Materia ls and Methods
This descriptive study involving 150 subjects was conducted at Sri Manakula Vinayagar Medical College and Hospital (SMVMCH), a teaching hospital located in Pondicherry, south India, in July-August 2010. SMVMCH is a 750 bedded rural tertiary care hospital. It caters to a rural population with a geographical distribution of about 50-60 km, which surrounds the hospital. In-patients who had type 2 DM for more than 1 month were included in the study, irrespective of their diagnoses at admission. After obtaining their written informed consents, a trained final year medical student interviewed the subjects within 24 hours of their admissions by using a pre-designed, pre-tested, structured questionnaire. Information regarding patient characteristics, diabetes medication adherence, adherence to self care measures and family support was collected. Medication adherence was measured by using Morisky’s Medication Adherence Scale (MMAS). Permission was obtained to use this 8-item, structured, medication adherence scale. Each item in the scale measures a specific medication-taking behaviour. Response categories were yes/no for each item with a dichotomous response and for the last item, it was a 5 -point likert scale. The Alpha reliability of the scale was 0.83 [8]. Adherence to self care activity, such as consuming a recommended diabetic diet, having physical activity for at least 30 minutes a day, inspection of feet and feet care were also measured. Subjects were asked to comment on number of days on which they followed these self care activities in the previous week. Social support that they received from their family members was evaluated by using a 6 item, 5-point Likert scale. The scale evaluated emotional support, tangible aids and appraisal that they received from their families and it was adapted from Chronic Illness Resources Survey and the Diabetes Family Behaviour Checklist [9]. The English version of the structured questionnaire was translated into the local language, Tamil, by using translation-back translation method. Institutional ethics committee approved the study protocol.