Effectiveness of the NERSD program in reducing HbA1c levels in patients with uncontrolled diabetes in Northern Thailand
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Abstract
Background: Uncontrolled diabetes mellitus (DM) is a public health problem that has a large impact on the economics of caring for individuals over the long term. This study aimed to evaluate the effectiveness of proper food consumption, regular exercise, Roy’s adaptation model, stress management, and regular drug taking (NERSD) program to reduce HbA1c in patients with uncontrolled diabetes.
Methodology: A randomized control trial was used to implement a NERSD program designed to control HbA1c levels among patients with diabetes in Wiang Chiang Rung District, Chiang Rai Province, Thailand. Intervention and control groups were assigned by a random allocation method after careful screening for uncontrolled blood glucose among 60 DM patients, indexed by HbA1c>7.0. The intervention program took 9 months to complete. A t-test and repeated measures analysis of variance was used to detect a significance level of a=0.05.
Results: A total of 60 patients with uncontrolled diabetes were recruited for the study, with 30 patients each in the intervention and control groups. Among the interventions, 80.0% of the patients were female, 50.5% were aged between 50 and 59 years, 66.7% had graduated from primary school, 83.4% were farmers, 90.0% were paid 5,000 baht per month, and 43.4 were diagnosed with diabetes for 1–5 years. In the control group, 70.0% of the patients were female, 53.4% were aged between 50 and 59 years, 86.7% had graduated from primary school, 76.7% were farmers, 96.7% were paid 5,000 baht per month, and 73.3% were diagnosed as having diabetes for 1–5 years. At the end of the intervention, knowledge of the disease and drugs (P-value <0.001) and preventive skills (P-value = 0.004) were found to be different between the groups. HbA1c levels between the control and intervention groups were statistically significant (P-value <0.001). Conclusion: The NERSD program was found to be effective in reducing HbA1c levels among patients with uncontrolled diabetes in district hospitals of northern Thailand. This program should be promoted for use in other district hospitals that handle similar populations in Thailand.
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