ประสิทธิผลของโปรแกรมการให้ความรู้และสนับสนุนการจัดการตนเอง ของผู้สูงอายุโรคเบาหวาน ในเขตตำบลท่าแร่ อำเภอเมือง จังหวัดสกลนคร

Pimwadee Karoon; Kittiphoom Phinyo

Authors

Pimwadee Karoon Faculty of Nursing, Khon Kaen University
Kittiphoom Phinyo Faculty of Nursing, Khon Kaen University

Keywords:

diabetes self-management education and support (DSMES) program, older adults, diabetes mellitus

Abstract

This study aimed to evaluate the effectiveness of an education and self-management support program for older adults with diabetes living in Tha Rae Subdistrict, Mueang District, Sakon Nakhon Province. A quasi-experimental design was applied. The sample consisted of 36 individuals aged 60 years or older. They were divided into the experimental group and the control group, 18 people for each group. The sample size was calculated using G*Power software. Participants who met the specified inclusion criteria were purposively selected and subsequently randomly selected by drawing lots without replacement until a total of 18 pairs of participants was obtained. The statistical significance level was set at 0.05. Data were collected at two time points, before and after the intervention.

The program was developed based on the concept of diabetes self-management education and support (DSMES) and comprised six activities conducted weekly - lasting approximately 30–90 minutes each - over a period of eight weeks. The content covered diabetes knowledge, self-care practices, medication adherence, healthy diet selection, appropriate physical activity, complication prevention, and stress management. Data collection tools included a general information interview form, a diabetes knowledge test, and a self-management behavior questionnaire. All instruments were validated by five experts. The content validity index (CVI) of the knowledge test and the selfmanagement behavior questionnaire was 0.99. The reliability of the knowledge test was measured using the Kuder–Richardson 20 (KR-20) formula, yielding a reliability coefficient of 0.89. The reliability of the self-management behavior questionnaire for older adults with diabetes was assessed using Cronbach’s alpha coefficient, which yielded a value of 0.87.

Findings revealed that after the intervention, the experimental group had significantly higher mean scores of self-management behavior than the control group (p < .001). There was no statistically significant difference between the groups in mean scores of diabetes knowledge and blood glucose levels. The results suggest that structured education and ongoing support can effectively improve health behaviors among older adults with diabetes. Long-term follow-up is recommended to further assess clinical outcomes.

References

Office of Disease Prevention and Control, Region 7 Khon Kaen. November 14 of every year: World Diabetes Day [Internet]. Khon Kaen: Department of Disease Control; 2023 [cited 2024 Dec 15]. Available from: https://ddc.moph.go.th/odpcnews.php?news=47616&deptcode=odpc7&news_views=212 (in Thai)

Lin X, Xu Y, Pan X, Xu J, Ding Y, Sun X, et al. Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025. Sci Rep 2020;10(1):14790. doi:10.1038/s41598-020-71908-9.

Yang JJ, Yu D, Wen W, Saito E, Rahman S, Shu XO, et al. Association of diabetes with allcause and cause-specific mortality in Asia: a pooled analysis of more than 1 million participants. JAMA Netw Open 2019;2(4):e192696. doi:10.1001/jamanetworkopen.2019.2696.

Ministry of Public Health. Standard report [Internet]. Bangkok: Ministry of Public Health; 2022 [cited 2024 Sep 20]. Available from: https://ddc.moph.go.th/ (in Thai)

Department of Health. Situation report on noncommunicable diseases in Thailand, 2022 [Internet]. Bangkok: Ministry of Public Health; 2022 [cited 2024 Sep 20]. Available from: https://www.anamai.moph.go.th/ (in Thai)

Anderson RM, Funnell MM. Patient empowerment: reflections on the challenge of fostering the adoption of a new paradigm. Patient Educ Couns 2005;57(2):153–7. doi:10.1016/j.pec.2004.05.008.

Saengngoen S. Blood glucose control behaviors among older adults with type 2 diabetes mellitus in the western border area of Tak Province. In: Proceedings of the 13th National Conference of the Higher Education Research Network; 2019 Nov 20–22; Chiang Mai, Thailand. Chiang Mai: [publisher unknown]; 2019. p. 885–92. (in Thai)

Lorig KR, Holman H. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med 2003;26(1):1-7. doi:10.1207/S15324796ABM2601_01.

Jaidee S, Suksawat P, Maneerat N. Factors associated with self-management among older adults with type 2 diabetes mellitus in rural areas. Thai Journal of Public Health 2023;53(2):45-58. (in Thai)

Powers MA, Bardsley JK, Cypress M, Duker P, Funnell MM, Fischl AH, et al. Diabetes selfmanagement education and support in adults with type 2 diabetes: a consensus report of the American Diabetes Association, the Association of Diabetes Care and Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care 2020;43(7):1636–49. doi:10.2337/dci20-0023.

Suksatan W, Prabsangob K, Choompunuch B. Association between health literacy, selfcare behavior, and blood sugar level among older patients with type 2 diabetes in rural Thai communities. Ann Geriatr Med Res 2021;25(4):318–23. doi:10.4235/agmr.21.0117.

hang Y, Wang S, Li L. Health literacy, self-efficacy, and self-care behaviors among older adults with diabetes: a mediation model. BMC Geriatr 2023;23(1):1027.

Ong-Artborirak P, Seangpraw K, Boonyathee S, Auttama N, Winaiprasert P. Health literacy, self-efficacy, self-care behaviors, and glycemic control among older adults with type 2 diabetes mellitus: a cross-sectional study in Thai communities. BMC Geriatr 2023;23(1):297. doi:10.1186/s12877-023-04010-0.

Duangpaeng S, Lerttrakarnnon P, Srithanaviboonchai K. Health literacy and diabetes selfmanagement among Thai older adults with type 2 diabetes. BMC Public Health 2024;24:10238.

Diabetes Association of Thailand under the Patronage of Her Royal Highness Princess Maha Chakri Sirindhorn. Clinical practice guideline for diabetes 2023. 1st ed. Bangkok: Srimuang Printing Co., Ltd.; 2023. (in Thai)

Camargo-Plazas P, Robertson M, Alvarado B, Paré GC, Costa IG, Duhn L. Diabetes selfmanagement education (DSME) for older persons in Western countries: A scoping review. PLoS One 2023;18(8):e0288797. doi:10.1371/journal.pone.0288797.

Doemkhunthot N, Suromrakul S, Khwancharoen R, Chuantantikamol C. Effects of diabetes self-management education and support in patients with poorly controlled type 2 diabetes. Vajira Nursing Journal 2022;24(1):1-24. (in Thai)

Thadaeng C. Effects of self-management on perceived self-efficacy, self-management behaviors, and glycated hemoglobin among persons with type 2 diabetes mellitus in Mueang District, Ang Thong Province [thesis]. Phitsanulok: Naresuan University; 2020. (in Thai)

Jalilian F, Shamsi M, Mahboubi M. Application of the Health Belief Model to predict diabetes preventive behaviors among the elderly. Diabetes Metab Syndr 2022;16(3):1025-32.

Rahmati-Najarkolaei F, Rahnama P, Fesharaki MG, Jafari MR. Applying the Health Belief Model to predict self-care behaviors of patients with type 2 diabetes. Iran J Public Health 2015;44(1):1-8.