PART ONE-SOCIO-DEMOGRAPHIC CHARACTERISTICS
Q101 Age of patients with DM types 2
Gender
Q103 Marital Status
Q104 Educational Status
Q105 Occupation
Q106 Economic status(monthly income)
PART TWO –Clinical and other factors related to diabetes
Q201 How long you have been diagnosed with diabetes Mellitus?
Q202_Do_you_have_any_diabetic_
Q203 If your answer is yes Q202 which type of complications do have?
Q204 Have you ever diabetic health education about diabetes self-care
Q205 If your answer is yes to Q204 from where did you set health education
Q206 Are you a member of the diabetic association
PART THREE – Self-care Knowledge Questionnaire Modifiable lifestyle
Q301 Are you aware of the importance of maintaining a balanced diet for overall health and wellness?
Q302 Do you understand the significance of regular physical activity in improving your lifestyle?
Q303 Are you knowledgeable about the adverse effects of smoking and the benefits of quitting?
Q304 Do you know the recommended guidelines for alcohol consumption and the potential risks of excessive drinking?
Q305 Are you aware of the impact of stress on your health and the importance of stress management techniques?
Q306 Do you understand the importance of adequate sleep for your overall well-being?
Q307 Are you knowledgeable about the benefits of maintaining a healthy body weight?
Q308 Do you understand the risks associated with excessive sedentary behavior and the importance of regular movement throughout the day?
Q309 Are you aware of the significance of maintaining good oral hygiene for overall health?
Q310 Do you understand the importance of regular health check-ups and screenings for early detection of potential health issues?
Q311 Are you knowledgeable about the harmful effects of prolonged exposure to the sun and the importance of using sun protection?
Q312 Do you understand the benefits of drinking an adequate amount of water and staying hydrated?
Q313 Are you aware of the potential risks of excessive consumption of processed foods and the benefits of choosing whole, unprocessed foods?
Q314 Do you understand the impact of excessive caffeine intake on your health and the importance of moderation?
Q315 Are you knowledgeable about the benefits of maintaining social connections and engaging in positive relationships?
Q316 Do you know the importance of allocating time for relaxation and engaging in hobbies or activities you enjoy?
Q317 Are you aware of the impact of excessive screen time on your physical and mental well-being?
Q318 Do you understand the benefits of practicing mindfulness and incorporating stress-reduction techniques into your daily life?
A_Medication_Adheren_morsiky_item_tool_
Q319 Do you sometimes forget to take your diabetes Medication?
Q320 People sometimes miss taking their medications for reasons other than forgetting .Thinking over the past two weeks ,were there any days when you did not takes your medicine?
Q321 Have you ever cut back or stopped taking your medicine without telling your doctor because you felt worse when you took it?
Q322 Are you sometimes when you travel or leave home , in a hurry and forget to take your diabetes medication?
Q323 . Do you take all your medicine yesterday?
Q324_When_you_feel_l_aking_your_medicine_
Q325 Taking medicine every day is a real inconvenience for some people,do you ever feel hassled about sticking to your treatment plan?
Q326 How often do you have difficulty remembering to take all your medicine?
A consequence of uncontrolled blood sugar level (4 items)
Q327 If blood sugar is close to normal, a person with diabetes is likely to have more energy, feel less thirsty, and urinate less often
Q328 Prolonged high blood sugar levels can cause eye problems or even blindness
Q329 Prolonged uncontrolled blood sugar levels can cause heart attack, stroke, and kidney problem
Q330 Shaking, confusion, behavioral change, and sweating are signs of high blood sugar
PART FOUR: SUMMARY OF DIABETES SELF-CARE ACTIVITIES QUESTIONNAIRE
A.Diet
Q401 How many of the last SEVEN DAYS have you followed a healthful eating plan?
Q402 On average, over the past month, how many DAYS PER WEEK have you followed you’re eating plan?
Q403 On how many of the last SEVEN DAYS did you eat five or more servings of fruits and vegetables?
Q404 On how many of the last SEVEN DAYS did you eat high-fat foods, such as red meat or full-fat dairy products?
Q405 On how many of the last SEVEN DAYS did you space carbohydrates evenly through the day?
B.Physical Activity
Q406 On how many of the last SEVEN DAYS did you participate in at least 30 minutes of physical activity (Total minutes of continuous activity, including walking).
Q407 On how many of the last SEVEN DAYS did you participate in a specific exercise session (such as swimming, walking, biking) other than what you do around the house or as part of your work?
C.Blood Sugar Testing
Q408 On how many of the last SEVEN DAYS did you test your blood sugar?
Q409 On how many of the last SEVEN DAYS did you test your blood sugar the number of times recommended by your health- care provider?
D.Foot Care
Q410 On how many of the last SEVEN DAYS did you check your feet?
Q411 On how many of the last SEVEN DAYS did you inspect the inside of your shoes?
Q412 On how many of the last SEVEN DAYS did you wash your feet?
Q413 On how many of the last SEVEN DAYS did you soak your feet?
Q414 On how many of the last SEVEN DAYS did you dry between your toes after washing?
E.Medication
Q415 On how many of the last SEVEN DAYS, did you take your recommended diabetes medication?
Q416 On how many of the last SEVEN DAYS did you take your recommended insulin injections?
Q417 On how many of the last SEVEN DAYS did you take your recommended number of diabetes pills?
F. Smoking
Q418 Have you smoked a cigarette, even a puff, in the past SEVEN DAYS?
PART FIVE: Self-Care Recommendations
_1_DIET_MANAGEMENT
_1_1_Follow_a_low_fat_eating_plan
_1_2_Follow_a_complex_carbohydrate_diet
_1_3_Reduce_the_numbe_u_eat_to_lose_weight
_1_4_Eat_lots_of_food_igh_in_dietary_fiber
_1_5_Eat_lots_at_lea_ruits_and_vegetables
_1_6_Eat_very_few_swe_et_sodas_candy_bars
_1_7_I_have_not_been_my_health_care_team
_2_PHYSICAL_EXERCISE
_2_1_Get_low_level_ex_ng_on_a_daily_basis
_2_2_Exercise_continu_least_3_times_a_week
_2_3_Fit_exercise_int_k_away_and_walk_etc
_2_4_Engage_in_a_spec_nd_level_of_exercise
_2_5_have_not_been_gi_my_health_care_team
_3_SUGAR_LEVEL
_3_1_Test_your_blood_er_and_a_color_chart
_3_2_Test_your_blood_to_read_the_results
_3_3_Test_your_urine_for_sugar
_3_4_have_not_been_gi_my_health_care_team
_4_Smoking
_4_1_At_your_last_do_your_smoking_status
_4_2_If_you_smoke_at_out_stopping_smoking
_4_3_Do_not_smoke_Never_Smoke
_4_4_When_did_you_las_arette_never_smoked
_4_5_When_did_you_las_e_than_two_years_ago
_4_6_When_did_you_las_One_to_two_years_ago
_4_7_When_did_you_las_to_twelve_months_ago
_4_8_When_did_you_las_to_three_months_ago
_4_9_When_did_you_las_ithin_the_last_month
_4_10_When_did_you_la_e_a_cigarette_Today
Interviewer ID
Age Group
Name Of Hospitals
Duration of Diabetes
Over all Self care knowledge
Ovrallknowlegne
overalldiet
physicalex
sugarlevel
smoking
COMPUTE Medtn=medication / 8
medicationadeherence
overallselefcarepractice
income
Modifiable
Uncontrol
Predicted probability
Predicted group
Leverage value
DFBETA for constant
DFBETA for Gender(1)
COMPUTE footC=(Q310_Do_you_understa_ential_health_issues + Q311_Are_you_knowle_using_sun_protection + Q312_Do_you_understa_and_staying_hydrated + Q313_Are_you_aware_o_e_unprocessed_foods + Q314_Do_you_understa_rtance_of_moderation) / 5
Foot_Care_Practice
Rank of selfcare
Social_Support