Development of a behavior modification model for uncontrolled type 2 diabetic patients with family participation at Srisomdet Hospital, Roi Et Province

Abstract

Purposes : To study the problem situation, model development and the results of a behavior modification model for uncontrolled type 2 diabetic patients with family participation.

Study design : Action Research.

Materials and Methods : This research is divided into 3 phases: 1) Problem situation analysis. Key informants were 132 type 2 diabetic patients who applied to participate in behavior modification activities during the specified period 2) Development a model. Key informants were 15 chronic disease care committee members and 132 type 2 diabetic patients from phase 1 and 3) Monitoring and evaluating results in a model of a behavior modification model for uncontrolled type 2 diabetic patients with family participation. Key informants were 132 type 2 diabetic patients from phase 1. Data were collected using the developed data collection form and the quality of the instrument was checked by finding the content validity index (CVI) of 0.98. Data were analyzed using descriptive statistics. Compare results before and after development with paired sample t-test and content analysis.

Main findings : Problems in diabetes control in the area include lack of knowledge about diabetes and its complications, inappropriate medication and diet, lack of physical activity and appropriate stress management, and lack of diabetes knowledge among family members of type 2 diabetic patients. Model of a behavior modification model for uncontrolled type 2 diabetic patients with family participation has 6 aspents 1) Providing knowledge about diabetes and complications 2) Using medication appropriate and with awareness 3) Controlling and adjusting food behavior to be balanced 4) Physical activities and foot care 5) Training to manage stress 6) Building cooperation with the family by continuously following up together. Following the implementation of the intervention, significant improvements were observed among diabetic patients. Fasting blood sugar (FBS) levels decreased by 26.37 mg%, and glycated hemoglobin (HbA1c) levels declined by 1.40 mg%. Total cholesterol levels were reduced by 25.95 mg/dL, while low-density lipoprotein (LDL) cholesterol levels dropped by 24.13 mg%. These reductions were statistically significant (p < .001 for all parameters). In addition, high-density lipoprotein (HDL) cholesterol levels increased by 3.05 mg%, and estimated glomerular filtration rate (eGFR) improved by 2.88 mL/min/1.73 m², both showing statistically significant changes (p = .009 and p < .001, respectively). However, serum creatinine levels showed no significant difference (p = .100).

Conclusion and recommendations: a behavior modification model for uncontrolled type 2 diabetic patients with family participation results in patients being able to control their HbA1c levels, More effective self-care has led to better diabetes control.