ประสิทธิผลของการดูแลผู้ป่วยเบาหวานที่ควบคุมระดับน้ำตาลไม่ได้ โดยทีมแพทย์เวชศาสตร์ครอบครัวที่มีการดูแลด้านสุขภาพจิตร่วมด้วย ในเครือข่ายหน่วยบริการปฐมภูมิ ตำบลเสริมซ้าย อำเภอเสริมงาม จังหวัดลำปาง

Sittikorn Sariwat

Authors

Sittikorn Sariwat Muang Pan Hospital, Lampang Province

Keywords:

Diabetes, network of primary care unit, depression, stress

Abstract

This community trial, in two groups design with pretest and posttest measurement aimed to study effectiveness of caring by family physician care team in conjunction with mental health care among diabetic patients with poor glycemic control undergoing services in the network of primary care unit (NPCU) in Soem Sai sub-district, Soem Ngam district, Lampang province during August 2021 to January 2022. Population was 132 diabetic patients with poor glycemic control, divided into 66 persons per place. The instruments included 1) a questionnaire consisting of personal data questions, depression assessment questions, and stress assessment questions 2) blood glucose measurement scale and caring program by family physician care team in conjunction with mental health care. Data were analyzed by using descriptive statistics, independent t-test, paired t-test and Pearson correlation.

The study revealed that undergoing services at Thapong NPCU and Soem Ngam Hospital were not associated with changing in HbA1c. The group of patients undergoing services at Thapong NPCU had a large decrease in the average depression score and the average stress score more than the group of patients undergoing services at Soem Ngam Hospital with statistically significance (p-value<.05). Changes in the depression score and stress score were positively associated with HbA1c of the posttest with statistically significance 0.05. It was also found that the changed stress score was positively associated with changed HbA1c with statistically significance level of 0.05.Therefore, caring diabetic patients with poor glycemic control to undergoing services at NPCU should make a close care plan by a multidisciplinary team and mental health care should be taken into consideration as well.

References

World Health Organization. (2016). NCD Management-Screening, Diagnosis and Treatment. Global report on diabetes. Retrieved 30 January 2021 from: https://www.who.int/publications/i/item/9789241565257/.

Department of Disease Control, Ministry of Public Health. (2020). Annual Report 2019 (NCD). Nonthaburi: Aksorn Graphic and Design publishing limited partnership. (in Thai)

Department of Disease Control, Ministry of Public Health. (2017). 5-Year National NCDs Prevention and Control Plan (2017-2021). Bangkok: Emotion Art Co., Ltd..12-13.

Health Administration Division, Ministry of Public Health. (2016). Guideline primary care cluster service. Retrieved 29 January 2021 from: http://www.amno.moph.go.th/amno_new/files/Manual%20PCC%2020 17(1).pdf.

Ministry of Public Health. (2021). Lampang Health Data Center. Retrieved 30 January 2021 from: https://lpg.hdc.moph.go.th/.

Yodnarong, K. (2012). Development of Diabetic Care System in Pua Contracting Unit for Primary Care, Nan Province. Journal of Health Systems Research. 6(2), 290-7. (in Thai)

Tieampet, D., Sangrattanapiman, K., Aksornde, M., Taweebut, P., Changkaew, W. (2016). Development of Diabetes Millitus (DM) Care System Continued Seamlessly to Communities, Muang District, Srakaew Province. Nursing Journal of the Ministry of Public

Health. 25(3), 156-169. (in Thai)

Department of Mental Health, Ministry of Public Health. (2015). Mental health assessment guideline for health care service in community hospital (NCDs clinic). Revised edition. Nonthaburi: The agricultural Co-operative Federation of Thailand., LTD. 7. (in Thai)

Wang F., et al. (2019). Prevalence of comorbid major depressive disorder in Type 2 diabetes: a meta‐analysis of comparative and epidemiological studies. Diabetes UK. Retrieved 28 January 2021 from: https://onlinelibrary.wiley.com/doi/abs/10.1111 /dme.14042#.

Thamrongchaichana, J., Laohasiriwong, W., Thinkamrop, W. (2018). Situation and Factors Associated with Depression among Diabetes Mellitus Type II Patients in Khon Kaen Province. Royal Thai Navy Medical Journal. 45(3), 613-631. (in Thai)

Rungreangkulkij, S., Thavornpitak, Y., Kittiwatanapaisan, W., Kotnara, I., Kaewjanta, N. (2014). Prevalence and Factors of Depression among Type 2 Diabetic Patients. Journal of the Psychiatric Association of Thailand. 59(3), 287-298. (in Thai)

Palizgir, M., Bakhtiari, M., Esteghamati, A. (2013). Association of depression and anxiety with diabetes mellitus type 2 concerning some sociological factors. Iran Red Crescent Medical Journal. Retrieved 28 January 2021 from: https://pubmed.ncbi.nlm.nih.gov/24578829/.

Sunongbua, A., Sripornkitkajorn, D. (2017). The outcome of Network Development for Diabetic Patients Care at Health Promoting Hospital, Mueang Chaiyaphum District. Chaiyaphum medical journal. Retrieved 19 March 2011 from: https://thaidj.org/index.php/CMJ/article/ view/7340/9386. (in Thai)

Tangsangwornthamma, C., Wasuwithitgul, S., Rattanamongkolgul, S. (2013). The Comparative studies of Treatment Outcomes of Diabetes Thai patients in HRH Princess Mahachakri Sirindhorn Medical Center Using The ADA 2008 guideline. Journal of Medicine and Health Sciences. 20(1), 29-40. (in Thai)

Sulukananuruk, C., Jaisanook, W., Muktabhant, B. (2016). Association of Depression and Stress with HbA1c level of Type 2 Diabetic Patients Attending the Diabetes Clinic of Nampong Hospital, Khon Kaen Province. Srinagarind Medical Journal. 31(1), 34-46. (in Thai)

Pechsombut, R. (2016). Reducing Stress in Type 2 Diabetes Patients using a Modified Brain Fitness Program. Master of Science (Research and Statistics in Cognitive Science). Burapha University. (in Thai)

Phaitrakoon, J., et al. (2019). Factors Correlated with Stress of Patients with Diabetes Mellitus Type 2 in Princess Maha Chakri Sirindhorn Medical Center, Ongkharak, Nakhonnayok Province. Nursing Journal of the Ministry of Public Health. 29(1), 21-31. (in Thai)