Research design
The study employed a descriptive cross-sectional survey design to collect quantitative data. A cross-sectional design enables data collection at a specific point in time without variable manipulation, making it appropriate for this research. The data collection process spanned four months. Researchers frequently use quantitative approaches to address research questions involving numerical values. This design was suitable for the study as it allowed for the collection and analysis of data on DM patients’ knowledge of complication prevention at Twifo Atti-Morkwa District Hospital at a specific point in time, without follow-ups. Participants were selected based on predetermined inclusion and exclusion criteria. The cross-sectional design provided several advantages for this study. It allowed for a snapshot of the current state of patient knowledge. It facilitated the collection of data from a diverse group of patients simultaneously. It was time-efficient, enabling the completion of data collection within the four-month timeframe. And it also provided a foundation for potential future longitudinal studies on the same topic. This methodological approach aligned well with the study’s objectives, enabling a comprehensive assessment of patients’ knowledge regarding DM complication preventive measures at the specified hospital.
Study population
The study population for this research comprised patients living with diabetes mellitus (both type 1 and type 2) receiving care at the Twifo Atti-Morkwa District Hospital in Ghana. The target population consisted of 1,212 registered diabetes patients at the hospital.
The inclusion criteria for the study were patients aged 18 years and above, patients with diagnosis of diabetes mellitus (type 1 or type 2) and patients receiving care at the Twifo Atti-Morkwa District Hospital. The exclusion criteria also were patients with gestational diabetes, individuals with severe cognitive impairment, those with mental illness, and critically ill patients.
By applying these inclusion and exclusion criteria, the researchers identified the eligible study population from the total of 1,212 registered diabetes patients. This rigorous selection process ensured that the sample was representative of the target population and could provide reliable data to address the research objectives. This approach offered several advantages: It focused the study on the most relevant patient group; It minimized potential confounding factors that could affect the results; It ensured that participants were capable of providing informed consent and accurate responses; It aligned the study population with the specific research goals related to type 1 and type 2 diabetes knowledge and complication prevention. The careful definition of the study population and application of inclusion/exclusion criteria strengthened the validity and reliability of the research findings, making them more applicable to the broader population of diabetes patients receiving care in similar settings.
Sample size
Using Slovin’s formula for calculating sample size which is \(\:n\:=\:\frac{\text{N}}{1+\text{N}\text{e}2\:}\) (where N represented number of DM patients at the Twifo Atti-Morkwa district hospital and taking precision (e) to be 0.05, the sample size (n) for the study will be 301.
Sample size calculation \(\:n\:=\:\frac{\text{N}}{1+\text{N}\text{e}2\:}\)
Where N = population sample, n = sample size, e = level of precision which is assumed to be 0.05 in this study. N = 1212 n =? e = 0.05 \(\:n\:=\:\frac{860}{1+860\left(0.05\right)2\:}\)n = 273.02.
To cater for the potential attrition rate, 10% of the sample size calculated was added. Hence, a sample size of 301 will be used for the study.
Data collection instruments
Questionnaires were administered to obtain information from all study participants. These questionnaires were personally administered to patients with DM during their visits to the Twifo Atti-Morkwa District Hospital. The researchers created the instrument based on the research questions derived from the related literature [9]. The structured questionnaire was divided into two sections, A and B with close-ended questions. Section A: Socio-demographic variables and Section B: Patient knowledge on DM and its complications. This approach to data collection offered several advantages for the study. The use of a structured questionnaire ensured consistency in data collection across all participants. The close-ended questions facilitated quicker responses and easier data analysis. By basing the questionnaire on research questions, the researchers ensured that the collected data was pertinent to the study objectives. The two-section structure allowed for a thorough assessment of both demographic factors and disease-specific knowledge. Personal administration of the questionnaires allowed researchers to clarify any participant queries, potentially improving response accuracy. Administering the questionnaires during hospital visits ensured that participants were in a relevant setting, potentially enhancing their focus on health-related questions. This methodological approach to data collection was designed to gather comprehensive, relevant, and reliable data to address the research objectives effectively.
Validity and reliability
The questionnaire’s validity and reliability were established through a comprehensive literature review and expert panel validation [10]. Validity assessed the instrument’s accuracy, while reliability evaluated its consistency [11]. After analysis, the instrument demonstrated a reliability coefficient of 0.7, indicating good reliability [12]. Consequently, the questionnaire was deemed both reliable and valid for use in the study [13].
Pre-testing
A pilot study was conducted to validate the research instrument’s content and clarity. This preliminary assessment involved a small sample of twenty (20) diabetic patients at the Cape Coast Metropolitan Hospital. These participants were selected due to their similar conditions to those at the Twifo Atti-Morkwa District Hospital (TADH).
Data collection procedures
An introductory letter from the Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast was presented to the Medical Superintendent of the Twifo Atti-Morkwa District Hospital (TADH). Official permission was obtained from the facility’s administration to commence data collection, which was conducted over four months. Respondents were assured of the confidentiality of their responses. Each participant was allocated twenty (20) minutes to complete the questionnaire. All questionnaires were completed and returned to the researchers, ensuring a comprehensive data set for analysis.
Ethical consideration
Ethical approval for the study was obtained from the Ghana Health Service Ethics Review Board (ERB). Informed consent was secured from all participants prior to their inclusion in the study. To ensure confidentiality and anonymity, no names were recorded on the questionnaires. Participants were fully informed of their right to withdraw from the study at any stage without consequence. These measures were implemented to uphold ethical standards and protect participants’ rights throughout the research process.
Data processing and analysis
The questionnaires were coded by assigning numbers to the different response categories for analysis and then entered into the Statistics Package for Social Sciences (SPSS) version 25 for Windows. Prior to coding the questionnaires, each item was reviewed to ensure that instructions were followed and responses were correctly given. Frequencies and percentages were used to describe the demographic characteristics of the responses, while mean and standard deviation were employed to analyze the extent of knowledge variables.
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