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Ethnic and Gender Differences in the Relationship between Psychological, Socio-cognitive and Socio-demographic Variables in People with Diabetes Mellitus in Nigeria

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David, Onyekachi P. (2017) Ethnic and Gender Differences in the Relationship between Psychological, Socio-cognitive and Socio-demographic Variables in People with Diabetes Mellitus in Nigeria. PhD thesis, University of Gloucestershire.

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Abstract

Background: Diabetes is a growing public health problem affecting people worldwide both in the developed and developing countries, and poses a major socio-economic, psychological and Behavioral challenge. Consequently, diabetes takes a staggering toll on the people in Nigeria and the economic burden is very high. It is a well known fact that numerous factors influence diabetes self-care: such as patient’s physical, psychological, social, cognitive and health care system factors. In this study, the researcher set out to elicit an understanding of the association between socio-demographic, socio-cognitive, and psychological health and to specifically provide explanations for how these three factors are related and differ across ethnicity, gender and type of diabetes. Conversely, studies investigating the psychological health in people with diabetes have observed disparities in terms of gender, ethnicity and the type of diabetes. More so, the impact of socio-cognitive health indicators on psychological status in the Nigerian context remains invisible and unknown. Additional investigations were carried out to assess the pattern of the psychological health of diabetic patients using socio-demographic and socio-cognitive factors, to identify if differences occur in the psychological and socio-cognitive factors by gender, ethnicity and type of diabetes. Finally, an exploration of the contextual and explanatory factors perceived to have underlain the gender ethnicity and type of diabetes differences observed in the psychological status and socio- cognitive health was carried out. Methods: A sequential explanatory mixed methods design comprising a quantitative phase followed by a qualitative phase was employed. In the quantitative phase general survey, data from the N= 486 participants were analysed to test for significant differences of ethnic groups, gender, type of diabetes and the relationship they all have on psychological status and socio-cognitive health. The qualitative phase on the other hand, was based on a follow up of the significant results by using semi-structured focus group interviews with 18 recruited respondents across gender, ethnic groups and type of diabetes. Findings: A 2x4x2 MANOVA hypotheses: 2 and 3 from the quantitative study showed a significant interaction between gender, ethnicity and type of diabetes; ethnicity and type of diabetes; gender and type of diabetes; gender and ethnicity. From the partial eta squared 2 , type of diabetes explains more of the variance remaining (after excluding the variance attributable to other variables) (21.4% vs 20.1%); than gender (21.1% vs 13.3%); which, in turn, explains more of the variance than ethnicity (5.6% vs 6.5%) on the combined DVs Psychological and Socio-cognitive health respectively. The qualitative results revealed extreme and overwhelmingchallenges diabetes imposed on the sufferers. It provided specific insight and on patients contextual experiences such as non-adherence; concerns about the present and the future’ health care systems and the way medical practitioners interact with patients which negatively impact on psychological status. These factors broadened the quantitative result in terms of the consistence in the patients’ descriptions of living with and self-managing their diabetes. Conclusions: The outcome of the t study has extended knowledge on the complex and dynamic nature of individuals’ responses to the challenges of diabetes in day-to-day self-care management and how best diabetic patients should be supported in order to promote adherence, positive treatment processes, provide assistance to the physical discomfort associated with diabetes, and support pro-diabetes coping behaviors (diet), through psychotherapy so as to enhance optimal psycho-behavioral health.

Item Type:

Thesis (PhD)

Thesis Advisors:

Thesis Advisor	Email	URL
Catherwood, Dianne	dcatherwood@glos.ac.uk	https://www.glos.ac.uk/staff/profile/dianne-catherwood/
Edgar, Graham	gedgar@glos.ac.uk	https://www.glos.ac.uk/staff/profile/graham-edgar/
Taiwo, Abigail	ataiwo@glos.ac.uk	UNSPECIFIED