Date of Award

12-2025

Degree Type

Thesis

Degree Name

Master of Science in Advanced Practice Nurs​ing (MSc-APN)​

First Advisor

Dr Irene Mageto

Second Advisor

Dr Diana Kassaman

Department

School of Nursing and Midwifery, East Africa

Abstract

Introduction: Despite advances in the management of Type 2 diabetes mellitus (T2DM), anecdotal reports from Thika Level Five Hospital indicate that patients still present with diabetes mellitus-associated complications. Therefore, this research aimed to determine the predictors of complications among adult patients diagnosed with T2DM in the hospital.

Methodology: Analytical cross-sectional design was utilized in this research. To select the respondents, purposive sampling was used to recruit six nurse managers and their deputies (making a total of 12 nurses), while 294 patients in the clinic were recruited using systematic sampling. Purposive sampling was also used to recruit 15 patients with T2DM who were admitted to the wards. Data was analyzed using R Studio version 4.4.3 software. Frequencies for the patient characteristics and other predictors were generated, while logistic regressions were computed to determine the predictors for complications among the respondents.

Ethical considerations: Ethical approvals were obtained from the Aga Khan University School of Nursing and Midwifery Departmental Research Committee (DRC), Institutional Scientific and Ethics Review Committee (ISERC), and other relevant authorities, while informed consent was obtained from the respondents.

Results: It was established that 35.9% of respondents had complications such as poor vision, hypertension, and chronic kidney disease, among others. Patient related predictors included primary education (AOR=0.37, CI= 0.13-0.95, p= 0.047), secondary education (AOR= 0.09, CI= 0.03-0.25, p < 0.001) and tertiary education (AOR= 0.21, CI= 0.06-0.66, p = 0.010). Being a casual (AOR= 0.184, CI= 0.058 - 0.587, p = 0.004), being on insulin or combined therapy (AOR= 3.8, CI= 1.96-7.54, p = < 0.001) and (AOR= 6.54, CI= 2.09-23.06, p = 0.002) respectively. Not actively engaged in exercises (AOR= 4.345, CI= 2.617- 7.214, p < 0.001), monitoring blood sugar levels (AOR= 0.360, CI= 0.170 - 0.760, p = 0.007) and presence of co- morbidities (AOR= 3.722, CI= 2.030-6.824, p = < 0.001).were also patient related predictors. Hospital related predictors included teachings in the hospital (AOR = 0.28, CI = 0.07-0.83, p= 0.037) and long appointment dates (AOR = 1.98, CI = 1.10-3.920, p= 0.049).

Conclusion and recommendations: Various patient and hospital related predictors for T2DM related complications were identified. In this case, more than one third of the respondents presented with the complications. Therefore, there is a need to develop targeted patient education, reduce appointment time, and explore the available patient support systems for referral and home visits when necessary.

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Last Page

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