Ramesh Venkatesaperumal

Women’s well-being and reproductive health in Indian mining community: need for empowerment

This paper is a qualitative study of women’s well-being and reproductive health status among married women in mining communities in India. An exploratory qualitative research design was conducted using purposive sampling among 40 selected married women in a rural Indian mining community. Ethical permission was obtained from Goa University. A semi-structured indepth interview guide was used to gather women’s experiences and perceptions regarding well-being and reproductive health in 2010. These interviews were audiotaped, transcribed, verified, coded and then analyzed using qualitative content analysis. Early marriage, increased fertility, less birth intervals, son preference and lack of decision-making regarding reproductive health choices were found to affect women’s reproductive health. Domestic violence, gender preference, husbands drinking behaviors, and low spousal communication were common experiences considered by women as factors leading to poor quality of marital relationship. Four main themes in confronting women’s well-being are poor literacy and mobility, low employment and income generating opportunities, poor reproductive health choices and preferences and poor quality of martial relationships and communication. These determinants of physical, psychological and cultural well-being should be an essential part of nursing assessment in the primary care settings for informed actions. Nursing interventions should be directed towards participatory approach, informed decision making and empowering women towards better health and well-being in the mining community.

Do Perceptions of Empowerment Affect Glycemic Control and Self-Care Among Adults with Type 2 Diabetes?

Background: The Arab adult with T2DM is understudied with less known facts about the perception of empowerment and its relationship with self-care and glycemic control. Purpose: The purpose of this study was to determine the extent to which perception of empowerment by Arab adults living with Type 2 Diabetes Mellitus (T2DM) was associated with better glycemic control and self-care management. Methods: A cross-sectional descriptive study was led among 300 Arab adults living in Oman with T2DM in an outpatient diabetes clinic. The Diabetes Empowerment Scale (DES), glycosylated haemaglobin (HbA1c) and Body mass index was assessed. The DES was found to be valid and reliable for the population. ANOVA, Regression analysis, and Structural equation modeling was used for analysis. Results: The composite score and three subscales of DES were a significant and strong predictor of good glycemic control among Omani adults with T2DM (p<0.001). Age, education, duration of DM, prior DM education program and medications were significantly associated with DES. Conclusion: Diabetes nurse educators engaged in the care of adults with T2DM should assess self-empowerment and tailor interventions to increase empowerment for better glycemic control. Patient empowerment plays an essential role in maintaining self-care behaviours and HbA1c.

Health Related Quality of Life among Omani Men and Women with Type 2 Diabetes

The aim of this study was to explore predictors of health related quality of life (HRQoL) among men and women with type 2 diabetes. This cross-sectional descriptive study consisted of a random sample of 300 adults with type 2 diabetes in a selected public hospital. Euro-QoL and Revised Summary of Diabetes Self-Care Activities scales were used to collect data between January and June 2010. Schooling and ability to manage positively were highly significant predictors of quality of life (QoL) among women as compared to men. Age, prevention of activities of daily living and knowledge/management of diabetes were significant predictors of Health state among women as compared to men. Findings demonstrate that 30.6% (versus 35.7%) of the variance in the total QoL and 14% (versus 23%) of the variance in health state could be explained by personal and clinical characteristics among women and men, respectively. The study underlines the importance for nurse educators to assess HRQoL among men and women and to develop effective self-care management strategies based on personal and clinical characteristics.

Determinants of Glycosylated Haemaglobin among Adults with Type 2 Diabetes Mellitus

Purpose: The purpose of this study is to assess the determinants of demographic and clinical factors associated with HbA1C levels among adults with type 2 diabetes mellitus (T2DM) in Muscat. Glycosylated Hemoglobin (HbA1C) is used as marker for long term blood glucose control in adults with type 2 diabetes mellitus. Methods: A cross-sectional design was used. Simple random sampling was used to select 300 adults with T2DM in Oman in 2011. Ethical approval and hospital permission was completed from the Institutional Research and Ethics Committee. Informed consent was obtained from the participants. Chi-square and multiple logistic regression models with demographic and clinical characteristics as predictors of glycemic control (HbA1C) were used to analyze the results. Results: Nearly half percentage of the adults with T2DM had better or controlled HbA1C ( 7%). Younger ages, females, higher education, non-tobacco users, short duration of diabetes, compliance with OHA and high waist-hip ratio predicted better control of HbA1C. Conclusions: Socio-demographic and clinical factors were consistently associated with glycemic control. Gender, education, perception of prevention of ADL, doctor-patient relationship, compliance with medications, and non-tobacco users were significant predictors of better glycemic controls among adults with T2DM. Relevance to clinical practice. Assessment of determinants of HbA1C may assist in determining individualized goals and strategies, subsequently improve glycemic control and enhance self-care management.

Risk-assessment score for screening diabetes mellitus among Omani adults

Purpose: The purpose of this study was to evaluate a self-administered risk-assessment scoring system for identifying Omani adults with type 2 diabetes mellitus (T2DM). Methods: An exploratory cross-sectional design was used. Simple random sampling was used to select 93 adults in Muscat. Ethical approval was obtained from the College of Nursing Research and Ethics Committee. The Finnish Diabetes Risk Score (FINDRISC) was used to collect the data in 2009. Informed consent was obtained from the participants. Data were analysed with the Pearson chi-square test. Results: A total of 9.7% of the adults had very high FINDRISC and 17.2% had slightly elevated risk of developing T2DM within 10 years. The risk assessment (family history, waist circumference, body mass index, physical activity, dietary intake, hypertension and high blood glucose) of T2DM was significant and positively related to the prediction of T2DM among Omani adults.

Examining the Risk Factors among Omani Women: Risk Assessment and Their Implications

Osteoporosis is common among postmenopausal women, giving rise to morbidity and diminishing the quality of life. There is lack of information about the risk factors of osteoporosis among local Omani women. To explore the risk factors of Osteoporosis among Omani Women using a Modified Fracture Risk Assessment Tool. This is an exploratory research design using a simple random sampling. A pilot study was conducted among 35 local Omani women from the Muscat region, who completed the validated and reliable Modified Fracture Risk Assessment Tool (MFRAT). Bone Mineral Density (BMD) was measured among 11 women at moderate-high risk based on MFRAT. The data was analyzed using inferential statistics. Fourteen Omani women were at moderate-high risk for Osteoporosis fracture due to premenopausal, Vitamin D Deficiency, increased parity, increased lactation period and sedentary lifestyle. Among these five women revealed low BMD and required early intervention and support. Determinants of Osteoporosis can be elicited among premenaopausal Omani women with a specific risk assessment tool. There is a need to construct a cultural sensitive risk assessment tool for Omani women for early screening and detection of Osteoporosis. Nurses can identify, provide intervention and education for Omani women at-risk of fracture.