The Analysis of Effects of COVID-19 Pandemic on Service System for Patients with Diabetes Mellitus in Thailand

Authors

Abstract

This descriptive qualitative research aimed to conduct the analysis of the effects of COVID-19 pandemic on service system for patients with diabetes mellitus in Thailand. The thirty-four key informants were purposefully recruited from directors and registered nurses in five tertiary hospitals with high incidence of COVID-19. The structured interview questionnaires were used for in-depth interviews. The content analysis was employed for descriptive information.

The findings revealed that the COVID-19 pandemic limited access to systemic services for patients with diabetes mellitus, including blood testing and essential drugs such as insulin. With consideration of the Expanded Chronic Care Model, community and health systems were effective collaboration to support ‘new normal’ healthcare services, including 1) building healthy public policy by minimizing crowding and supporting social distancing, 2) creating supportive environments by generating safe conditions for healthcare and the prevention of nosocomial infection, 3) strengthening communities by implementing co-operation and networking. The health system consisted of 6 dimensions: 1) supporting self-management by using self-care but ineffective communication between patient and healthcare providers, 2) developing personal skills through the use of social media, 3) designing delivery systems by emerging the ‘new normal’ paradigm, 4) re-orienting health services by categorizing patients through health risk screening, 5) providing support in decision-making by effective leadership and crisis management, and 6) providing support for the management of information systems and technology.

In conclusion, patients with diabetes mellitus were affected by the COVID-19 pandemic in term of the access to health services in hospitals, but communities and health system can adjust the service system to provide continuing care for patients.

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References

The Johns Hopkins Department of Civil and Systems Engineering. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) [Internet]: Johns Hopkins University (JHU); 2020 [updated April 15, 2020; cited 2020 April 15]. Available from: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6.

Fisher, D. & Heymann, D. Q&A: The novel coronavirus outbreak causing COVID-19. BMC Med. 2020;18(1):1-3. doi: https://doi.org/10.1186/s12916-020-01533-w.

Shang, L., Shao, M., Guo, Q., Shi, J., Zhao, Y., Xiaokereti, J., et al. Diabetes mellitus is associated with severe infection and mortality in patients with COVID-19: A systematic review and meta-analysis. Arch Med Res. 2020;51(7):700-9. doi: 10.1016/j.arcmed.2020.07.005.

Kaufman, N.D., Chasombat, S., Tanomsingh, S., Rajataramya, B. & Potempa, K. Public health in Thailand: Emerging focus on non‐communicable diseases. Int J Health Plan Manag 2011;26(3):e197-e212. doi: https://doi.org/10.1002/hpm.1078.

Morens, D.M., Folkers, G.K & Fauci, A.S. The challenge of emerging and re-emerging infectious diseases. Nature. 2004;430(6996):242-9. doi: https://doi.org/10.1038/nature02759.

Barrett, R., Kuzawa, C.W., McDade, T. & Armelagos, G.J. Emerging and re-emerging infectious diseases: the third epidemiologic transition. Annu Rev Anthropol 1998;27(1):247-71. doi: https://doi.org/10.1146/annurev.anthro.27.1.247.

Boutayeb, A. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 2006;100(3):191-9. doi: https://doi.org/10.1016/j.trstmh.2005.07.021.

Barr, V., Robinson, S., Marin-Link, B., Underhill, L., Dotts, A., Ravensdale, D., et al. The expanded chronic care model. 2003. doi: https://www.area-c54.it/public/the%20expanded%20chronic%20care%20model.pdf.

Lincoln YS, Guba EG. Naturalistic inquiry: sage;1985.

Cope, D.G. Methods and Meanings: Credibility and Trustworthiness of Qualitative Research. Oncol Nurs Forum 2014;41(1):89-91. doi: 10.1188/14.ONF.89-91.

Connelly, L.M. Trustworthiness in qualitative research. Medsurg Nurs 2016;25(6):435.

United Nations Thailand. Social Impact Assessment of COVID-19 in Thailand. United Kingdom: Oxford Policy Management;2020.

สมาคมโรคเบาหวานแห่งประเทศไทย. แนวทางเวชปฏิบัติสําาหรับโรคเบาหวาน 2560 Clinical Practice Guideline for Diabetes 2017. ปทุมธานี: บริษัท ร่มเย็น มีเดีย จำกัด;2560.

Nouhjah, S.& Jahanfar, S. Challenges of Diabetes Care Management in Developing Countries with a High Incidence of COVID-19: A brief report. Diabetes & Metabolic Syndrome. JCRR 2020;14:731-2. doi: https://doi.org/10.1016/j.dsx.2020.05.012.

Bornstein, R.S., Rubino, F., Khunti, K., Mingrone, G., Hopkins, D., Birkenfeld, L.A, et al. Practical recommendations for the management of diabetes in patients with COVID-19. Lancet Diabetes Endocrinol 2020;8:546-50. doi: https://doi.org/10.1016/S2213-8587(20)30152-2.

Koliaki, C., Tentolouris, A., Eleftheriadou, I., Melidonis, A., Dimitriadis, G. & Tentolouris, N. Clinical management of diabetes mellitus in the era of COVID-19: practical issues, peculiarities and concerns. J Clin Med 2020;9(7):2288. doi: https://doi.org/10.3390/jcm9072288.

Standiford, T.C, Davuluri. K., Trupiano, N., Portney, D., Gruppen, L. & Vinson, A.H. Physician leadership during the COVID-19 pandemic: an emphasis on the team, well-being and leadership reasoning. BMJ Lead 2021;5:20-5. doi: doi:10.1136/leader-2020-000344.

Published

2022-06-30

How to Cite

Ngamkham, S., & Wattanakul, B. (2022). The Analysis of Effects of COVID-19 Pandemic on Service System for Patients with Diabetes Mellitus in Thailand. Journal of Nurses Association of Thailand Northern Office, 28(1), 91–103. Retrieved from https://he01.tci-thaijo.org/index.php/jnorthnurse/article/view/255422

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Research Articles