@2024 Afarand., IRAN
ISSN: 2383-2150 Journal of Education and Community Health 2019;6(4):257-264
ISSN: 2383-2150 Journal of Education and Community Health 2019;6(4):257-264
Effectiveness of Educational Intervention on Reducing Self-Medication Behaviors of Patients with Diabetes Type 2: Application of BASNEF Model
ARTICLE INFO
Article Type
Original ResearchAuthors
Khani Jeihooni A. (*1)Bararti M. (1)
Kouhpayeh S.A. (2)
Kashfi S.M. (3)
Khiyali Z. (1)
(*1) Public Health Department, Health Faculty, Fasa University of Medical Sciences, Fasa, Iran
(2) Pharmacology Department, Medicine Faculty, Fasa University of Medical Sciences, Fasa , Iran
(3) Public Health Department, Health Faculty, Shiraz University of Medical Sciences, Shiraz,, Iran
Correspondence
Address: Fasa University of Medical Sciences, Ibn Sina Square, Fasa, Iran. Postal code: 7461686688Phone: +98 (71) 53350994
Fax: +98 (71) 53357091
khani_1512@yahoo.com
Article History
Received: July 7, 2019Accepted: August 24, 2019
ePublished: December 21, 2019
ABSTRACT
Aims
Self-medication in diabetic patients will lead to severe fluctuations in their blood glucose levels, which can lead to early complications of diabetes in patients. The aim of this study was to investigate the effect of educational intervention based on the BASNEF model on self-medication behaviors in patients with diabetes type 2.
Materials & Methods This semi-experimental study was carried out on 200 patients with diabetes type 2 covered the diabetes center of Fasa city in 2018. The subjects were selected by random sampling method and randomly divided into experimental and control groups (100 people in each group). Data gathering tool was a questionnaire including demographic information, BASNEF model (knowledge, attitude, empowering factors, subjective norms, and behavioral intention) and self-medication behaviors about diabetes that was completed before and three months after intervention. Educational intervention was conducted for the experimental group in 7 training sessions of 50-55 minutes. Data were analyzed by SPSS 22 software, using Chi-square, independent t-test and paired t-test.
Findings After intervention, the mean scores of knowledge, attitude, empowering factors, subjective norms, and behavioral intention was significantly increased in experimental group compared to control group. Also the mean score of self-medication behaviors significantly decreased.
Conclusion The educational intervention based on the BASNEF model is effective on reducing the self-medication behaviors in patients with diabetes type 2.
Materials & Methods This semi-experimental study was carried out on 200 patients with diabetes type 2 covered the diabetes center of Fasa city in 2018. The subjects were selected by random sampling method and randomly divided into experimental and control groups (100 people in each group). Data gathering tool was a questionnaire including demographic information, BASNEF model (knowledge, attitude, empowering factors, subjective norms, and behavioral intention) and self-medication behaviors about diabetes that was completed before and three months after intervention. Educational intervention was conducted for the experimental group in 7 training sessions of 50-55 minutes. Data were analyzed by SPSS 22 software, using Chi-square, independent t-test and paired t-test.
Findings After intervention, the mean scores of knowledge, attitude, empowering factors, subjective norms, and behavioral intention was significantly increased in experimental group compared to control group. Also the mean score of self-medication behaviors significantly decreased.
Conclusion The educational intervention based on the BASNEF model is effective on reducing the self-medication behaviors in patients with diabetes type 2.
Keywords:
Diabetes Type 2,
Self-Medication ,
BASNEF Model ,
Intention ,
Subjective Norm ,
Empowering Factors ,
CITATION LINKS
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[2]Zareban I, Niknami S, Hidarnia A, Rakhshani F, Shamsi M, Karimy M. Effective intervention of self-care on glycaemia control in patients with type 2 diabetes. Iran Red Crescent Med J. 2014;16(12):e8311.
[3]Mazloomi Mahmoodabad SS, Hajizadeh A, Alaei MR, Mirzaei Alaviche , Afkhami AM, Fatahi M. Status of preventive behaviors in individuals at risk for type 2 diabetes: Application of the health belief model. Iran J Diabetes Metab. 2012;11(6):544-50. [Persian]
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[5]Rahimian Boogar E, Besharat MA, Mohajeri Tehrani MR, Talepasand S. Diabetes self-management: social, demographical and disease factors. J Clin Psychol. 2010;1(4):43-57. [Persian]
[6]Rezasefat A, Mirhagjjou SN, Jafari Asl M, Koohmanaee Sh, Kazemnejad E, Monfared A. Correlation between self-care and self-efficacy in adolescents with type 1 diabetes. Holist Nurs Midwifery. 2014;24(72):18-24. [Persian]
[7]Hatamloo M, Poorsharifi H, Babapoor Kheirodin J. Role of Health Control Focus in Self-care behaviors in diabetic type 2 people. J Tabriz Univ Medl Sci. 2011;33(4):17-22. [Persian]
[8]Khezerloo S, Feizi A. A survey of relationship between perceived self-efficacy and self-care performance in diabetic patients referring to Urmia diabetes center. J Urmia Nurs Midwifery Fac. 2012;10(3):369-75. [Persian]
[9]Gelayee DA. Self-medication pattern among social science university students in Northwest Ethiopia. J Pharm (Cairo). 2017;2017:8680714.
[10]Rezaei Jaberi S, Hassani L, Aghamolaei T, Mohseni S, Eslami H. Study on the effect of educational intervention based on health belief model to prevent the arbitrary use of drugs in women referring to health centers of Bandar Abbas . J Health Educ Health Promot. 2018;6(1):1-11. [Persian]
[11]Jalilian F, Hazavehei SMM, Vahidinia AA, Moghimbeigi A, Zinat Motlagh F, Mirzaei Alavijeh M. Study of causes of self-medication among Hamadan province pharmacies visitors. Avicenna J Clin Med. 2013;20(2):160-6. [Persian]
[12]Kaboodi S, Hazavehei MM, Rahimi M, Roshanaei G. Application of BASNEF model in analyzing self-treatment behavior among type 2 diabetic patients in 2014. J Educ Community Health. 2015;2(1):38-49. [Persian]
[13]Heshmati H, Behnampour N, Khorasani F, Moghaddam Z. Prevalence of chronic complications of diabete and its related factors in referred type 2 diabetes patients in Freydonkenar diabetes center. J Neyshabur Univ Med Sci. 2014;1(1):36-43. [Persian]
[14]Masoudi Alavi N, Izadi F, Ebadi A, Hajibagheri A. Self-treatment experience in diabetes mellitus type 2. Iran J Endocrinol Metab. 2009;10(6):581-8. [Persian]
[15]Saffari M, Shojaeizadeh D, Ghofranipour F, Heidarnia A, Pakpour A. Theories, models and methods of health education and health promotion. 1st Edition. Tehran: Asar-e Sobhan; 2009. [Persian]
[16]Singh J, Singh R, Gautam CS. Self-medication with herbal remedies amongst patients of type 2 diabetes mellitus: a preliminary study. Indian J Endocrinol Metab. 2012;16(4):662-3.
[17]Alatawi YM, Kavookjian J, Ekong G, Alrayees MM. The association between health beliefs and medication adherence among patients with type 2 diabetes. Res Social Adm Pharm. 2016;12(6):914-25.
[18]Sharifirad Gh, Najimi A, Hassanzadeh A, Azadbakht L. Application of BASNEF educational model for nutritional education among elderly patients with type 2 diabetes: improving the glycemic control. J Res Med Sci. 2011;16(9):1149-58.
[19]von Arx LBW, Gydesen H, Skovlund S. Treatment beliefs, health behaviors and their association with treatment outcome in type 2 diabetes. BMJ Open Diabetes Res Care. 2016;4(1)4:e000166.
[20]- Badiger S, Kundapur R, Jain A, Kumar A, Pattanshetty S, Thakolkaran N, et al. Self-medication patterns among medical students in South India. Australas Med J. 2012;5(4):217-20.
[21]Hazavehei MM, Khani Jeyhouni A, Hasanzadeh A, Rashidi M. The Effect of educational program based on basnef model on diabetic (type ii) eyes care in Kazemi's Clinic, (Shiraz). Iran J Endocrinol Metab. 2008;10(2):145-54. [Persian]
[22]Hartayu TS, Mohamed Izham MI, Suryawati S. Improving type 2 diabetes patients' quality of life by using a community based interactive approach– diabetes mellitus strategy in Yogyakarta, Indonesia. J Pharm Health Serv Res. 2012;3(2):95-102.
[23]Askari A, Khani Jeihooni A, Kashfi SM, Marzban A, Khiyali Z. The effect of educational program based on belief, attitude, subjective norm, and enabling factors model on changing the metabolic indices in elderly patients with type ii diabetes. Int J Prev Med. 2018;9:74.
[24]Tol A, Farhandi H, Mohebbi B, Sadeghi R. BASNEF Model intervention on blood pressure modification among hypertensive diabetic patients. J Educ Health Promot. 2017;6:47
[25]Movahed E, Shojaeizadeh D, Zareipour MA, Arefi Z, Sha Ahmadi F, Ameri M. The effect of health belief model-based training (HBM) on self-medication among the male high school students. Iran J Health Educ Health Promot. 2014;2(1):65-72. [Persian]
[26]Jafarpour K, Arastoo AA, Gholamnia Shirvani Z, Saki A, Araban M. The effect of health education intervention based on the theory of planned behavior to promote physical activity in women's health volunteers of Shushtar health centers. Iran J Obstet Gynecol Infertil. 2016;19(37):62-74. [Persian]
[27]Zhong X, Tanasugarn C, Fisher EB, Krudsood S,Nityasuddhi D. Awareness and practices of self-management and influence factors among individuals with type 2 diabetes in urban community settings in Anhui Province, China. Southeast Asian J Trop Med Public Health. 2011;42(1):185-6.
[28]Khattab M, Khader YS, Al-Khawaldeh A, Ajlouni K. Factors associated with poor glycemic control among patients with type 2 diabetes. J Diabetes Complications. 2010;24(2):84-9.
[29]Sharifirad G, Entezari MH, Kamran A, Azadbakht L. The effectiveness of nutritional education on the knowledge of diabetic patients using the health belief model. J Res Med Sci. 2009;14(1):1-6.
[30]Afshari M, Tol A, Taghdisi MH, Kamal A. The effect of BASNEF-based blended educational program on diabetes control among type 2 diabetic patients referred to diabetes clinic of Samirom city. Razi J Med Sci. 2015;22(132):56-62. [Persian]
[31]Babazadeh T, Mokammel A, Moradi F, Shariat F, Banaye Jeddi M. The effect of educational intervention based on the extended theory of reasoned action on self-care behaviors in patients with type 2 diabetes. J Health. 2017;8(3):256-67. [Persian]
[32]Mehri A, Mazloomi Mahmoodabad SS, Morovati Sharifabad MA. The effect of an educational program based on the Theory of Planned Behavior on helmet use among employed motorcyclists. Payesh. 2012;11(1):13-20. [Persian]
[33]Rahaei Z, Baghiani Moghadam MH, Morovati Sharifabad MA, Zareian M, Fallahzadeh H, Vakili Mahmoodabad M. Determinants of self-monitoring of blood pressure among hypertensive patients using on path analysis of Basnef model. Payesh. 2012;11(5):621-7. [Persian]
[34]Arshad SM, Khani Jeihooni A, Moradi Z, Kouhpayeh SA, Kashfi SM, Dehghan A. Effect of theory of planned behavior-based educational intervention on breastfeeding behavior in pregnant women in Fasa City, Iran. J Educ Community Health. 2017;4(2):55-63. [Persian]
[35]Beiranvand S, Fayazi S, Asadi Zaker M, Latifi M. Survey of the foot care status in type II diabetic patients: application of the theory of Planned Behavior. J Clin Nurs Midwifery. 2014;3(2):57-66. [Persian]
[36]Ferreira G, Pereira MG. Physical activity: The importance of the extended theory of planned behavior, in type 2 diabetes patients. J Health Psychol. 2017;22(10):1312-21.
[37]Pooreh S, Hosseini Nodeh Z. Impact of education based on theory of planned behavior: an investigation into hypertension-preventive self-care behaviors in Iranian girl adolescent. Iran J Public Health. 2015;44(6):839-47.
[38]Maleki F, Hosseini Nodeh Z, Rahnavard Z, Arab M. Effectiveness of training on preventative nutritional behaviors for type-2 diabetes among the female adolescents: Examination of theory of planned behavior. Med J Islam Repub Iran. 2016;30:349.
[39]Parrott MW, Tennant LK, Olejnik S, Poudevigne MS. Theory of planned behavior: Implications for an email-based physical activity intervention. Psychol Sport Exerc .2008;9(4):511-26.
[40]Karimi M, Shamsi M, Zareban I, Kouhpaye Zad Esfahani J, Baradaran H. The effect of education based on extended parallel process model (EPPM) on the self-medication of elderly in Zarandieh. J Kermanshah Univ Med Sci. 2013;17(8):501-8. [Persian]
[41]Shamsi M, Bayati A, Mohammadbeygi A, Tajik R. The effect of educational program based on Health Belief Model (HBM) on preventive behavior of self-medication in woman with pregnancy in Arak, Iran. Pajouhandeh. 2010;14(6):324-31. [Persian]
[42]Kouhpayeh A, Jeihooni AK, Kashfi SH, Bahmandoost M. Effect of an educational intervention based on the model of health beliefs in self-medication of Iranian mothers. Invest Educ Enferm. 2017;35(1): 59-68.
[2]Zareban I, Niknami S, Hidarnia A, Rakhshani F, Shamsi M, Karimy M. Effective intervention of self-care on glycaemia control in patients with type 2 diabetes. Iran Red Crescent Med J. 2014;16(12):e8311.
[3]Mazloomi Mahmoodabad SS, Hajizadeh A, Alaei MR, Mirzaei Alaviche , Afkhami AM, Fatahi M. Status of preventive behaviors in individuals at risk for type 2 diabetes: Application of the health belief model. Iran J Diabetes Metab. 2012;11(6):544-50. [Persian]
[4]Esteghamati A, Gouya MM, Abbasi M, Delavari A, Alikhani S, Alaedini F, et al. Prevalence of diabetes mellitus and impaired fasting glucose in the adult population of Iran: the national survey of risk factors for non-communicable disease of Iran. Diabetes Care. 2008;31(1):96-8.
[5]Rahimian Boogar E, Besharat MA, Mohajeri Tehrani MR, Talepasand S. Diabetes self-management: social, demographical and disease factors. J Clin Psychol. 2010;1(4):43-57. [Persian]
[6]Rezasefat A, Mirhagjjou SN, Jafari Asl M, Koohmanaee Sh, Kazemnejad E, Monfared A. Correlation between self-care and self-efficacy in adolescents with type 1 diabetes. Holist Nurs Midwifery. 2014;24(72):18-24. [Persian]
[7]Hatamloo M, Poorsharifi H, Babapoor Kheirodin J. Role of Health Control Focus in Self-care behaviors in diabetic type 2 people. J Tabriz Univ Medl Sci. 2011;33(4):17-22. [Persian]
[8]Khezerloo S, Feizi A. A survey of relationship between perceived self-efficacy and self-care performance in diabetic patients referring to Urmia diabetes center. J Urmia Nurs Midwifery Fac. 2012;10(3):369-75. [Persian]
[9]Gelayee DA. Self-medication pattern among social science university students in Northwest Ethiopia. J Pharm (Cairo). 2017;2017:8680714.
[10]Rezaei Jaberi S, Hassani L, Aghamolaei T, Mohseni S, Eslami H. Study on the effect of educational intervention based on health belief model to prevent the arbitrary use of drugs in women referring to health centers of Bandar Abbas . J Health Educ Health Promot. 2018;6(1):1-11. [Persian]
[11]Jalilian F, Hazavehei SMM, Vahidinia AA, Moghimbeigi A, Zinat Motlagh F, Mirzaei Alavijeh M. Study of causes of self-medication among Hamadan province pharmacies visitors. Avicenna J Clin Med. 2013;20(2):160-6. [Persian]
[12]Kaboodi S, Hazavehei MM, Rahimi M, Roshanaei G. Application of BASNEF model in analyzing self-treatment behavior among type 2 diabetic patients in 2014. J Educ Community Health. 2015;2(1):38-49. [Persian]
[13]Heshmati H, Behnampour N, Khorasani F, Moghaddam Z. Prevalence of chronic complications of diabete and its related factors in referred type 2 diabetes patients in Freydonkenar diabetes center. J Neyshabur Univ Med Sci. 2014;1(1):36-43. [Persian]
[14]Masoudi Alavi N, Izadi F, Ebadi A, Hajibagheri A. Self-treatment experience in diabetes mellitus type 2. Iran J Endocrinol Metab. 2009;10(6):581-8. [Persian]
[15]Saffari M, Shojaeizadeh D, Ghofranipour F, Heidarnia A, Pakpour A. Theories, models and methods of health education and health promotion. 1st Edition. Tehran: Asar-e Sobhan; 2009. [Persian]
[16]Singh J, Singh R, Gautam CS. Self-medication with herbal remedies amongst patients of type 2 diabetes mellitus: a preliminary study. Indian J Endocrinol Metab. 2012;16(4):662-3.
[17]Alatawi YM, Kavookjian J, Ekong G, Alrayees MM. The association between health beliefs and medication adherence among patients with type 2 diabetes. Res Social Adm Pharm. 2016;12(6):914-25.
[18]Sharifirad Gh, Najimi A, Hassanzadeh A, Azadbakht L. Application of BASNEF educational model for nutritional education among elderly patients with type 2 diabetes: improving the glycemic control. J Res Med Sci. 2011;16(9):1149-58.
[19]von Arx LBW, Gydesen H, Skovlund S. Treatment beliefs, health behaviors and their association with treatment outcome in type 2 diabetes. BMJ Open Diabetes Res Care. 2016;4(1)4:e000166.
[20]- Badiger S, Kundapur R, Jain A, Kumar A, Pattanshetty S, Thakolkaran N, et al. Self-medication patterns among medical students in South India. Australas Med J. 2012;5(4):217-20.
[21]Hazavehei MM, Khani Jeyhouni A, Hasanzadeh A, Rashidi M. The Effect of educational program based on basnef model on diabetic (type ii) eyes care in Kazemi's Clinic, (Shiraz). Iran J Endocrinol Metab. 2008;10(2):145-54. [Persian]
[22]Hartayu TS, Mohamed Izham MI, Suryawati S. Improving type 2 diabetes patients' quality of life by using a community based interactive approach– diabetes mellitus strategy in Yogyakarta, Indonesia. J Pharm Health Serv Res. 2012;3(2):95-102.
[23]Askari A, Khani Jeihooni A, Kashfi SM, Marzban A, Khiyali Z. The effect of educational program based on belief, attitude, subjective norm, and enabling factors model on changing the metabolic indices in elderly patients with type ii diabetes. Int J Prev Med. 2018;9:74.
[24]Tol A, Farhandi H, Mohebbi B, Sadeghi R. BASNEF Model intervention on blood pressure modification among hypertensive diabetic patients. J Educ Health Promot. 2017;6:47
[25]Movahed E, Shojaeizadeh D, Zareipour MA, Arefi Z, Sha Ahmadi F, Ameri M. The effect of health belief model-based training (HBM) on self-medication among the male high school students. Iran J Health Educ Health Promot. 2014;2(1):65-72. [Persian]
[26]Jafarpour K, Arastoo AA, Gholamnia Shirvani Z, Saki A, Araban M. The effect of health education intervention based on the theory of planned behavior to promote physical activity in women's health volunteers of Shushtar health centers. Iran J Obstet Gynecol Infertil. 2016;19(37):62-74. [Persian]
[27]Zhong X, Tanasugarn C, Fisher EB, Krudsood S,Nityasuddhi D. Awareness and practices of self-management and influence factors among individuals with type 2 diabetes in urban community settings in Anhui Province, China. Southeast Asian J Trop Med Public Health. 2011;42(1):185-6.
[28]Khattab M, Khader YS, Al-Khawaldeh A, Ajlouni K. Factors associated with poor glycemic control among patients with type 2 diabetes. J Diabetes Complications. 2010;24(2):84-9.
[29]Sharifirad G, Entezari MH, Kamran A, Azadbakht L. The effectiveness of nutritional education on the knowledge of diabetic patients using the health belief model. J Res Med Sci. 2009;14(1):1-6.
[30]Afshari M, Tol A, Taghdisi MH, Kamal A. The effect of BASNEF-based blended educational program on diabetes control among type 2 diabetic patients referred to diabetes clinic of Samirom city. Razi J Med Sci. 2015;22(132):56-62. [Persian]
[31]Babazadeh T, Mokammel A, Moradi F, Shariat F, Banaye Jeddi M. The effect of educational intervention based on the extended theory of reasoned action on self-care behaviors in patients with type 2 diabetes. J Health. 2017;8(3):256-67. [Persian]
[32]Mehri A, Mazloomi Mahmoodabad SS, Morovati Sharifabad MA. The effect of an educational program based on the Theory of Planned Behavior on helmet use among employed motorcyclists. Payesh. 2012;11(1):13-20. [Persian]
[33]Rahaei Z, Baghiani Moghadam MH, Morovati Sharifabad MA, Zareian M, Fallahzadeh H, Vakili Mahmoodabad M. Determinants of self-monitoring of blood pressure among hypertensive patients using on path analysis of Basnef model. Payesh. 2012;11(5):621-7. [Persian]
[34]Arshad SM, Khani Jeihooni A, Moradi Z, Kouhpayeh SA, Kashfi SM, Dehghan A. Effect of theory of planned behavior-based educational intervention on breastfeeding behavior in pregnant women in Fasa City, Iran. J Educ Community Health. 2017;4(2):55-63. [Persian]
[35]Beiranvand S, Fayazi S, Asadi Zaker M, Latifi M. Survey of the foot care status in type II diabetic patients: application of the theory of Planned Behavior. J Clin Nurs Midwifery. 2014;3(2):57-66. [Persian]
[36]Ferreira G, Pereira MG. Physical activity: The importance of the extended theory of planned behavior, in type 2 diabetes patients. J Health Psychol. 2017;22(10):1312-21.
[37]Pooreh S, Hosseini Nodeh Z. Impact of education based on theory of planned behavior: an investigation into hypertension-preventive self-care behaviors in Iranian girl adolescent. Iran J Public Health. 2015;44(6):839-47.
[38]Maleki F, Hosseini Nodeh Z, Rahnavard Z, Arab M. Effectiveness of training on preventative nutritional behaviors for type-2 diabetes among the female adolescents: Examination of theory of planned behavior. Med J Islam Repub Iran. 2016;30:349.
[39]Parrott MW, Tennant LK, Olejnik S, Poudevigne MS. Theory of planned behavior: Implications for an email-based physical activity intervention. Psychol Sport Exerc .2008;9(4):511-26.
[40]Karimi M, Shamsi M, Zareban I, Kouhpaye Zad Esfahani J, Baradaran H. The effect of education based on extended parallel process model (EPPM) on the self-medication of elderly in Zarandieh. J Kermanshah Univ Med Sci. 2013;17(8):501-8. [Persian]
[41]Shamsi M, Bayati A, Mohammadbeygi A, Tajik R. The effect of educational program based on Health Belief Model (HBM) on preventive behavior of self-medication in woman with pregnancy in Arak, Iran. Pajouhandeh. 2010;14(6):324-31. [Persian]
[42]Kouhpayeh A, Jeihooni AK, Kashfi SH, Bahmandoost M. Effect of an educational intervention based on the model of health beliefs in self-medication of Iranian mothers. Invest Educ Enferm. 2017;35(1): 59-68.