ประสิทธิผลของโปรแกรมการจัดการตนเองของผู้สูงอายุโรคเบาหวานโดยใช้การพยาบาลทางไกล โรงพยาบาลส่งเสริมสุขภาพตำบลบ้านจู้ด จังหวัดลำปาง

Supitcha  Booncharoen; Nanthawan  Teerawongsa

Authors

Supitcha Booncharoen Ban Jood Health Promotion Hospital, Lampang Province
Nanthawan Teerawongsa Boromarajonani College of Nursing, Lampang Faculty of Nursing, Praboromarajchanok Institute

Keywords:

Older Adults with Diabetes, Self-Management Program, Tele-nursing

Abstract

This quasi-experimental study with a two-group posttest-only design compared the effects of a telenursing-based self-management program with those of a conventional program among older adults with diabetes receiving care at Ban Chut Subdistrict Health-Promoting Hospital, Lampang Province. The sample comprised 84 older adults with diabetes, selected through purposive sampling and allocated to an experimental group (n = 42) and a control group (n = 42). The experimental group received the telenursing-based self-management program, whereas the control group received conventional care. Data were collected using a self-management program, a diabetes knowledge questionnaire, and a self-management behavior assessment. The instruments were reviewed by three experts, with reliability coefficients of .81, .89, and .91, respectively. Data were analyzed using frequencies, percentages, standard deviations, and independent-samples t tests.
The findings revealed that the experimental group had significantly higher mean knowledge scores and self-management behavior scores than the control group (p < .001). In addition, a significantly greater proportion of participants in the experimental group achieved HbA1c levels below 7% compared with those in the control group (p < .001). These findings indicate that the telenursing-based self-management program was more effective than the conventional program in enhancing knowledge, self-management behaviors, and glycemic control among older adults with diabetes. This approach should be further developed as a clinical practice guideline for diabetes care.

References

Audthiya, P., Wiwoot, P., & Kreuangchai, S. (2024). The effects of autonomy support program on self-management behaviors and HbA1c among older persons with diabetes mellitus in Hang Chat District, Lampang Province. Journal of Health Sciences Scholarship, 11(1). https://he01.tci-thaijo.org/index.php/johss/article/view/267771/181162 (in Thai)

Bingham, J. M., Black, M., Anderson, E. J., Li, Y., Toselli, N., Fox, S., et al. (2021). Impact of telehealth interventions on medication adherence for patients with type 2 diabetes, hypertension, and/or dyslipidemia: A systematic review. Annals of Pharmacotherapy, 55(5), 637–649.

Chaisena, C. (2014). The effects of a health education program on health belief and diabetes prevention behaviors among risk groups in Pasang District, Lamphun Province (Master's thesis, Chiang Mai University). (in Thai)

Diabetes Association of Thailand. (2023). Clinical practice guideline for diabetes 2023. Srimung Printing. (in Thai)

Hatayakan, C. (2014). The effects of a health education program on health belief and diabetes prevention behaviors among risk groups in Pasang District, Lamphun Province (Master's thesis, Chiang Mai University, Thailand). (in Thai)

Kanfer, F. H., & Gaelick-Buys, L. (1991). Self-management methods. In F. H. Kanfer & A. P. Goldstein (Eds.), Helping people change: A textbook of methods. Pergamon Press.

Knowles, M. S. (1984). Andragogy in action: Applying modern principles of adult learning. Jossey-Bass.

Mananchaya, J. (2023). The effects of health literacy promotion based on the Pitts principle on self-management among older adults with multiple chronic diseases (Master's thesis, Chiang Mai University, Thailand). (in Thai)

National Statistical Office. (2023). Summary of important results: Survey on the use of information and communication technology in households 2023. Ministry of Digital Economy and Society. https://www.nso.go.th/nsoweb/storage/survey_detail/2024/20240426085831_43202.pdf (in Thai)

Nittaya, S., & Wichet, C. (2023). Effects of a self-management program combined with the "Bau-Jai" diabetes mobile application on foot ulcer prevention behaviors among patients with type 2 diabetes. Journal of Behavioral Science for Development, 15(2), 1–16. (in Thai)

Partiprajak, S., Hanucharurnkul, S., & Piaseu, N. (2014). Factors predicting self-care abilities and quality of life in persons with type 2 diabetes. Nursing Research and Innovation Journal, 20(1), 97–111. https://he02.tci-thaijo.org/index.php/RNJ/article/view/19200 (in Thai)

Phaitoon, S. (2020). The relationship between diabetes knowledge and self-management among patients with type 2 diabetes. Journal of Nursing and Health Sciences, 14(2), 86–100. (in Thai)

Sriprasert, K., Aungwattana, S., & Tamdee, D. (2023). The Effect of a Tele-Nursing-Based Self-Management Program on Health Behavior of Persons with Uncontrolled Diabetes Mellitus in a Community. Nursing Journal CMU, 50(3), 99–115. https://he02.tci-thaijo.org/index.php/cmunursing/article/view/262506 (in Thai)

World Health Organization. (2016). Global report on diabetes. World Health Organization. https://www.who.int/publications/i/item/9789241565257

Wong, Z. S., Siy, B., Da Silva Lopes, K., & Georgiou, A. (2020). Improving patients' medication adherence and outcomes in nonhospital settings through eHealth: Systematic review of randomized controlled trials. Journal of Medical Internet Research, 22(8), e17015. https://doi.org/10.2196/17015