A causal relationship model of factors influencing glycemic control among pre-diabetes in Phrom Phiram district Phitsanulok province, Thailand 10.55131/jphd/2025/230306
Article Sidebar
Main Article Content
Abstract
This research aimed to study the causal relationships model of the factors influencing glycemic control among pre-diabetes population in Phrom Phiram district, Phitsanulok province. Determining the sample size under the assumptions of the structural equation analysis.
The sample consisted of 530 participants, who were recruited by a multistage sampling.
Data were collected by questionnaire with reliability value between 0.83- 0.95. Data were analyzed using descriptive statistics and Structural Equation Model (SEM) by LISREL 8.52 software. The study results revealed that 530 participants were Thai (80.8%), Lao Krang ethnic group (14.3%), and Thai of Chinese origin (4.9%) respectively. The majority of participants were female (58.5 %), The mean age was 49.59 years and S.D. of 7.15. 42.5% had primary school level of educational. The mean income was 10,000 bath and S.D. of 7,243.84. 76.6% had duration of pre-diabetes 1-6 years, 77.2% had a family history of diabetes and the mean fasting blood sugar level was 112.57 mg./dl. and S.D. of 8.80. Based on the analysis, a structural equation model that fit to the data was obtained with Chi-Square/df =1.17, P-value=0.0576, GFI=0.99, AGFI=0.97, SRMR=0.030, RMSEA=0.018 and CN= 706.08. A causal relationships model showed that social support explained the variance in health literacy at 46%. Meanwhile, social support, attitude towards glycemic control, norm, and health literacy co-explained the variance in intention at 100%. Then, health literacy, self-efficacy, and intention co-explained the variance in glycemic control behavior at 40%. And glycemic control behavior explained the variance in blood sugar levels at 100%. In conclusion, social support was the most important factor on health literacy. Meanwhile, the health promotion focused mainly on self-efficacy, intention, and health literacy toward glycemic control behavior. That could help to control blood sugar levels of pre-diabetes.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
World Health Organization. World health statistics 2022: monitoring health for the SDGs, sustainable development goals. World Health Organization. 2022.
International Diabetes Federation. IDF Diabetes Atlas-10th Edition. International Diabetes Federation. 2021.
Ekkapalakorn W, Phakcharoen H, Thaikla K, Satiannoppakao W. National Health Examination Survey 5th in 2014. Bangkok: Aksorn Graphic and Design Publishing House. 2016.
Ekkapalakorn W, Phakcharoen H, Satiannoppakao W. National Health Examination Survey 6th in 2020. Bangkok: Aksorn Graphic and Design Publishing House. 2021.
Health Information System Development Office. Health statistics of Thai people [Internet]. [Cited 2023 August 12]. Available from: https://www.hiso. or.th/thaihealthstat/area/index.php?ma=2&pf= 01818101 &tp=4409.
World Health Organization. Classification of diabetes mellitus. World Health Organization. 2019.
Scott MG. Pre-Diabetes, Metabolic Syndrome, and Cardiovascular Risk. JACC. 2012;59(7):635-643. doi: 10.1016/j.jacc.2011.08.080
Hostalek U. Global epidemiology of prediabetes - present and future perspectives. Clin Diabetes Endocrinol. 2019;5(5):1-5. doi: 10.1186/s40842-019-0080-0
Charonesrimaung S, Suphunnakul P, Nakamadee B, Ekthamasut N. Lifestyle and related factors that prevention diabetes type 2 in the pre-diabetes group of Phitsanulok province. J Nurs Educ. 2020;13(3):59-71.
Phitsanulok Provincial Public Health Office. Health survery report 2022. Phitsanulok Provincial Public Health Office. 2022.
Ministry of Public Health. Health Data Center [Internet]. [Cited 2023 August 12]. Available from: https://hdcservice. moph.go.th.
Charonesrimaung S, Suphunnakul P, Ngernchaeng J. Factors influencing glycaemic control among pre-diabetes in Maung district, Phitsanulok province. J Health Sci. 2019;28(4): 628-638.
Suphunnakul P, Songthap A, Sihanat A, Watcharaput N, Nakamadee B, Konkaew K, Junsukon E. A causal relationship of factors influencing glycaemic control behaviour among the elderly with type 2 diabetes mellitus uncontrolled blood sugar levels. EAU Heritage Journal Science and Technology. 2023;17(2):148-161.
Yarmohammadi S, Momenyan S, Ghaffari M, Ali R, Azizpour M. Impact of functional, communicative and critical health literacy on glycaemic control among patients with type 2 diabetes, and the mediating role of self-care. Psychol Res and Behav Manag. 2019;12(2019):427-435. doi: 10.2147/ PRBM.S207466
Badpar S, Bakhtiarpour S, Heidari A, Moradimanesh F. Causal model of self-care based on social support and health literacy through self-efficacy in managing diabetes in diabetic patients. J Diabetes Nurs. 2019;7(2):752-763.
Jaseicha R, Kanokthet T. The multi-level causal factors affecting of self-care behaviours among the elderly with type 2 diabetes and fasting blood sugar (FBS) with uncontrolled condition: a case study of Phichit province. EAU Heritage Journal Science and Technology. 2019;13(2):145-158.
Zhao R, Zhang X, Wang S, Zhao N, Li D, Fan H. Factors affecting T2DM patients’ behaviours associated with integrated treatment and prevention services in China. Int J Equity Health. 2023;22(1):1-11. doi: 10.1186/s12939-023-020289
Putthong S, Sornketrin A, Kaewpradist P. Predictive factors on the plasma glucose levels in type 2 diabetes mellitus client: relative analysis under the theory of planned behaviour in Suratthani hospital. Reg 11 Med. 2017; 31(1):83-96.
Gao M, Chen X, Sun X, Wang F, Fan L, Sun X. Predicting stage of exercise among patients with type 2 diabetes: a test of the extended theory of planned behaviour. Patient Prefer Adherence. 2020;14(1):277-285. doi: 10.2147/ PPA.S236813
Ajzen I. The theory of planned behaviour. Organ Behav Hum Decis Process. 1991;50(2):179-211.
House JS. Work stress and social support. California: Addison-Wesley. 1981.
Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int. 2000; 15(3):259-267.
Non-communicable Disease Division. Diabetes risk screening report 2023, Phrom Phiram Hospital. Phrom Phiram Hospital. 2023.
Kline R. Principles and practice of structural equation modelling. 3rd ed. New York: Guilford Press. 2011.
Comrey AL, Lee HB. A first course in factor analysis. New Jersey: Erlbaum. 1992.
Schermelleh-Engel K, Moosbrugger H, Muller H. Evaluating the Fit of Structural Equation Models: Tests of Significance and Descriptive Goodness-of-Fit Measures. Methods of Psychological Research. 2003;8(2): 23-74.
Phadungyotee V, Phumonsakul S, Chansatitporn N, Piaseu N. A Model of factors influencing glycaemic control behaviour among pregnant women with gestational diabetes mellitus A1. PRIJNR. 2024;28(2):377-389.
Hongsanun W, Kitreerawutiwong N. Application of theory of planned behaviour and reduction sugar-sweetened beverages behaviours intention in adolescents. JPNC. 2020; 31(2):240-256.
Phungdee T, Sirisopon N, Rawdaree P. A causal relationship structure model of dietary behaviour to control blood glucose levels of type 2 diabetes mellitus patients. IRR. 2022;17(2):26-30.
Bandura A. Self-efficacy: toward a unifying theory of behavioural change. Psychol Rev. 1977;84(2):191-215.
World Health Organization. Health Promotion Glossary. World Health Organization. 1998.
Sheeran P, Webb TL. The intention–behaviourgap. Soc Personal Psychol. 2016;10(9): 503-518.
Fornell C, Larcker DF. Structural equation models with unobservable variables and measurement error: Algebra and statistics. JMR. 1981; 18(3): 382-388.
Diekmann A, Preisendorfer P. Green and greenback: the behavioral effects of environmental attitudes in low-cost and high-cost situations. Ration Soc. 2003; 15(4): 441-472.
