Self Care Behaviors Relating to Nutrition among Type 2 Diabetic Patients Living in a Village of Chiangyuen District, Mahasarakham Province

Abstract

This qualitative study aimed to describe self-care behaviors relating to nutrition among 20 patients with type 2 diabetic in a village of Chiang Yuen District, Mahasarakham Province. Perception and beliefs about diabetes, self-care behavior in nutrition, and general self-care were investigated. Qualitative data were collected during March to July 2015 by using in-depth interviews and observational techniques. Data on food intake were collected through 24 hr dietary recall; and the energy and nutrient intakes were analyzed by using INMUCAL program as well as the qualitative data by content analysis and analytic induction method. As for the findings, the study subjects believed that diabetes was an untreatable disease caused by the consumption of sweet foods, genetic transmission or chemical contamination. They also understood that complications including eye disorders, foot ulcers, kidney failure and death often occurred in patients with the disease. This perception came from the health providers’s messages and the patient’s own experience. The patients who could control their blood sugar levels consumed a limited amount of sweet food and sweet fruit. Those who could not control blood sugar levels reported uncontrolled con-sumption of these foods because they thought that they had no symptoms. Neither group liked to eat fried food, and they preferred salty which were common in the Northeast region. Sticky rice was the staple food among the patients. They reported that, if they ate white rice they would not feel full. Furthermore, they did not need to buy sticky rice because it was available at home from their own farms. They did not follow their doctor’s recommendations to eat less sticky rice because it made them feel fatigued. Following the advice of neighbours and radio advertisements, they used herbal medicines and dietary supplements together with modern drugs to treat their diabetes. Their energy intake was only 50% of the Thai recommended level, and 70% of their energy intake was contributed by carbohydrate. In conclusion, the understanding of the diabetic patients about the causes and complications of diabetes was consistent with medical principles. They preferred a typical northeastern diet, and sticky rice was a staple food which is difficult to change. They used traditional medicine together with modern medicines for treatment.