Majda Sebbani

Psychometric Properties of a Moroccan Version of the Summary of Diabetes Self-Care Activities Measure

Background. The Summary of Diabetes Self-Care Activities (SDSCA) is a widely used self-report measure for diabetes self-management. It is an interesting tool for practice and research. Objectives. To translate and culturally adapt the SDSCA to the Moroccan context and to assess psychometric properties of the adapted version among type 2 diabetic patients. Methods. The Moroccan version was obtained following forward and backward translations. An expert panel issued a final version. The adapted version was administered to patients aged 30 years and older who have type 2 diabetes. Psychometric evaluation consisted of assessing validity through internal consistency (Cronbachs alpha, item-to-scale and interitem correlations) and exploratory factor analysis and reproducibility (test-retest reliability). Results. Seventy-five participants were included. Cronbachs alpha ranged from 0.20 (diet) to 0.99 (exercise). Moderate to good interitem and item-to-scale correlations were found. Factor analysis resulted in a Moroccan SDSCA version consisting of 8 items, organized in four subscales that explained 89.6% of the variance: diet, exercise, blood sugar testing, and foot-care. Intraclass correlations ranged from 0.27 to 0.52 for subscales. Conclusion. This study provides preliminary evidence for suitability of use of the Moroccan SDSCA among type 2 diabetic patients in order to assess diabetes self-management.

Short-term effectiveness of a culturally tailored educational intervention on foot self-care among type 2 diabetes patients in Morocco

Background Self-management education (SME) is an important yet unacknowledged aspect of diabetes care. Despite the raise of diabetes and its complications with significant burden in developing countries, research on SME interventions in Morocco is lacking. Aims To assess the effectiveness of a culturally tailored SME intervention on foot-care self-management practices among type 2 diabetes patients and to identify factors associated with practices variation. Methods We designed a pre-post prospective quasi-experimental study and recruited patients with type 2 diabetes aged 30 years old or above. The intervention consisted of an interactive group discussion using different materials: a narrative video, a PowerPoint presentation and a printed guide. Foot-care practices were assessed prior to the session and one month later using 2 items from the Summary of Diabetes Self-Care Activities (SDSCA). Binary logistic regression was performed to identify factors associated with a favorable variation, defined as an increase in the mean frequency score of foot-care by a minimum of 1 day/week. Results A total of 199 participants were recruited and 133 completed the second assessment. Mean age was 55.2 ± 11.2 years old. Women represented 67% and 72% of participants was illiterate. The foot-care score mean increased from 3.5 ± 2.9 days to 5.9 ± 1.8 days one month after the intervention (mean variation was 2.4 ± 3.1 days; p < 0.001). A favorable variation was found among 75 (37.7%) participants. In multivariate analysis, literacy was associated with higher likelihood of a favorable variation of foot-care practices (OR = 2.82; 95%CI: 1.09–7.31) while previous education about diabetic foot was associated with lower likelihood of a favorable variation (OR = 0.26; 95%CI: 0.08–0.78). Conclusions There was a general improvement in foot-care practices after the intervention. Our findings suggest the role of literacy and previous patient education in shaping the observed variation. Culturally tailored interventions targeting other disease management domains are needed in our context.

P120: Aspects qualitatifs et quantitatifs de l’apport alimentaire chez les diabétiques de type 2 jeuneurs et non jeuneurs durant le Ramadan

Introduction et but de l’etude Durant le mois de Ramadan, les musulmans s’abstiennent de manger et de boire depuis le lever jusqu’au coucher du soleil ; le jeune diurne s’accompagne de changements majeurs dans les habitudes alimentaires et l’activite physique chez les diabetiques jeuneurs et non jeuneurs. La presente etude transversale visait a evaluer les apports alimentaires journaliers chez les diabetiques de type 2 consultant au CHU Mohamed VI de Marrakech pendant le ramadan en 2010 Materiel et methodes Il s’agit d’une etude transversale a visee descriptive. Les donnees sociodemographiques et cliniques ont ete collectees lors d’entretiens. L’appreciation des apports alimentaires qualitatifs et quantitatifs, basee sur les tables nutritionnelles francaises, a ete effectuee par une dieteticienne. Resultats et Analyse statistique Sur les 71 patients inclus, 55 % observaient le jeune. La moyenne d’âge des participants etait de 56,3 ans (ET 11,2). Il n’y avait pas de differences cliniques statistiquement signi catives entre le groupe des jeuneurs et celui des non-jeuneurs, sauf pour le surpoids/l’obesite et l’insulinorequerance qui etaient plus frequents chez les non-jeuneurs. L’apport calorique total journalier etait signi cativement plus bas chez les jeuneurs que chez les non-jeuneurs (1 447,5 [ET 756,3] kcal/j contre 1 919,0 [ET 823,4] kcal/j), de meme que l’apport en glucides, lipides et protides. L’apport en glucides representait 57 % et 56 % de l’apport calorique total. Conclusion Globalement, le regime alimentaire des jeuneurs durant le ramadan etait hypocalorique et inadequat alors que celui des non-jeuneurs etait excessif, les exposant au risque de complications, d’ou la necessite d’une education nutritionnelle du patient diabetique adaptee a ce mois.