The Effectiveness of the Health Literacy Promotion Program on Self-Management Behaviors and Clinical Outcomes in Patients with Type 2 Diabetes in Buayai Hospital, Nakhonratchasima Province

Abstract

This research aimed at studying the effectiveness of health literacy programs on self-management behaviors and examining the clinical outcomes in patients with Type 2 diabetes. The participants were a group of patients with Type 2 diabetes, who had been unable to control glucose levels and had been admitted to the Diabetes Clinic at Buayai Hospital. The participants were divided into two groups:
1) an  experimental group consisting of 30 patients, who had been enrolled in a health literacy promotion program  provided the close observation of clinical outcomes and health behavior records , the-in clinic medication and nutrition-specific group discussion, health literacy skill training searching for online information and health care home visit, taking 12 weeks 2) a control group that also consisted of 30 patients, who had attended a regular treatment program.

The research information was collected by using a research instrument that was divided into two parts.  The first part consisted of questions about each participant’s personal data, diabetes knowledge, behavioral health, dietary habits, diabetes medications, and health literacy, as well as satisfaction assessments. The second part of the questionnaire focused upon the health literacy promotion program. The data was analyzed using descriptive and inferential statistics, Paired t-test and the Independent t-test statistics. were used for the analysis of health literacy, satisfaction, knowledge, and comprehension of diabetes within the group and between the groups, respectively.

It was observed that the average scores of the health literacy, satisfaction, knowledge, and comprehension about diabetes before and after being introduced to the program between the experimental group and the control group did not differ. The average scores on self-management before and after the program were observed to have shown significant differences between the two groups of participants ( =2.43, S.D.=0.23; =2.67, S.D.=0.20; 95%CI=-0.37 -0.11) (p<0.05). Regarding the clinical outcomes, the FBS ( =166, S.D.=51.95; =139, S.D.=43.21; 95%CI=5.29  2.53 ) and HbA1C levels reduced significantly in the experimental group ( =8.91, S.D.=1.35; =7.51, S.D.=0.89; 95%CI= 0.91  1.88) , while the figures for Cr, Micro albumin, and eGFR that were observed had not shown any differences between the two groups of participants. The results of the comparative analysis between the experimental group with the control group before and after the program, health literacy ( =3.67, S.D.=0.70; =3.19, S.D.=0.21; 95%CI=0.21 0.75; =3.88, S.D.=0.48; =3.14, S.D.=0.10; 95%CI=0.55  0.92), knowledge, comprehension about diabetes ( =11.73, S.D.=3.74; =12.93, S.D.=2.55 ; 95%CI=-2.85  0.45); ( = 11.8, S.D.=3.15; =11.47, S.D.=1.85; 95%CI=-1.00 1.67) were observed to have shown significant differences between the two groups of participants (p<0.05), the experimental group with the control group before the program, Micro albumin ( =259, S.D.=656; =93, S.D.=167; 95%CI=-81.56 413 ) were observed to have shown significant differences between the two groups of participants (p<0.05), while the figures for self-management, satisfaction, and clinical outcomes that were observed had not shown any differences between the two groups of participants (p >0.05).

In summary, the health literacy promotion program results in an ability to lower blood sugar levels and is possible to implement for diabetes patients in a diabetes service clinic in general.