PSYCHOSOCIAL BURDEN ON SUFFERERS OF DIABETES MELLITUS IN THE TAMALE METROPOLIS

Abstract

Introduction: Diabetes as a cause of disease burden has increased over time. Whiles many work has been done on the psychosocial burden it poses, little is done about it in Ghana and the African region as a whole. The objective of this study was to determine the psychosocial burden of diabetes on its sufferers in the Tamale metropolis. Methods: This cross sectional study was carried out in May 2014 on 293 participants at the 3 main government hospitals in the Tamale metropolis that provides routine diabetic clinics. Questionnaires were used to collect data on the financial, social, medical, emotional and psychological burden they face that affect their quality of life. Psychological burden was assessed using Patient Health Questionnaire 9 (PHQ 9). A binary logistics regression was used to analyse for strength of associations between the dependent (depressive symptoms) and independent variables (socio economic status) obtained whiles a multinomial logistic regression was used to derive significant predictors for psychosocial burden. Results: From the analysis 37.9% had out-of-pocket expenses every month for needed medication, 12.6% had moderately severe depression, 65% had comorbid chronic conditions and 17.7% had complications resulting from diabetes. Individuals in informal employment were 17 times more likely to be burdened by depressive symptoms compared with those in the formal sector (aOR=17.0; 95% CI: 1.7-177.6; P=0.017). Respondents who did not know how they got the disease were less likely to default in their clinic attendance (OR=O.4; 95%CI=-0.2-O.7; P=0.005) compared to those that had an idea of how they got the disease, whiles at the same time respondents who did not know how they got the disease were 8 times more likely to be burdened by depressive symptoms compared with those who could tell how they got the condition (aOR=8.0; 95%CI: 1.9-32.8; P=0.004). Respondents without family history of the disease were 4.5 times more likely to express depressive symptoms compared to those without it (aOR=4.5; 95% CI: 1.0-20.1; P= 0.049). While 73.4% of respondents believed the disease was God given, 93.5% of respondents believed in religious coping. Patients' had a variety of social, spiritual and environmental perceptions of how they had the disease which influenced their coping strategies. Conclusion: Analysis showed respondents in the informal sector, poor social support and no personal glucometers were significant predictors of the psychosocial burden of diabetes mellitus in the metropolis. Informed education and collaboration between patients and health care professionals will help improve psychosocial outcomes.