ปัจจัยทำนายพฤติกรรมส่งเสริมสุขภาพของผู้ป่วยโรคเบาหวานชนิดที่ 2 ที่มารับบริการในโรงพยาบาลส่งเสริมสุขภาพตำบล จังหวัดอุดรธานี

Natthakul Buengmoom; Soiy Anusornteerakul

Authors

Natthakul Buengmoom Faculty of Nursing, Ratchathani University, Udon Thani Campus
Soiy Anusornteerakul Faculty of Nursing, Ratchathani University, Udonthani Campus

Keywords:

predicting factors, health-promoting behavior, diabetic disease

Abstract

This predictive descriptive study aimed to examine factors predicting healthpromoting behaviors among patients with type 2 diabetic mellitus (DM) attending Subdistrict Health- Promoting Hospitals in Udon Thani Province. The sample consisted of 9 8 patients with DM receiving services at Nadi and Sok Nam Khao Subdistrict Health-Promoting Hospitals in Mueang Udon Thani District, Udon Thani Province. The research instruments included a general information questionnaire, a diabetes knowledge questionnaire, an attitude questionnaire towards diabetes, and a health-promoting behavior questionnaire for patients with DM. The reliability coefficients of the knowledge, attitude, and health-promoting behavior questionnaires were .82, .73, and .89, respectively. Descriptive statistics, chi-squared analysis, and stepwise multiple regression analysis were used to analyze the data.

The results revealed that factors related to health-promoting behaviors were marital status (p<.01), education level (p<.01), occupation (p<.01), types of healthcare coverage (p<.001), and treatment (p<.001). Three factors that could predict health-promoting behaviors of patients with DM were the universal health coverage, which decreased the health-promoting behavior score by 7.15 points (B=-7.15, p<.01), the agricultural and labor occupations decreased the health-promoting behavior score by 2.61 points (B=-2.61, p<.05). secondary education or higher increased the health-promoting behavior score by 3.11 points (B=3.11, p<.05). The model explained 17.7% of the variance in health-promoting behaviors among with DM (R²=.177, F=5.33, p<.05).

In conclusion, personal factors are important variables in changing health-promoting behaviors of diabetic patients. Therefore, health care services should take into account the types of healthcare coverage, occupation, and educational level of each patient.

References

Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract [Internet] 2022 [cited 2023 Oct 25];183:109119. Available from: https://doi.org/10.1016/j.diabres.2021.109119

Department of Disease Control, Ministry of Public Health. Diabetes reports [Internet] 2022 [cited 2024 Oct 20]. Available from: https://datariskcom-ddc.moph.go.th/download (in Thai)

Pachariyanon W, Kessomboon P, Suwanmola L, Chongwarin S, Puhern N. Factors associated with poor control of diabetes mellitus. Mahasarakham Hosp J 2018;15(1):118-27 (in Thai)

The Diabetes Association of Thailand under the Royal Patronage of Her Royal Highness Princess Maha Chakri Sirindhorn. Clinical practice guideline for diabetes 2017. 3rd ed. Pathum Thani: Romyen Media; 2017 (in Thai)

The Royal College of Physicians of Thailand under Royal Patronage, The Diabetes Association of Thailand under the Royal Patronage of Her Royal Highness Princess Maha Chakri Sirindhorn, The Endocrine Society of Thailand, Department of Medical Services, Ministry of Public Health, The National Health Security Office. Clinical practice guideline for diabetes 2023. Bangkok: Srimuang Printing; 2023. (in Thai)

Bin Rakhis SA, AlDuwayhis NM, Aleid N, AlBarrak AN, Aloraini AA. Glycemic control for type 2 diabetes mellitus patients: a systematic review. Cureus 2022;14(6):e26180. doi:10.7759/cureus.26180.

The Royal College of Physicians of Thailand under Royal Patronage. Clinical practice guideline for diabetes 2023. 2nd ed. Bangkok: Sri Muang Printing; 2024. (in Thai)

Udon Thani Hospital. Health strategic plan for health service network, fiscal year 2023. Udon Thani: Udon Thani Provincial Public Health Office; 2023. (in Thai)

Health Data Center (HDC), Ministry of Public Health. Percentage of diabetic patients by area and fiscal year. Nonthaburi: Ministry of Public Health; 2025. (in Thai)

Udon Thani Provincial Public Health Office. Summary report on diabetes morbidity rate data for 2020–2023 [Internet]. 2023 [cited 2023 Sep 20]. Available from: https://udn.hdc.moph.go.th/ (in Thai)

Samngammee A, Sumpowthong K, Homkham N. Factors related to preventive behavior regarding diabetes and hypertension among supporting staff in Lampang Rajabhat University. Vajira Med J 2020;64(2):97-108. (in Thai)

Pengchai J, Mekrungrongwong S. Factors affecting health behaviors on 3 aor 2 sor 1 yor among type 2 diabetic patients in Khanu Woraluksaburi District, Kamphaeng Phet Province. J Prapokklao Nurs Coll 2025;36(1):1-15. (in Thai)

Peerawankul N. Self-care behavior of type 2 diabetes patients at Prankratai Hospital, Kamphaeng Phet Province. Sci Technol North J 2022;3(3):39-55. (in Thai)

Siangdung S. Self-care behaviors of patients with uncontrolled DM. The Southern College Network Journal of Nursing and Public Health 2017;4(1):191-204. (in Thai)

Neawsupap S, Kannalak S, Klatnum S, Thongboon A, Channarong N. Factors affecting self-care behaviors of elderly with type 2 diabetes in Phayuha Subdistrict, Phayuha Khiri District, Nakhon Sawan Province. Research and Development Health System Journal 2025;18(2):68-81. (in Thai)

Limthin P, Thirawiwat M, Imami N, Pekali A. Factors related to self-management behavior to control blood sugar of patients with type 2 diabetes in Phang Nga Province. Academic Journal for Primary and Public Health System Development 2023;1(2):70-84. (in Thai)

Chantasin W, Banchonhattakit P, Chusak T, Sillaparassamee R. Self-care behavior of diabetics in the area of Tambon Administrative Organization Chang Dai Yai, Muang District, Yasothon Province. Regional Health Promotion Center 9 Journal 2024;18(2):498-511. (in Thai)

Khamcharoen N, Sutkhiao S, Phanoakson A, Nopnarin W. The knowledge, attitudes, and self-care behaviors of diabetic patients receiving services at the Primary Care Unit, Yang Riang Subdistrict Health Promotion Hospital, Khlong Mae Lai Subdistrict, Mueang Kamphaeng Phet District, Kamphaeng Phet Province. Institute for Urban Disease Control and Prevention Journal 2025;10(1):233-50. (in Thai)

Weanprom J, Saethao O, Seijaroen W, Trongtokit Y, Samruayruen K, Junsukon E, Saengai A. Knowledge, attitude and self-care behavior of diabetic patients receiving services at the health promoting hospital, Muang District, Phitsanulok Province. In: Proceedings of the 13th National Conference, Nakhon Pathom Rajabhat University; 2021 Jul 8-9; Nakhon Pathom, Thailand. Nakhon Pathom: Nakhon Pathom Rajabhat University; 2021. p. 2810-9. (in Thai)

Sirikutjatuporn K, Wirojratana V, Jitramontree N. Factors predicting self-management behaviour of elderly patients with type 2 diabetes. Thai J Nurs Counc 2017;32(1):82-93. (in Thai)

Sriwong N. Self-care behaviors of type II diabetes mellitus patients attending Hun Na Ngam Subdistrict Health Promoting Hospital, Si Bun Rueang District, Nong Bua Lamphu Province. J Health Sci 2019;28(4):622-7. (in Thai)

Kuranam K, Srineth N, Sumasawanna A. Self-care behavior of diabetics in the area of Tambon Administrative Organization Chang Dai Yai Muang District Yasothon Province. Chalermkanjana Acad J 2020;7(2):81-94. (in Thai)

Setthachan J, Manisuwan K, Bun-in P. Health-promoting behaviors of diabetic patients receiving services at Ban Pak Phay Subdistrict Health Promoting Hospital, Tha Sak Subdistrict, Nakhon Si Thammarat. Chalermkanjana Acad J 2018;5(1):180-91. (in Thai)

Chaoddamrongsakul S. Self-care behaviors and blood sugar level of diabetic patients at Sida Hospital, Nakhon Ratchasima Province. Med Public Health Acad J Nakhon Ratchasima Prov Public Health Off 2024;4(1):85-95. (in Thai)

ingpaiboonsuk U, Dangthongdee S, Nakasuwan V. Factors related to health care behavior of elderly with hypertension and diabetes mellitus in the Puranawat Temple Elderly Club, Bangkok. J Chulabhorn Royal Acad 2022;4(4):179-88. (in Thai)

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.

Pender NJ, Murdaugh CL, Parsons MA. Health promotion in nursing practice. 7th ed. Boston: Pearson; 2015.

Fakfang O. Factor analysis to predict health-promoting behavior of patients with type 2 diabetes at Bang Kradi Subdistrict Health Promoting Hospital, Bang Kradi Subdistrict, Mueang Pathum Thani District, Pathum Thani Province. J Environ Community Health 2022;7(2):100-8. (in Thai)

Duangsanjun W, Suttharattanakun S, Kiriram P. Effects of a health literacy enhancement program on health-promoting behaviors and hemoglobin A1c level among elderly with type 2 diabetes. Thai J Nurs 2022;71(2):28-37. (in Thai)

Polit DF, Beck CT. Nursing research: principles and methods. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2021.

Anderson LW, Krathwohl DR, Airasian PW, Cruikshank KA, Mayer RE, Pintrich PR, et al. A taxonomy for learning, teaching, and assessing: a revision of Bloom's taxonomy of educational objectives. 1st ed. New York: Longman; 2001

Fung CSC, Wan EYF, Wong CKH, Jiao F, Chan AKC, Lam CLK. Non-skilled occupation as a risk factor of diabetes mellitus among working population in Hong Kong. BMC Public Health 2021;21:1182. doi:10.1186/s12889-021-11187-0.

Ariyasit J. Health literacy to control blood sugar level in type 2 diabetic patients. Sawanpracharak Medical Journal 2021;18(2):142-55. (in Thai)

Plienwong L. Perceived health and health behavior of patients with diabetes mellitus in the internal medicine ward at Chumphon Khet Udomsak Hospital, Thailand. Thai Journal of Public Health and Health Sciences 2017;20(4):67-76. (in Thai)