the
prevention of both acute and chronic complications. Data from the Diabetes Control and
Complications Trial study (DCCT, 1993) and studies carried out in other countries have confirmed
this belief. They also have found that education of the person with diabetes is a vital part of the
control program. 3
WHO estimates that mortality from diabetes, heart disease and stroke costs about $210
billion in India in the year 2005. Much of the heart disease and stroke in these estimates was linked
to diabetes. WHO estimates that diabetes, heart disease and stroke together will cost about $ 333.6
billion over the next 10 years in India alone. 4
Therefore let all of us join together in wishing that diabetes may soon be cured and, even
better prevented, so that one day this need will become unnecessary. Until that time, we hope that
our efforts through the care we give will assist those who are afflicted with this chronic problem,
those who care for them professionally, and those they are close to, family and friends alike.
6.2. NEED FOR THE STUDY:
3
Diabetes Mellitus is recognized as an important problem both nationally and worldwide.
Our specific understanding of the spectrum of health effects of DM has increased and numerous
studies are finding important heath complications from DM at levels once considered safe. Youth
and adults are the most susceptible to DM.
As per King (1998) prevalence of Diabetes in India will increase by 195% in 2025 and
majority of sufferers will be young adults.5
Diabetes is growing; prevalence of diabetes in the world is about 170 millions and is
growing rapidly. In fact International Diabetic Federation (IDF) has claimed epidemic status for
diabetes. 6
It is estimated that India has around 40 million diabetic persons at present. It is supposed to
double by 2030. It is true for type 2 diabetes that it is genetically transmitted and also it depends on
diet and lifestyle. 6
It is estimated that 80% of type 2 diabetes can be prevented or postponed for several years.
Exercise, lifestyle management, diet and drugs to some extent prevent type 2 diabetes. There is a
25% risk of getting diabetes if one parent is diabetic. The risk increases, if both parents are diabetic
the risk increases with obesity, and sedentary lifestyle. 6
The disease is affecting at an alarming rate to both rural and urban population in India. 5
The first systematic nation-wide study in India was performed by the Indian Council of
Medical Research Task Force on Diabetes. Population sampling in urban areas was based on
stratified random design and in rural areas on clustered sampling. In large cities in North and
South India (i.e. Chennai, Trivandrum, Mumbai, Delhi, Jaipur and Gauhati), Diabetes prevalence
among adults (more than 20 yrs) had ranged from 8 – 15%.5
The prevalence of Diabetes was more on Southern parts of the country and was least in
Eastern parts. 5
The increased prevalence of Diabetes in India has a lot to do with a switch from the Diet,
Lifestyle patterns and Cultural mix. 5
4
According to Diabetes Atlas of 2007, an estimated 40 million persons were diabetic in
India and this number would touch 70 million by 2025. Yet, India had no institution to tackle all
disorders related to diabetes under one roof, till Karnataka decided to take the first step. 7
The Diabetes Awareness Survey in Hyderabad (DASH) study conducted in twin cities has
recently pointed out that Diabetes Prevalence levels have grown significantly from 16.6% as per
Natural Urban Diabetes Survey (NUDS) of 2001. Exact reason is not yet ascertained. The DASH
study revealed nearly 43% of Hyderabad population was unaware of a condition called Diabetes &
65% did not know that Diabetes could affect the eyes, which could lead to decreased sight. 5
A study was conducted to estimate the Global prevalence of diabetes and the number of
people of all ages with diabetes for years 2000 and 2030. The result showed that the prevalence of
diabetes for all are-groups worldwide was estimated to be 2.8% in 2000 and 4.4% in 2030. The
total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in
2030. These findings indicate that the “diabetes epidemic” will continue even if levels of obesity
remain constant. 8
The number of people with diabetes is increasing due to population growth, aging,
urbanization, and increasing prevalence of obesity and physical inactivity. Quantifying the
prevalence of diabetes and the number of people affected by diabetes, now and in the future, is
important to allow rational planning and allocation of resources. 8
Exact cause of increased prevalence of diabetes in persons of indian origin is unknown.
Nature and nurture both may have a role. 5
So, I have taken up the nurture aspect for preventing the further increase in the percentage
of diabetes by trying to improve the knowledge and practice of people of hassan who are also a
part of India.
6.3 STATEMENT OF PROBLEM:
5
“A study to assess the effectiveness of Planned Teaching Programme on
Knowledge of Diabetes and its Management and the Practice of Diabetic Diet among the
rural people in selected villages at Hassan, Karnataka.”
6.4 OBJECTIVES OF THE STUDY:
1. To assess the knowledge of Diabetic clients regarding Diabetes & its management before
administration of Planned Teaching Programme among the rural people of Hassan.
2. To assess the Practice pattern of Diabetic diet among the rural Diabetic clients.
3. To develop and administer Planned Teaching Programme regarding Diabetes and its
management (Dietary and Pharmacological).
4. To assess the knowledge of Diabetic clients on Diabetes & its Management after
administration of Planned Teaching Programme among the rural people of Hassan.
5. To evaluate the effectiveness of Planned Teaching Programme on knowledge of Diabetes
and its management among diabetic clients of rural villages at Hassan.
6. To associate the post-test knowledge score of diabetic clients with selected socio-
demographic data.
6.5 HYPOTHESIS:
6
1. NULL HYPOTHESIS:
H1: There will not be a significant difference between the pre-test and post-test
knowledge scores of diabetic clients who have received the Planned Teaching Programme
on Diabetes and its Management.
H2: There will not be a significant difference in the dietary habits after administration of
Planned Teaching Programme on Diabetes and its Management.
2. RESEARCH HYPOTHESIS:
H1: There will be a significant difference between the pre – test and post – test knowledge
scores of diabetic clients who have received the Planned Teaching Programme on Diabetes
and its Management.
H2: There will be significant association between selected socio-demographic variables
and the post – test knowledge of diabetic clients regarding Diabetes and its Management.
6.6 ASSUMPTIONS:
1. The rural people of Hassan have lack of knowledge regarding Diabetes.
2. The rural people of Hassan have lack of knowledge regarding management of Diabetes,
specially the dietary pattern.
3. Lack of knowledge may progress their condition which may give rise to complications.
4. This study will improve the knowledge of diabetic clients regarding Diabetes and its
management (Diet and Pharmacological).
5. The study will improve the knowledge of diabetic clients regarding different aspects of
Diabetes such as definition, etiology, risk factors, signs & symptoms, management and
practice of diabetic diet.
6.7 OPERATIONAL DEFINITIONS:
7
1. EFFECTIVNESS:
It refers to significant increase in the level of knowledge and practice of diabetic clients
regarding Diabetes, its management and diet which is measured from the response of pre-test,
Planned Teaching Programme and post-test.
2. PLANNED TEACHING PROGRAMME:
It refers to systematically organized instructions and discussions of Diabetes and its
Management - Meaning, causes, etiology, clinical manifestation, management (diet, drug and
exercise), complication and follow up.
3. KNOWLEDGE:
It refers to the correct responses from diabetic clients regarding various aspects of Diabetes
Mellitus like - Meaning, causes, etiology, clinical manifestation, management (diet, drug, exercise)
complication and follow up.
4. DIABETES:
Diabetes Mellitus is a syndrome as opposed to a single disease. It is characterized by a
chronic state of hyperglycemia (raised blood glucose levels). This is due either to insufficient
insulin or inadequate action of insulin. The syndrome results in the disorder of the metabolism of
carbohydrates, proteins and fat. The overall long-term effect is degenerative changes in all blood
vessels.22
5. MANAGEMENT:
Refers to various measures of managing Diabetes by dietary modification, drug, exercise,
regular follow up and identification of complications.
6. PRACTICE:
It refers to habits or custom regarding diet mainly of diabetic clients which they are
following; the dietary modifications for Diabetes.
7. DIABETIC DIET:
8
Diabetic diet is the modification of dietary pattern in the Diabetic clients in order to
regulate or control the sugar level.
8. RURAL PEOPLE:
People living in villages mainly depending on agriculture and other allied occupations; and
for the study purpose, the people who have been affected with Diabetes and those who are residing
in the rural area (Boovanahalli, Kanahavalli, Onnenahalli, Dodda Gangiri & Chikka Gangiri)
6.8 CRITERIA FOR SAMPLE SELECTION:
a) Inclusion criteria:
1. Diabetic clients of selected villages at Hassan.
2. Diabetic clients who are present at the time of study.
b) Exclusion criteria:
1. People in villages those who do not have Diabetes.
2. Diabetic clients who are not present at the time of study.
6.9 LIMITATIONS OF THE STUDY:
Study is limited to
Diabetic clients of selected rural areas, Hassan.
A period of 4 -6 weeks.
Sample size is limited to 50 diabetic clients of selected rural areas, Hassan.
6.10 SIGNIFICANCE OF THE STUDY:
9
This study signifies the importance of Planned Teaching Programme on the knowledge of
diabetic clients regarding Diabetes and its Management. And it also paves the way for diabetic
clients to gain knowledge on Diabetic diet as the study implies the practice of the dietary pattern.
“A well planned work is half done,” so if the people are given an education regarding the
Diabetes and its Management, I think they will try to improve their health by dietary modification,
drug intake and by knowing the signs and symptoms and complications in order to lead a healthy
life.
6.11 CONCEPTUAL FRAME WORK:
Conceptual frame work is based on the “Nalo.J, Pender’s health promotion model”.
6.12 REVIEW OF LITERATURE:
Review of literature is a key step in research process. Review of literature refers to an
extensive, exhaustive and systematic examination of publications relevant to the research
project .Before any research can be started whether it is a single study or an extended project,
literature reviews of previous studies and experiences related to proposed investigations should be
done. One of the most satisfying aspects of the literature review is the contribution it makes to the
new knowledge, insight and general scholarship of the researcher.
A study was conducted by Suzanne Bennett Johnson, R. Timothy Pollak of University of
Florida Health Center, Gainesville (Mar 16, 1981) to assess the knowledge among young adults
about insulin-dependent diabetes. RESULT: More than 80% of young adults made significant
errors on urine testing & almost 40% made serious errors in self-injection. A number of other
knowledge deficits were also noted.9
A study was conducted on 20 May 2002, with objective of to assess whether Diabetes
Mellitus knowledge is related to prior attendances at Diabetes education programme, visits to
dieticians or the current use of Self Monitoring Blood Glucose (SMBG) in a community based
subjects with type 2 DM. METHODS: Subjects answered 15 standard MCQ about Diabetes & its 10
management. RESULTS: Attendance at education programme, visits to dieticians & SMBG were
independently associated with greater diabetes knowledge. CONCLUSION: Study concluded that
Diabetes education programme, dietetic advice, SMBG are associated with and may be important
sources of improved Diabetes knowledge in patients with type 2 DM. 10
A study was conducted on 15TH June 2010 by a team of Kasturba Medical College, Manipal
in Coastal Karnataka to estimate the prevalence of diabetes among adults aged 30 yrs and above.
This study suggests that Muslims living in Coastal Karnataka are at a higher risk of developing
diabetes and identified increasing age, Muslims, a skilled or professional job, sedentary lifestyle,
positive family history of diabetes, history of current hypertension, and being overweight or obese
as having significant indicators for being diabetic. This study did not offer any explanation for its
findings. 11
A study was conducted on Clinical Characteristics of Type 2 Diabetes Patients according to
Family History of Diabetes by Department of Internal Medicine, Jeju National University
Hospital, Korea. This study is cross – sectional involving 621 T2DM patients. Among the total 651
patients, 38.4% had a family history of diabetes. The study concluded that in T2DM patients with a
family history of diabetes, the disease tended to develop earlier. 12
A study was conducted on Self Management Education for Adults with Type 2 Diabetes by
Susan L. N, Joseph Lau, S. Jay smith. The objective was to evaluate the efficacy of self –
management education on GHb in adults with Type 2 diabetes. A total of 31 studies of 463
initially identified articles met selection criteria. On average the intervention decrease GHb by
0.76% more than the control group at immediate follow up, by 0.26% at 1 – 3 months follow up,
and by 0.26% at >= 4 months of follow up. GHb deceased more with additional contact time
between participant and educator. The study concluded that self – management education improves
GHb levels at immediate follow – up, and increased contact time increases the effects. 13
A study was conducted on Interventions to Improve the Management of Diabetes in
Primary Care, Outpatient, and Community Settings. Standard search methods of the Cochrane
Effective Practice and Organization of Care Group were used. A total of 41 studies met the
inclusion criteria. Complex professional interventions improved the process of care, regular review
of patients by the organizations showed a favorable effect on process measures, and the enhanced
role of a nurse led to improvements in patient outcomes. 14
11
A study was conducted on 24th Dec 2001 to study factors such as sex, educational status
and place of care, which might influence knowledge and self – management of diabetes, and
glycaemic control in a Pakistani Moslem diabetic population attending primary care general
practices and secondary care clinics at the Manchester Diabetes Center (MDC). Patients took part
in a one–to–one semi–structured interview. 201 patients entered the study, knowledge about
diabetic diet was good (72%), patients claimed to perform regular glucose measurements (66%),
but they were not good at applying their knowledge to problems in daily life. It concluded that
women who can not read in this population are likely to have poorer glycaemic control and may be
finding it more difficult to learn how to apply their knowledge to daily life. 15
As part of the evaluation of diabetes services in Central Manchester, 243 patients attending
the traditional diabetic clinic at the Manchester Royal Infirmary were randomly selected to
complete knowledge questionnaire. 160 patients gave response rate of 63%. The mean knowledge
score in insulin–treated patients was significantly higher than in non insulin–treated patients.
Knowledge of dietary management was generally poor, and half of the patients were unaware of
the link between glycaemic control and long term complications. It was particularly worrying that
32% of insulin–treated patients were unaware that they should continue to take their insulin when
ill. 16
A study was conducted to study the demographic details of diabetes patients and their
knowledge, attitude and practices (KAP) regarding diabetes in Nepal. The KAP of the diabetes
patients visiting the Manipal Teaching Hospital (MTH) during the period from 22nd Aug to 7th Dec
2006 were studied by using the KAP questionnaire developed by the researchers. 182 patients were
enrolled in the study. Knowledge score was 4.90; attitude 2.03 and practice 0.84. The study
concluded that the KAP scores of the patients were low. 17
A study was conducted by Devin .M. Mann, Diego Ponieman, Howard Leventhal,
Ethan .A. Halm to determine diabetic patients' knowledge and beliefs about the disease and
medications that could hinder optimal disease management. A cross-sectional survey of 151 type 2
diabetic patients characterizing diabetes knowledge and beliefs about the disease and medications
was conducted. Over half of the patients (56%) believed that normal glucose is ≤200 mg/dl, 54%
reported being able to feel when blood glucose levels are high, 36% thought that they will not
always have diabetes, 29% thought that their doctor will cure them of diabetes, one in four (23%)
said there is no need to take diabetes medications when glucose levels are normal, and 12% 12
believed they have diabetes only when glucose levels are high. The study concluded that diabetes
knowledge and beliefs inconsistent with a chronic disease model of diabetes were prevalent in this
sample. 18
A study was conducted to explore the relationship among health literacy, patients' readiness
to take health actions, and diabetes knowledge among individuals with type 2 diabetes. Sixty-eight
patients with type 2 diabetes receiving care in an academic general internal medicine clinic were
administered the Rapid Estimate of Adult Literacy in Medicine (REALM) literacy instrument.
After controlling for other covariates of interest, no significant association between DHBM scale
score and REALM literacy level was found (P = .29). However, both DKT score and most recent
hemoglobin A1Clevel were found to be significantly associated with patient literacy (P = .004 and
P = .02, respectively). Low health literacy is a problem faced by many patients that affects their
ability to navigate the health care system and manage their chronic illnesses. The study concluded
that while low health literacy was significantly associated with worse glycemic control and poorer
disease knowledge in patients with type 2 diabetes, there was no significant relationship with their
readiness to take action in disease management. 19
A study was conducted to describe diet and exercise practices from a nationally
representative sample of U.S. adults with type 2 diabetes by Karin M. Nelson, Gayle Reiber and
Edward J. Boyko. They analyzed data from 1,480 adults older than 17 years with a self-reported
diagnosis of type 2 diabetes. Fruit and vegetable consumption was obtained from a food frequency
questionnaire; the percentages of total calories from fat and saturated fat were obtained from a 24-
h food recall. Physical activity was based on self report during the month before the survey. Of
individuals with type 2 diabetes, 31% reported no regular physical activity and another 38%
reported less than recommended levels of physical activity. Sixty-two percent of respondents ate
fewer than five servings of fruits and vegetables per day. Almost two thirds of the respondents
consumed >30% of their daily calories from fat and >10% of total calories from saturated fat. The
study concluded that the majority of individuals with type 2 diabetes were overweight, did not
engage in recommended levels of physical activity, and did not follow dietary guidelines for fat
and fruit and vegetable consumption. Additional measures are needed to encourage regular
physical activity and improve dietary habits in this population. 20
A study was conducted to know whether type 2diabetes can be prevented by interventions
that affect the lifestyles of subjects at high risk for the disease. We randomly assigned 522 middle-
13
aged, overweight subjects (172 men and 350 women; mean age, 55 years; mean body-mass index
[weight in kilograms divided by the square of the height in meters], 31) with impaired glucose
tolerance to either the intervention group or the control group. Each subject in the intervention
group received individualized counseling aimed at reducing weight, total intake of fat, and intake
of saturated fat and increasing intake of fiber and physical activity. The mean (±SD) amount of
weight lost between base line and the end of year 1 was 4.2±5.1 kg in the intervention group and
0.8±3.7 kg in the control group; the net loss by the end of year 2 was 3.5±5.5 kg in the intervention
group and 0.8±4.4 kg in the control group (P<0.001 for both comparisons between the groups).
The cumulative incidence of diabetes after four years was 11 percent (95 percent confidence
interval, 6 to 15 percent) in the intervention group and 23 percent (95 percent confidence interval,
17 to 29 percent) in the control group. During the trial, the risk of diabetes was reduced by 58
percent (P<0.001) in the intervention group. The reduction in the incidence of diabetes was
directly associated with changes in lifestyle. The study concluded that Type 2 diabetes can be
prevented by changes in the lifestyles of high-risk subjects. 21
7. MATERIAL AND METHODS OF STUDY:
7.1 SOURCES OF DATA:
The data will be collected from the diabetic clients from selected villages (Boovanahalli,
Kanahavalli, Onnenahalli, Dodda Gangiri & Chikka gangiri) under Shantigrama P.H.C at Hassan,
Karnataka.
7.2 METHOD OF DATA COLLECTION:
1. Research design: Pre – experimental single group pre-test post-test design is planned for the
research study.
Schematic plan of the study:-
14
Group Pretest Intervention Post-test
A group of 50 diabetic clients of
selected rural areas of Hassan.
O1 X O2
Key:-
O1= Pretest knowledge of diabetic clients regarding Diabetes and its Management.
X = Planned Teaching Programme on Diabetes and its Management.
O2 = Post test knowledge of diabetic clients regarding Diabetes and its Management.
2. Research setting: The setting selected for study is rural areas (Boovanahalli, Kanahavalli,
Onnenahalli, Dodda Gangiri & Chikka gangiri) under Shanthigrama P.H.C of Hassan, Karnataka.
3. Accessible Population: People at rural areas.
4. Target Population: Diabetic clients.
5. Sample: Sample will be screened for Diabetes; or will know cases of Diabetes Mellitus with
records.
6. Sample size: 50 diabetic clients in selected villages at Hassan, Karnataka.
7. Sampling technique: Convenient sampling technique will be used for the study.
8. Collection of data: - Data will be collected by using structured questionnaires regarding the
knowledge of Diabetes and its Management.
8. VARIABLES:
15
Independent variable:
Planned Teaching Programme regarding knowledge of Diabetes and its Management.
Dependent variable:
Knowledge of Diabetic clients on Diabetes and its Management and check list on
practice of Diabetic diet.
9. PLAN FOR DATA ANALYSIS:
Descriptive statistics
Descriptive statistics include percentage, frequency, mean and standard deviation.
Inferential statistics
It include paired ‘t-test’ with chi - square test and “ANOVA” “f” test for the assessment of
knowledge and to associate the socio demographic variable is planned .
10. PILOT STUDY:
10% of sample size is planned for the pilot study.
11. ETHICAL CONSIDERATION:
1. Does the study require any intervention to be conducted on diabetic clients?
Yes
2. Has ethical clearance been obtained from your institution?
16
Yes
3. Has the consent been taken from P.H.C?
Yes
12. LIST OF REFERENCES (VANCOUVER STYLE)
1. www.brainyquote.com/quotes/keywords/d...
2. www.entplaza.com/quotes-poems/research/
3. www.springerpub.com/samples/978082611...
4. www.expresshealthcare.in/200808/diabe...
5.Kamla-Raj, Analava Mitra, B.C. Roy Tech Hospital & Adjunct Faculty, School of Medical
Science and Technology, Indian Institute of Technology,“Anti-diabetic Uses of Some Common
Herbs in Tribal Belts of Midnapur (West) District of Bengal” 2007 Ethno-Med.,1(1): 37-45 (2007)
6 Karnataka Institute of Diabetology, info@kidbangalore.in.
7.Sunitha Rao. R , Karnataka Institute of Diabetology, “Prevelence of diabetes”, Bangalore, Jan
16,2009
8.Wild S, Roglic G, Green A, Sicree R, King H, Public Health Sciences, University of Edinburgh,
Edinburgh, Scotland “Global prevalence of diabetes: estimates for the year 2000 and projections
for 2030” Diabetes Care, 2004 May;27(5):1047-53
9.Suzanne Bennett Johnson, R. Timothy Pollak , Janet H. Silverstein, Arlan L. Rosenbloom ,
Rebecca Spillar , Martha McCallum, Jill Harkavy, Departments of Psychiatry, Pediatrics, and
Clinical Psychology, University of Florida Health Center, Gainesville “Cognitive and Behavioral
17
Knowledge About Insulin-Dependent Diabetes Among Children and Parents”, PEDIATRICS Vol.
69 No. 6 June 1982, pp. 708-713
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and knowledge in patients with type 2 diabetes from the community: The Fremantle Diabetes
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11. TCN NEWS, “Study in coastal Karnataka finds Muslims at higher for Diabetes” JUNE-15
2010.
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literacy skills, known diabetic complications and place of care on diabetic knowledge, reported
self-monitoring management and glycaemic control” Diabetic Medicine
Volume 16 , Issue 7 , pages 591–597, July 1999
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16. A MORAN, C HESSETT, J POOLEY, DR A J M BOULTON,
“An assessment of patients’ knowledge of Diabetes, its management and complications” Practical
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17. Dinesh K Upadhyay, Subish Palaian, P Ravi Shankar,
Pranaya Mishra, Departments of Hospital and Clinical Pharmacy and Department
Of Pharmacology, Manipal Teaching Hospital / Manipal College of Medical Sciences
Pokhara, Nepal, “Knowledge, Attitude and Practice about Diabetes
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19. Caroline K, Center for Health Disparities Research. Powell, Elizabeth G.Hill, Dawn E.
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January/February 2007 vol. 33 no.1 144-151.
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Type 2 Diabetes”Third National Health and Nutrition Examination Survey (NHANES III)
Diabetes Care October 2002 vol. 25 no. 10 1722-1728
21. Jaakko Tuomilehto, Jaana Lindström, Johan G. Eriksson, Timo T.Valle, Helena Hämäläinen,
Pirjo Ilanne-Parikka, et al “Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among
Subjects with Impaired Glucose Tolerance” N Engl J Med 2001; 344:1343-1350May 3, 2001
19
22. Lullian.S.Brunner, Doris.S.Suddarth: Textbook of adult nursing, 1st edition, published by
Chapman & Hall (1992) page no. 620.
13 Signature of the candidate
14 Remarks of the guide
15 Name and designation
15.1 Guide
15.2 Signature
15.3 Co-guide
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15.4 Signature
15.5 Head of the department
15.6 Signature
16 Remarks of principal
16.1 Signature
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