The Development and Evaluation of a Self-Management Model for Type 2 Diabetes Patients

Abstract

Diabetes is achronic disease that is foundin all countries. As a complicated
disease, treatment by the doctor alone is not enough. Patient's behavior, particularly selfmanagement
by patients with Type 2 Diabetes, is also an important component of
managing the effects of this disease. Thus, having a model for self-management in patients
with Type 2 Diabetes can have a significant impact on improving public health.
This research aimed to 1) develop a self-management model for Type 2 Diabetes
patients, and 2) evaluate the effectiveness of the self-management model. Subjects (510
patients with Type 2 Diabetes) were recruited from four hospitals in Muang district of Uthai
Thani province for Phase 1 (developing the model). A total of 52 subjects for Phase
2(evaluating the model) were recruited from Nong Kha Yang district. These subjects were
divided into an experimental group of 26 subjects and a control group of 26 subjects, with
an experimental period of 9 weeks. Instruments used included a questionnaire, knowledge
test, behavior test, the guide to self-management and 5) An activity plan of knowledge and
skills about self-management. Data analysis included descriptive statistics, t-test, and
structural equation modeling analysis using the software Amos.
The results showed that: 1) Knowledge behavior directly affected attitudinal
behavior and Cognitive behavioral modification. Attitudinal behavior did not directly affect
the effectiveness of self-management of Type 2 Diabetes patients, whereas Cognitive
behavioral modification directly affected the effectiveness of self-management of Type 2
Diabetes patients; 2) After using the self-management program, the knowledge level on
diabetes, dietary control, exercising, medicine usage and relaxation within the experimental
group was higher than pre-program, as well as that of the control group; 3) After using the
program, the mean level of self-management behavior in the experimental group was
higher than pre-program (p<0.05), whereas there was no significant post-program difference
in the control group. The mean level of self-management behavior was also higher in the
experimental group, when compared to that of the control group (p<0.05); 4) After using he
program, the mean levels of fasting plasma glucose and of glycosylated HbA1C of the
experimental group were better than before using the program as well as better than those
of the control group (p<0.05), whereas there was no post-program difference in the control
group.