โปรแกรมการส่งเสริมการจัดการตนเองในผู้ป่วยเบาหวานชนิดที่ 2 ที่ควบคุมไม่ได้
คำสำคัญ:
การจัดการตนเอง, ผู้ป่วยโรคเบาหวานชนิดที่ 2, ควบคุมค่าน้ำตาลไม่ได้บทคัดย่อ
โรคเบาหวานเป็นโรคเรื้อรังที่รักษาไม่หายขาด ผู้ที่เป็นโรคเบาหวานต้องสามารถจัดการตนเองเพื่อควบคุมค่าน้ำตาลในเลือดให้เหมาะสมและลดภาวะแทรกซ้อนจากโรคเบาหวาน การวิจัยกึ่งทดลองนี้ มีวัตถุประสงค์เพื่อศึกษาผลของโปรแกรมการส่งเสริมการจัดการตนเองของผู้ป่วยเบาหวานชนิดที่ 2 ที่ควบคุมไม่ได้ กลุ่มตัวอย่าง คือ ผู้ป่วยเบาหวานชนิดที่ 2 ที่ไม่สามารถควบคุมค่าน้ำตาลในเลือด จำนวน 50 คน โดยสุ่มอย่างง่ายโดยการจับฉลากเข้ากลุ่มทดลองจำนวน 25 คน ได้รับโปรแกรมการส่งเสริมการจัดการตนเองที่ประยุกต์ใช้แนวคิดการจัดการของ Creer โดยการให้ความรู้ สร้างความตระหนักรู้ สร้างเสริมทักษะและพฤติกรรมในการจัดการตนเอง และกลุ่มเปรียบเทียบจำนวน 25 คน ดำเนินการทดลองตามโปรแกรม ระยะการทดลอง 4 สัปดาห์ ในสัปดาห์ที่ 1, 2 และ 4 เก็บรวบรวมข้อมูล หลังการทดลองทันทีในสัปดาห์ที่ 4 และระยะติดตามในสัปดาห์ที่ 8 วิเคราะห์ข้อมูล โดยใช้ ร้อยละ ค่าเฉลี่ย ส่วนเบี่ยงเบนมาตรฐาน สถิติ Repeated measures ANOVA และ Independent t-test
ผลการศึกษาพบว่า กลุ่มทดลองมีคะแนนเฉลี่ยความรู้เรื่องโรคเบาหวาน ความตระหนักรู้ในโรคเบาหวาน ทักษะการจัดการตนเองและพฤติกรรมการจัดการตนเองในการควบคุมโรคเบาหวาน มากกว่าก่อนการทดลองและมากกว่ากลุ่มเปรียบเทียบ อย่างมีนัยสำคัญทางสถิติ (p-value < .001) ค่าเฉลี่ยค่าน้ำตาลในเลือดหลังอดอาหาร 8 ชั่วโมง (FBS) ของกลุ่มทดลองลดลงจากก่อนการทดลองและลดลงกว่ากลุ่มเปรียบเทียบ อย่างมีนัยสำคัญทางสถิติ (p-value < .001)
สรุปได้ว่าโปรแกรมดังกล่าว ส่งเสริมให้ผู้ป่วยเบาหวานชนิดที่ 2 มีทักษะการจัดการตนเองและมีพฤติกรรมการจัดการตนเองเพื่อควบคุมโรคเบาหวาน สามารถลดระดับน้ำตาลในเลือดได้และสามารถนำไปใช้กับผู้ป่วยกลุ่มอื่น ๆ ได้
References
1. International Diabetes Federation (IDF) [Internet]. Belgium: IDF Diabetes atlas. [updated 2017 Oct 20; cited 2016 Jan 10]. Available from: http://www.diabetesatlas.org.
2. World Health Organization. Global report on diabetes. Switzerland; 2016.
3. Office of the Inspector General Ministry of Public Health and Office of Inspection and Assessment, Government Inspection Plan. Ministry of Public Health. (2018). (in Thai).
4. Suwattanakul T. Factors related to blood sugar control among diabetes mellitus type 2 patients. Journal of Health Systems Research 2018;12(3):515-22. (in Thai).
5. Rakchim A, Lerkiatbundit S, Saengcharoen W. Factors affecting blood sugar control among diabetes mellitus type 2 patients in Pak Phanang hospital at Nakhon Si Thammarat province. Walailak Research National Conference 10th. 27-28 March 2019. (in Thai).
6. Dermkuntod N, Leewattanapat P. A study of the effects of diabetes education program on HbA1c for patient with type 2 diabetes. Vajira Nursing Journal 2017;19(1):33-41. (in Thai).
7. Al-Shookri A, Khor GL, Chan YM, Loke SC, Al-Maskari M. Effectiveness of medical nutrition treatment delivered by dietitians on glycaemic outcomes and lipid profiles of Arab, Omani patients with type 2 diabetes. Diabetic Medicine 2012;29:236-44.
8. Diabetes Clinic Public Health Center 47 Khlong Khwang disease registration. Bangkok: Public Health Center 47 Khlong Khwang; 2017. (in Thai).
9. Likhitluecha N, Atthachaiwat A, Wongsuvansiri S, Sathira-angkura T, Leelawong S. Development of care management model for patients with uncontrolled diabetes. Journal of Nursing Division 2017;44(2):141-58. (in Thai).
10. Wankham C, Wattana C, Khampalikit S. The effects of a self-management program on hypertension-controlling behaviors, and mean arterial pressure among persons with hypertension. Nursing Journal 2015;42(1):49-60. (in Thai).
11. Sairat P, Wattana C, Takviriyanun N. Effects of a self-management training program on functional performance, acute exacerbation and quality of life among patients chronic obstructive pulmonary disease. Nursing Journal 2014;41(4):23-35. (in Thai).
12. Ritklar L, Wattana C, Kitipawong P. Effects of a self-management program on self-management behaviors, dyspnea, activities of daily living, and quality of life among patients with congestive heart failure. Nursing Journal 2012;39(1):64-76. (in Thai).
13. Boonsatean W. Self-management in persons with diabetes: individual process. Journal of Nursing and Health Care 2014;32(4):18-24. (in Thai).
14. Wattana C, Suprakitcharoen C, Rungwongprayoon N, Raetong P. Effects of self-efficacy for disease self- management promoting program on disease control behaviors, blood pressure level, and quality of life among people with hypertension: a longitudinal study. Journal of Phrapokklao Nursing College 2015;26(1):73-89. (in Thai).
15. Khunthong T, Isaramalai S, Komjakraphan P. Impact of a self-managed supporting program on self-management behaviour and sugar levels in category 2 insulin-dependent diabetes patients. Thai Journal of Nursing Council 2014;28(1):85-99. (in Thai).
16. Creer T. Self-management of chronic illness. In: Boekaerts M, Pintrich PR, Zeidner M, editors. Handbook of self-regulation. California: Academic 2000; 601-29.
17. Nato S, Vannarit T, Somrarnyart M. Effects of self-management promotion through diabetic camp participation on glycemic control behaviors and hemoglobin A1C level among persons with type 2 diabetes. Nursing Journal 2016;43(4):92-104. (in Thai).
18. Wattana C. Self-management support: strategies for promoting disease control. Journal of Phrapokklao Nursing College 2015;26(1):117-27. (in Thai).
19. Kongsakul S. The effects of a self-management skill training program on self-management behaviors regarding glycemic control and blood sugar level among persons with type 2 diabetes mellitus (master’s thesis). Pathumthani: Thammasat University;2009. (in Thai).
20. Kanghae P, Wattana C. The effectiveness of Empowering Self-management program on diabetes knowledge, self-management behaviors, and glycemic control among type 2 diabetic patients. Journal of Phrapokklao Nursing College 2015;26(2):63-77. (in Thai).
21. Sirisombut A, Kusuma na ayuthya S, Puwarawuttipanich W, Jirajariyavej S. The effect of a group-based diabetic self- management program on hemoglobin A1C among people with type 2 diabetes. Journal of Nursing Science 2016;34(1):118-28. (in Thai).
22 Phormpayak D, Eimatab R, Jujan P, Wattanakul W. Self-management experience of diabetes patients living in highland areas: a case study in Wang Thong district, Phitsanulok province. Thai Red Cross Nursing Journal 2017;10(1):66-80. (in Thai).
23. Chantawang S. Effects of a self-management supporting program on self-management behaviors and serum lipid level among elders with dyslipidemia (master’s thesis). Chiangmai: Chiangmai University; 2012. (in Thai)
24. Wattana C. Self-management support: strategies for promoting disease control. Journal of Phrapokklao Nursing College 2015;26(1):117-27.
25. Bloom BS. Taxonomy of education objectives handbook I: cognitive domain (7thed.). New York: David Makay;1972.
26. Tanomcheep R, Duangsong R. diabetes type 2 patients. Srinagarind Medical Journal 2016;31(5):297-304. (in Thai)
27. Akasriworn B, Tiamchan R, Chawapong W. Increasing awareness to prevent diabetes mellitus among risk group of diabetes mellitus in Nonglong sub-district, Wiangnonglong district, Lamphun province (master’s thesis). Chiangmai: Chiangmai University; 2016. (in thai)
28. Kongrith T. Modify food consumption behavior among diabetes mellitus type 2 patients by participatory learning process. Independent study report, Master Degree of Nursing Community Health Nursing Program, Faculty of Nursing Khon Kaen University. 2015. (in Thai).
29. Rongmuang D, Tongdee J, Songsri C. The Nursing’ role in caring the person with diabetes mellitus receiving glycemic control medication in community. Nursing Public Health and Education Journal 2016;17(3):3-16. (in Thai)
30. Piboon K. Self-management skills for behavior modification and sustainable support. Bangkok: Veterans Welfare Organization under the Royal Patronage. 2017. (in Thai).
31. Tripeuch K,Malathum P, Hanprasitkam K, Kantaranakul V. A synthesis of research of exercise influencing glycemic control in persons with type 2 diabetes. Rama Nurse Journal 2010;16(2):259-78. (in Thai)
32. Phungdee T, Sirisopon N, Kainakha P, Nititham A, Chaleoykitti S. The Effectiveness of exercise behaviors promotion program of diabetes mellitus type 2 patients. Journal of The Royal Thai Army Nurses 2017;18(Supplement):291-98. (in Thai)
33. Sulukananuruk C, Jaisanook W, Muktabhant B. Association of depression and stress with HbA1c level of type 2 diabetic patients attending the diabetes clinic of Nampong hospital, Khon Kaen province. Srinagarind Med Journal 2016;31(1):34-46. (in Thai)
34. Umbangthalud D. Effectiveness of intensive care program for patients with type II diabetes on knowledge, self-management behavior and blood glucose levels of diabetic patients in the PCU, Bang Pa-In District, Pra Nakhon Si Ayutthaya province. Journal of Nursing, Public Health, and Education 2017;18(1):11-20. (in Thai).
35. Wijathus D, Synlapakitkosol U. Effectiveness of group learning process program on health behaviors and glycosylated hemoglobin of uncontrolled type 2 diabetic patients attended diabetic clinic at Phanomsarakham hospital. Thai Journal of Nursing and Midwifery Practice 2018;5(2):39-54. (in Thai).
36. Sattanako C, Sota C. Effects of self-management program on glycemic control in patients with type 2 diabetes. Journal of Nursing and Education 2017;10(4):32-47. (in Thai).
2. World Health Organization. Global report on diabetes. Switzerland; 2016.
3. Office of the Inspector General Ministry of Public Health and Office of Inspection and Assessment, Government Inspection Plan. Ministry of Public Health. (2018). (in Thai).
4. Suwattanakul T. Factors related to blood sugar control among diabetes mellitus type 2 patients. Journal of Health Systems Research 2018;12(3):515-22. (in Thai).
5. Rakchim A, Lerkiatbundit S, Saengcharoen W. Factors affecting blood sugar control among diabetes mellitus type 2 patients in Pak Phanang hospital at Nakhon Si Thammarat province. Walailak Research National Conference 10th. 27-28 March 2019. (in Thai).
6. Dermkuntod N, Leewattanapat P. A study of the effects of diabetes education program on HbA1c for patient with type 2 diabetes. Vajira Nursing Journal 2017;19(1):33-41. (in Thai).
7. Al-Shookri A, Khor GL, Chan YM, Loke SC, Al-Maskari M. Effectiveness of medical nutrition treatment delivered by dietitians on glycaemic outcomes and lipid profiles of Arab, Omani patients with type 2 diabetes. Diabetic Medicine 2012;29:236-44.
8. Diabetes Clinic Public Health Center 47 Khlong Khwang disease registration. Bangkok: Public Health Center 47 Khlong Khwang; 2017. (in Thai).
9. Likhitluecha N, Atthachaiwat A, Wongsuvansiri S, Sathira-angkura T, Leelawong S. Development of care management model for patients with uncontrolled diabetes. Journal of Nursing Division 2017;44(2):141-58. (in Thai).
10. Wankham C, Wattana C, Khampalikit S. The effects of a self-management program on hypertension-controlling behaviors, and mean arterial pressure among persons with hypertension. Nursing Journal 2015;42(1):49-60. (in Thai).
11. Sairat P, Wattana C, Takviriyanun N. Effects of a self-management training program on functional performance, acute exacerbation and quality of life among patients chronic obstructive pulmonary disease. Nursing Journal 2014;41(4):23-35. (in Thai).
12. Ritklar L, Wattana C, Kitipawong P. Effects of a self-management program on self-management behaviors, dyspnea, activities of daily living, and quality of life among patients with congestive heart failure. Nursing Journal 2012;39(1):64-76. (in Thai).
13. Boonsatean W. Self-management in persons with diabetes: individual process. Journal of Nursing and Health Care 2014;32(4):18-24. (in Thai).
14. Wattana C, Suprakitcharoen C, Rungwongprayoon N, Raetong P. Effects of self-efficacy for disease self- management promoting program on disease control behaviors, blood pressure level, and quality of life among people with hypertension: a longitudinal study. Journal of Phrapokklao Nursing College 2015;26(1):73-89. (in Thai).
15. Khunthong T, Isaramalai S, Komjakraphan P. Impact of a self-managed supporting program on self-management behaviour and sugar levels in category 2 insulin-dependent diabetes patients. Thai Journal of Nursing Council 2014;28(1):85-99. (in Thai).
16. Creer T. Self-management of chronic illness. In: Boekaerts M, Pintrich PR, Zeidner M, editors. Handbook of self-regulation. California: Academic 2000; 601-29.
17. Nato S, Vannarit T, Somrarnyart M. Effects of self-management promotion through diabetic camp participation on glycemic control behaviors and hemoglobin A1C level among persons with type 2 diabetes. Nursing Journal 2016;43(4):92-104. (in Thai).
18. Wattana C. Self-management support: strategies for promoting disease control. Journal of Phrapokklao Nursing College 2015;26(1):117-27. (in Thai).
19. Kongsakul S. The effects of a self-management skill training program on self-management behaviors regarding glycemic control and blood sugar level among persons with type 2 diabetes mellitus (master’s thesis). Pathumthani: Thammasat University;2009. (in Thai).
20. Kanghae P, Wattana C. The effectiveness of Empowering Self-management program on diabetes knowledge, self-management behaviors, and glycemic control among type 2 diabetic patients. Journal of Phrapokklao Nursing College 2015;26(2):63-77. (in Thai).
21. Sirisombut A, Kusuma na ayuthya S, Puwarawuttipanich W, Jirajariyavej S. The effect of a group-based diabetic self- management program on hemoglobin A1C among people with type 2 diabetes. Journal of Nursing Science 2016;34(1):118-28. (in Thai).
22 Phormpayak D, Eimatab R, Jujan P, Wattanakul W. Self-management experience of diabetes patients living in highland areas: a case study in Wang Thong district, Phitsanulok province. Thai Red Cross Nursing Journal 2017;10(1):66-80. (in Thai).
23. Chantawang S. Effects of a self-management supporting program on self-management behaviors and serum lipid level among elders with dyslipidemia (master’s thesis). Chiangmai: Chiangmai University; 2012. (in Thai)
24. Wattana C. Self-management support: strategies for promoting disease control. Journal of Phrapokklao Nursing College 2015;26(1):117-27.
25. Bloom BS. Taxonomy of education objectives handbook I: cognitive domain (7thed.). New York: David Makay;1972.
26. Tanomcheep R, Duangsong R. diabetes type 2 patients. Srinagarind Medical Journal 2016;31(5):297-304. (in Thai)
27. Akasriworn B, Tiamchan R, Chawapong W. Increasing awareness to prevent diabetes mellitus among risk group of diabetes mellitus in Nonglong sub-district, Wiangnonglong district, Lamphun province (master’s thesis). Chiangmai: Chiangmai University; 2016. (in thai)
28. Kongrith T. Modify food consumption behavior among diabetes mellitus type 2 patients by participatory learning process. Independent study report, Master Degree of Nursing Community Health Nursing Program, Faculty of Nursing Khon Kaen University. 2015. (in Thai).
29. Rongmuang D, Tongdee J, Songsri C. The Nursing’ role in caring the person with diabetes mellitus receiving glycemic control medication in community. Nursing Public Health and Education Journal 2016;17(3):3-16. (in Thai)
30. Piboon K. Self-management skills for behavior modification and sustainable support. Bangkok: Veterans Welfare Organization under the Royal Patronage. 2017. (in Thai).
31. Tripeuch K,Malathum P, Hanprasitkam K, Kantaranakul V. A synthesis of research of exercise influencing glycemic control in persons with type 2 diabetes. Rama Nurse Journal 2010;16(2):259-78. (in Thai)
32. Phungdee T, Sirisopon N, Kainakha P, Nititham A, Chaleoykitti S. The Effectiveness of exercise behaviors promotion program of diabetes mellitus type 2 patients. Journal of The Royal Thai Army Nurses 2017;18(Supplement):291-98. (in Thai)
33. Sulukananuruk C, Jaisanook W, Muktabhant B. Association of depression and stress with HbA1c level of type 2 diabetic patients attending the diabetes clinic of Nampong hospital, Khon Kaen province. Srinagarind Med Journal 2016;31(1):34-46. (in Thai)
34. Umbangthalud D. Effectiveness of intensive care program for patients with type II diabetes on knowledge, self-management behavior and blood glucose levels of diabetic patients in the PCU, Bang Pa-In District, Pra Nakhon Si Ayutthaya province. Journal of Nursing, Public Health, and Education 2017;18(1):11-20. (in Thai).
35. Wijathus D, Synlapakitkosol U. Effectiveness of group learning process program on health behaviors and glycosylated hemoglobin of uncontrolled type 2 diabetic patients attended diabetic clinic at Phanomsarakham hospital. Thai Journal of Nursing and Midwifery Practice 2018;5(2):39-54. (in Thai).
36. Sattanako C, Sota C. Effects of self-management program on glycemic control in patients with type 2 diabetes. Journal of Nursing and Education 2017;10(4):32-47. (in Thai).
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2020-04-01
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