Development of a nursing model to promote blood sugar control in patients with type 2 diabetes in primary care units, Muang District, Maha Sarakham Province

Abstract

This study was an action research that aimed to develop a nursing care in order to support blood sugar control in patients with diabetes mellitus type 2 of primary care units by using self management method. The research settings were four primary care units in Muang District, Maha Sarakham Province. The participants consisted of 61 patients with type 2 diabetes mellitus who had a mean Glycated Hemoglobin (HbA1C) of more than 9 mg%. The study was divided into 3 phases: 1) preparatory phase, 2) model development phase, and 3) evaluation phase. This study was conducted during July 2022 - February 2023. The data was gathered from medical records of primary care units and Health Data Center (HDC) of the Ministry of Public Health. Questionaries and focus group interviews recording were used as the research instruments. The statistical analysis was carried out using descriptive statistics, including percentage, mean, standard deviation; and content analysis.

The study revealed that The nursing model for promoting self-management of patients with type 2 diabetes mellitus consisted of 8 activities: 1. Survey , situation analysis, and identify patients’ problems in each area; 2. Consultation meeting with the working group to select the areas and find solution to the problems; 3. Establishing a special clinic called ‘Bao Jai Tai Dee (Good Heart & Good Kidney)’, and arrangement of consulting and setting goals; 4. Monitor patients’self-management by using patient diaries; 5. Home visits, to follow up self-care of patients and relatives; 6. Making appointments to follow up the results of the patient’s health condition and health behavior; 7. Evaluation and summarization, of self-management care and of the activities; and 8. Identify lesson learned, and modify the developed nursing model after trying out. The results also showed that after using this nursing model, majority of the patients (44 people, accounting for 72.13%) had a high score on diabetes knowledge factor. The perception of their health status was at a moderate level (mean=4.02, standard deviation=0.159). Self-care behaviors were at a moderate level (mean=3.64, standard deviation=1.448). In addition, most of the patients (42 people, accounting for 68.85%) had decreased Glycated Hemoglobin (HbA1C).