A mixed methods of qualitative and quantitative study of patients’ understanding about carbohydrate portion in type 2 diabetic subjects

Abstract

The purpose of this mixed methods study was to evaluate understanding about carbohydrate portion and determine factors which were associated to carbohydrate portion knowledge in adults with type 2 diabetes. The sample group was 135 adults with type 2 diabetes who attended the diabetic clinic of King Chulalongkorn Memorial Hospital. Knowledge of carbohydrate portion was evaluated by the test which developed in this study. The data about socio-demographic characteristics, medical history, self-management information, diabetes education information and general diabetes knowledge were collected. After that, 24 participants were selected by purposive sampling to attend food estimation skill test and interview. Data analysis were using descriptive statistics, independent t-test, ANOVA, Chi-squared test and Multivariable analysis for quantitative data and Framework method for qualitative data. The results showed mean score of carbohydrate portion knowledge was 16.24 points with SEM of 0.34. Most of participants had problem with interpretation of nutrition facts label. This study found that some misconceptions about identifying foods that contain carbohydrate and estimating carbohydrate content in foods. In addition, the association between carbohydrate portion knowledge and glycemic control was found in this study. The analysis of independent t-test and ANOVA indicated the factors which were associated with carbohydrate portion knowledge. There were age, education level, occupation, income and having glucose meter. In the same way, analysis of chi-square test and binary logistical regression showed low level of carbohydrate portion knowledge was associated with 5 variables. There were age, education level, income, receiving diabetes information from media and score of general diabetes. Therefore, it is important to be careful of miscommunication and misunderstanding in diabetes education, especially group of people with low level of carbohydrate portion knowledge.