الفهرس 
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Abstract
SUMMARY
Diabetes mellitus is a group of endocrine-metabolic disorder which characterized by elevated levels of glucose in the blood (hyperglycemia) resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels (Diabetes Care Journals, 2014).
Diabetes increases the risk for developing heart disease, stroke, blindness, neuropathy, kidney disease and amputations. The development of specific micro-vascular complications , retinopathy, which can lead to blindness, nephropathy with potential renal failure, and neuropathy. The latter carries the risk of foot ulcers and amputation and also autonomic nerve dysfunction. Diabetes is also associated with an increased risk of macro vascular disease (Richard et al ., 2010) and Shivananda et al ., (2014) .
Aim of the Study:
The aim of this study was to assess the knowledge and practices among diabetic clients regarding cardiovascular problems in a rural area, through:
Recognizing the diabetic client’s knowledge regarding diabetes mellitus and cardiovascular problems.
Assessing the diabetic client’s practices regarding cardiovascular problems by using quality of life scale.
Assessing the diabetic client’s compliance related to treatment regimen and follow up.
Summary
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Research questions:
1- Is there relation between socio-demographic characteristics of diabetic clients and their knowledge?
2- Is there relation between socio-demographic characteristics of diabetic clients and their practices by using QOL scale?
3- Is there relation between the diabetic client’s knowledge and their practices regarding cardiovascular problems by using QOL scale?
4- Is there relation between diabetic client’s compliance and their knowledge and practices regarding cardiovascular problems?
Research setting:
This study was conducted at diabetic’ outpatient clinic at Kafr El-sheikh General Hospital from May to July 2015 three days /weekly nearly about 4 hours /daily.
Sampling:
A purposive sample consists of 100 clients diagnosed with diabetes.
Tools for data collection:
The data was collected through the following tools:
First tool: An interviewing Questionnaire:
This tool was divided into four parts:
1. Part one: it was concerned with socio-demographic data as age, educational level, marital status, family size, crowding index and family income.
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2. Part two: it was concerned with clients’ past and current health history as duration of illness, symptoms, investigations, and medications.
3. Part three: it was concerned with clients’ knowledge regarding diabetes mellitus and cardiovascular problems as regard: definition of DM, its causes, signs and symptoms, early signs and symptoms of cardiovascular problems, methods of prevention, schedule of follow up related to cardiovascular problems, proper investigations, and proper screening.
4. Part four: Assessing diabetic clients’ compliance to treatment regimen and follow up.
Second tool: assessing Quality of life:
This tool adopted from )Jain, et al (2014), it was used to assess diabetic client’s practices regarding cardiovascular problems by using quality of life scale through four domains of quality of life: physical health, psychological health, social relationships, nutrition and environmental health.
Third tool: Physical Examination Sheet:
It will be developed to assess general and specific health condition of diabetic client; it includes (measurements of weight, height, respiration rate, ….etc.
Results:
The results of the present study could be summarized as following:
1. Less than three quarters of the total sample were females. And 82% of the study sample their age ranged from 45- 50 years. In educational levels the large portion were illiterate 72% in relation to 6% were secondary level.
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2. In relation to duration of diabetes almost of them, their duration of diabetes were 4:5 years period. And 54% of studied samples had family history of diabetes. And more than three quarters of the study sample’ treatd by insulin.
3. Regarding the total knowledge about diabetes more than three quarters of studied sample their knowledge were unsatisfied about diabetes. While 24% of them their knowledge were satisfied about diabetes.
4. As regard to total knowledge about diabetic cardiovascular problems almost of them, their knowledge were unsatisfied about diabetic cardiovascular problems.
5. More than half of studied sample were compliance to therapeutic regimens, and to follow up, and less than half were non-compliance.
6. In relation to diabetic client’s quality of life more than three quarters of the study sample had negative quality of life, while 22% of the study sample had Positive quality of life.
7. There was no statistical significant association between socio-demographic characteristics of diabetic clients and their knowledge and practices.
8. There was no statistically significant relation between diabetic clients’ knowledge and their practices regarding diabetic cardiovascular problems and their quality of life.
9. There was a statistically significant relation between diabetic clients’ practices to prevent cardiovascular problems and their compliance to follow up and treatment regimen, but there was no statistically significant relation with their knowledge regarding diabetic cardiovascular problems prevention and their compliance.
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Conclusion:
Based on the findings of the present study, the conclusion included that:
There was no statistical significant association between clients’ socio-demographic characteristics and their knowledge about diabetes mellitus, and their practices. Also the current study revealed that there was no statistically significant relation between diabetic clients’ knowledge and their practices regarding diabetic cardiovascular Problems and their quality of life. As well as there was a statistically significant relation between diabetic clients’ practices to prevent cardiovascular problems and their compliance to follow up and treatment regimen. But there was no statistically significant relation with their knowledge regarding diabetic cardiovascular problems prevention and their compliance.
Recommendations:
The findings of this study recomeneded that the needs for:
- In diabetic’ out patient clinic:
Periodic physical examination and screening for early identification and detection of diabetic health problems and prompt intervention.
6th monthly cardiovascular examinations are recommended for diabetic clients to prevent diabetic cardiovascular complications.
Accessibility of a specific booklet in out patients diabetic clinics that increase the diabetic clients’ knowledge and practices about diabetes and its complications, treatment compliance and regular follow up.
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- Further research about:
Continuing education program should be given for nurses close contact to diabetic clients to increase their awareness of compliance issues and familiarize them with client’s education tool that Help to reveal the gap of knowledge that needs to be reinforced.
Extensive health education and health promotion programs are recommended to prevent diabetic cardiovascular complications and life style modifications.
The factors that would affect patient compliance should be assessed and identify to the client community support services