Factors Influencing Behaviors in Using Herbs to Lower Blood Sugar among Older Adults with Diabetes in Rural Areas: A case study of Bang Nam Priao District, Chachoengsao Province

Abstract

Objective: To study the behaviors in using herbs to lower blood sugar among older adults with diabetes in Bang Nam Priao District, Chachoengsao Province, and factors influencing those behaviors. Methods: This study employed a mixed method approach. Phase 1 was quantitative research that collected the data with a questionnaire from 335 older adults with diabetes. The collected data included perceptions based on the Health Belief Model and behaviors in using herbs to lower blood sugar. Phase 2 or qualitative research involved in-depth interviews using semi-structured questions with 20 key informants using herbal medicines to reduce blood sugar. The interviews were conducted to understand their behaviors and perceptions regarding herbal use. Results: The majority of participants in quantitative study were female (78.2 %) with an average age of 66.9 ± 7.4 years old. About 40.3% used herbal medicines to lower blood sugar. The most commonly used herbal medicines was bitter melon (68.15 % of herbal users). They typically consumed fresh herbs or cooked as food. Most herbal users were influenced by friends or acquaintances (69 %). Perceived benefits from herbal use and cues to action significantly increased the likelihood of herbal use, with odds ratios (ORs) of 1.09 (95% CI: 1.03-1.14) and 1.10 (95% CI: 1.05-1.15), respectively. Conversely, perceived risks from herbal use was associated with a reduced likelihood of such behavior, with an odds ratio of 0.84 (95% CI: 0.74-0.94). In-depth interviews revealed that herbal use was linked to personal beliefs, and influence from those close to them and from community through word-of-mouth and local wisdom. However, most older adults did not inform their physicians about their herbal use due to fear of being blamed or being told to stop using. Conclusion: Healthcare personnel should be aware of appropriate herbal uses, and foster positive communication with patients in order to monitor side effects from herbal uses. They should also provide appropriate counseling on herbal use for older adults with diabetes.