Empowerment for Diabetic Nephropathy Stage 1 and 2 Patient through Family and Community Participation at One Community, Amnatcharoen province
The objective of action research were to analyze self-care management, problems and needs of diabetic nephropathy stage 1 and 2 patients and empowerment their to improve self-care management under the social and cultural context. Gibson’s model was the theoretical framework to empowerment the patients, families and community. The participants include 10 patients, 10 family members, 8 village health volunteers, 8 community leaders, 1 municipality representative and 2 professional nurse from hospital. The tools used to collected data including in-depth interviews guideline, focus group discussion and participant observation guidelines. Descriptive statistic was used for quantitative data and content analysis was used for qualitative data
The results showed that Patients don’t understand about diabetic nephropathy. Illness management behavior is not appropriate. Caregiver and Public Health Volunteers don’t understand about diabetic nephropathy and patient care. Community leader recognize the situation in the community but no problem solving activities. Health service system no continuous monitoring of patients in the community. This problem organized brainstorming sessions for those involved to plan and proceed as follows 1) Training workshop on diabetic nephropathy for patients and caregiver 2) Self help group to practice self-care skills, including self-monitoring of blood sugar levels, weight control, knowledge of nutrition, and SKT 3)Empowerment for caregiver in caring for diabetic nephropathy patients. 4) Empowerment for Public Health Volunteers in the home visit. 5) Home visit and individual patient care plan 6) Community campaign including power to reduce sweetness, reduce fat, reduce salty, reduce kidney disease in the community. After the implementation of the plan for a period of 12 weeks. Performance as follows patients can better manage their self-care behavior including blood sugar control, food control, reduce salty food especially sodium salt, increasing physical activity is 3-5 days a week and strictly taking more pills. Clinical results: After this study; 9 Diabetic patients can reduce fasting blood sugar levels (FBS). 7 patients can reduce Hemoglobin A1C (HbA1C) and 6 patients can increase the glomerular filtration rate (eGFR). Every activity creates participation by using an action research process. Resulting in the care of patients in the community of those involved Resulting in better self-care behavior And effective control of blood sugar levels.
Recommendations for patients who are unable to control blood sugar levels. Service personnel should find ways to empowerment and monitor patient behavior continuously that is appropriate for each patient.
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