Volume 5, Issue 12, December – 2020 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Assess the Compliance and Reasons for

Non Compliance to Life Style Modifications
among Patients with Diabetes Mellitus &
Coronary Artery Disease
Reena M & Jayanthi P
Vice Principal, Tagore College of Nursing, The Tamilnadu Dr MGR Medical University, Chennai, Tamil Nadu
Professor, Shri Sathya Sai College of Nursing, Sri Balaji Vidyapeeth University, Ammapettai, Tamil Nadu.
Corresponding Author:
Jayanthi P, Shri Sathya sai College of Nursing, Sri Balaji Vidyapeeth University, Ammapettai, Tamil Nadu.

Abstract:- In 1994 the American Medical Association in Chicago

Background: Diabetes mellitus and Coronary artery
disease has become a major health problem and multi-
factorial in nature and 2/3rd of deaths occur before the
patient reaching the hospital. Aim: To assess the
compliance and reasons for non-compliance to lifestyle
modification among patients with diabetes mellitus &
coronary artery disease. Material and Method:
Descriptive research design was used. 60 patients
diagnosed to have diabetes mellitus with coronary artery
disease in selected hospitals in Chennai selected by Non-
probability convenience sampling technique. A
structured interview schedule guide was administered to
assess the compliance and reasons for Non-Compliance
to lifestyle modification. Result: The study result showed
that 60% and 77% adhered to prescribed diet and
medication. 55% Non-Compliance to prescribed exercise
regularly and the reasons for Non-Compliance due to
general body weakness and tiredness.45% had Non-
Compliance to regular follow up and monitoring blood
glucose and cholesterol level due to lack of interest.
Conclusion: Health care personal has to create
awareness and motivate the clients who diagnosed to
have diabetes mellitus with coronary artery disease to
adhere to prescribed lifestyle modification.
Keywords:- Compliance, Reasons For Non-Compliance,
Life Style Modification, Diabetes Mellitus And Coronary
Artery Disease.
I. INTRODUCTION
Over the past several decades Diabetes mellitus and
Coronary artery disease has become a major health problem,
reaching epidemic proportions in many developing countries
including India. Presently 19.4 million individuals are
affected by Diabetes mellitus in India, Which likely to go up
to 57.2 million by the year 2025. The reasons for this
escalation are changes in life style practices and non
compliance to life style modifications.
enforced cardiac rehabilitation by life style modification The
epidemic of Type 2 diabetes, projected to reach 333 million
cases worldwide by 2025, is causing alarm in both medical
and political circle.. The onset of complications of diabetes
and coronary artery disease can be delayed by life style
modifications .Life style related risk factors play an
important role in the development of the secondary
complication among the patients diagnosed to have Diabetes
mellitus and Coronary artery disease. The risk factors like
dietary choices of high fat and high caloric diet, smoking,
alcohol consumption and sedentary life style1,2.
In 2004 according to the World Health Organization
the greatest increase in prevalence rate diabetes mellitus
with coronary artery disease is expected to occur in Asia and
Africa. The increase in incident of diabetes and coronary
artery disease in the developing countries follows the trend
of urbanization and life style changes3.
In the coming decades the burden of coronary artery
disease related to diabetes will increase substantially.
Changing prevalence and incident of diabetes mellitus with
coronary artery disease is a major public health and
economic problem in India. Worldwide estimates of its
prevalence are expected to rise from 2.8%(171 million
people) in 2000 to 4.4%(366 million people) in 2030.
The prevalence of diabetes mellitus with Coronary
artery disease is growing rapidly in both developing and
developed countries. The countries with the largest number
of cases in 2030 will be India, China and the United
States4,5.
Since diabetes mellitus with coronary artery disease is
a multi factorial disease involving both genetic and
environmental factor, a multi prolonged approach for
prevention of the complications is warranted. Since sudden
death or silent myocardial infarction in about half of the
patients diagnosed to have diabetes mellitus with coronary
artery disease and two third of deaths occur before reaching
the hospital. These people can be helped only through

IJISRT20DEC615 www.ijisrt.com 1236

Volume 5, Issue 12, December – 2020 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
preventive strategies and a strict compliance to life style Table 1: Factors that promotes to adhere / not adhere to
modifications in their day – to- day habits. life style modifications N=60
S. Responses about factors Frequency percentage
 Statement of the Problem No influencing to follow life
A study to assess the compliance and reasons for non style modifications
compliance to life style modifications among patients with A Factors promotes to
diabetes mellitus & coronary artery disease and receiving adhere life style 32 53.33
care in selected hospitals in Chennai. modifications 9 15.00
1. Family support 1 31.67
 Objectives 2. To reduce body weight
1.To assess the compliance and non compliance to life style B 3. Self motivation
modifications among patients with diabetes mellitus & 8 13.33
coronary artery disease Factors promotes not to 4 6.67
2.To assess the reasons for non compliance to life style adhere life style 7 11.67
modifications among patients with diabetes mellitus & modifications 3 5.00
coronary artery disease 1. Work load 3 5.00
3.To associate the compliance and non compliance to life 2. Family problems and 13 21.68
style modifications among patients with diabetes mental tension 1 1.66
mellitus & coronary artery disease with selected 3. Peer and friends 3 5.00
demographic variables. compulsion 1 1.66
4.To associate the reasons for non compliance to life style 4. Carelessness 17 28.33
modifications among patients with diabetes mellitus & 5. Same preparation of
coronary artery disease with selected demographic food for all family
variables. members
6. While going outside
II. MATERIAL AND METHODS and attending function
7. Unable to change my
Descriptive research design was used. 60 patients regular dietary habits
diagnosed to have diabetes mellitus with coronary artery 8. Forget to take
disease in 3 selected hospitals in Chennai selected by Non- medications
probability convenience sampling technique. Researcher 9. Economical factors
obtained formal permission from the hospital authorities. 10. No factors hindering
After obtaining written informed consent form the patients to adhere life style
of diabetes mellitus with coronary artery disease fulfilling modifications
the inclusion criteria were selected. The purpose of the study
was explained and a structured interview schedule guide
was administered to assess the compliance and reasons for
Non-Compliance to lifestyle modification. Statistical
analysis was performed using the Statistical Package for
Social Sciences Programme (SPSS) version 17.0.
Descriptive statistics was used for analysis.

III. RESULTS & IV DISCUSSION

38.3% (23) patients were in the age group of 41 – 50

years, 60% (36) of them were male, 76.7% (46) were
married, 70% (42) belonged to Hindu religion, 40% (24) of
them were completed their secondary education, 46.7%
(28) were unemployed and 38.3% (23) of them were earning
Rs. 4001 – Rs. 6000 per month.

Figure 1: Measures to overcome stress by the patient

having diabetes mellitus with coronary artery disease

IJISRT20DEC615 www.ijisrt.com 1237

Volume 5, Issue 12, December – 2020
Figure 2: Compliance and non compliance to learning to
cope up with stress
Figure3: Compliance and non compliance to prescribed
diet
Figure 4: Compliance and non compliance to performing
the prescribed exercise and checking the body weight
Researcher collected the compliance to the life style
modifications which include various aspects such as
prescribed diet regularly, performing the prescribed exercise
regularly, learning to cope with stress, taking the prescribed
medication regularly and regular follow-up care.
Regarding reasons for non compliance to salt restricted
diet, 71% of the samples expressed due to taste and 60%
IJISRT20DEC615 www.ijisrt.com
International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
expressed as they are not able to avoid the canned and
frozen foods during summer seasons. Regarding exercise
many of them expressed for non compliance due to general
body weakness and tiredness(49%), leg pain(9%), giddiness
and tachypenia(12%), work load(9%) and chest pain on
doing exercises(6%). 40% of them were not attending the
regular follow up care due to workload and lack of time.
The study findings were consistent with the study conducted
by Maleka 20076-10.
There was a significant association found between the
demographic variables such as age and monthly family
income with compliance and non compliance to checking
the blood glucose and cholesterol levels, gender with
performing the prescribed exercise and checking and
maintaining the ideal body weight, educational status and
dietary pattern with taking the prescribed medications
regularly, occupation with following measures to overcome
stress and monthly family income with compliance and non-
compliance to attending regular follow up care with
doctor/nurse.
IV. CONCLUSION
The investigator concluded that it is the responsibility
of health care personal to create awareness, plan teaching
program and motivate the patients with diabetes mellitus &
coronary artery disease to adhere to prescribed lifestyle
modification in order to prevent complication.
REFERENCES
[1]. Aggarwal. Indians most affected by heart diseases.
Indian Journal of Clinical Practice, Jun 2008, 19(1):9.
[2]. Asa Horuston. Personal Understandings of illness
among people with type 2 diabetes. Advanced Journal
of Nursing, 2004, 47(2): 17-182.
[3]. Bhattacharya N. et al. A study of compliance status of
diabetic patients. Indian Journal of public health, Jan
2005, 49(1):34-35.
[4]. Duff E-Metal. Self care compliance glycemic control
in adults with diabetes. West Indian Medical Journal,
Sep 2006, 55(4): 232-236
[5]. Brunner and Suddarth’s, Text Book of Medical
Surgical Nursing. 2008, Philadelphia : Lippincott
Williams and Wilkins publishers.
[6]. Elizabeth Thompson Beckly. Understanding Key to
medication compliance. Doc News, July 2004,1 (17).
[7]. Giorda C.Maggini et al. Secondary Prevention of
Coronary artery diseases in high risk diabetes patients.
Cardio vascular disease, Aug 2003:238-243.
[8]. James R.Gavin. et al. Reducing Cardiovascular risks in
patients type II diabetes mellitus. A Message from the
National Diabetes Educational program, 2000-2004.
[9]. J.S. Charterjee. From Compliance to concordance in
diabetes. Journal of Medical Ethics, 2006, 32:507-510.
[10]. Lisspers, J. et al. Multifactorial evaluation of a
program for life style behavior change in rehabilitation
and secondary prevention of coronary artery disease.
Cardiovascular Journal, 1996, 9-16.
1238