Effects of a Self-Management Program on Self-Management Behaviors for Slowing the Progression of Diabetic Nephropathy among Diabetic Patients at Fang Hospital, Chiang Mai Province

Abstract

Diabetic patients who are unable to control their blood sugar levels can experience kidney blood vessels impairment, resulting in reduced filtration rates and eventually kidney failure. If patients are unable to self-manage and delay the progression of kidney disease, it can ultimately result in the need for kidney replacement therapy ultimately. The objectives of this two-group pretest-posttest quasi-experimental design research were: 1) to compare the average scores of self-manage behaviors, and 2) to compare the clinical outcomes of diabetic patients with chronic kidney disease between the experimental and control groups. The sample consisted of type 2 diabetes patients receiving treatment at Fang Hospital, Chiang Mai. A purposive sampling method was used to recruit the participants into experimental and control groups, 30 for each group. Research tools included a personal data questionnaire, a self-management program for behavior changing to delay the progression of chronic kidney disease in diabetic patients, an assessment questionnaire for blood sugar control behaviors in diet control and medication. The content validity index of the last two research tools were 1.0, and their reliability coefficients, measured with Cronbach's alpha, were .73 and .78, respectively. Personal data were analyzed using descriptive statistics. ANCOVA was used to compare the average scores of blood sugar control behaviors in diet and medication between the experimental and control groups.

The results revealed that after participating in the program, the experimental group had higher mean scores of self-manage (blood sugar control behaviors regarding diet and medication), higher estimated glomerular filtration rate and lower blood sugar level than  the control group, statistical significance at p-value <.001. Therefore, the self-management program for behavior changing can delay the progression of chronic kidney disease in diabetic patients.