Effects of a case management with family participation program in caring for uncontrolled diabetes mellitus older adults with comorbidities on health care behavior and clinical outcomes
Keywords:
uncontrolled sugar level, case management, family participation, older adult, clinical outcome, health behavior, diabetes mellitus, co-morbidityAbstract
The older adults with uncontrolled diabetes mellitus and co-morbidities are at high risk of developing both acute and chronic health-threatening complications. The objective of this quasi-experimental research was to study the effects of a case management with family participation program in caring for uncontrolled diabetes mellitus older adults with comorbidities on health care behaviors and clinical outcomes. The sample consisted of 52 pairs of uncontrolled diabetes mellitus with co-morbidity older adults and their caregivers. They were divided into either the experimental group or the control group, 26 pairs for each group, using a matched-pair design based on specified characteristics. The research instruments consisted of two parts: 1) the experimental instrument, which was the case management and family participation program, and 2) data collection instruments, which included (1) a demographic questionnaire, (2) a health behavior questionnaire, and (3) a clinical outcome record form, including HbA1c, blood pressure, and blood lipid levels. Data were analyzed using descriptive statistics, t-test and Mann-Whitney U test with a statistical significance level of .05.
The results of the study found that the experiment, the experimental group had significantly higher mean score of health care behaviors than before the experiment (p<0.001) and significantly higher than the control group (p<0.001). The HbA1c, Systolic blood pressure, Diastolic blood pressure, Total cholesterol, and LDL- low density lipoprotein were significantly lower than before the experiment (p<0.001; p<0.05; p<0.05; p<0.001 and p<0.001, respectively) and significantly lower than the control group (p<0.01; p<0.01; p<0.05; p<0.05 and p<0.001 respectively).
The research findings could be concluded that the case management and family participation program can modify the behaviors of older adults with diabetes mellitus, resulting in consistent appropriate health care behaviors, reducing HbA1c, and controlling comorbidities such as hypertension and hyperlipidemia to normal ranges.
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