ประสิทธิผลของโปรแกรมการสนับสนุนการจัดการตนเองต่อความรู้ในการดูแลเท้า  พฤติกรรมการดูแลเท้า การรับรู้การได้รับการสนับสนุนจากสังคม และระดับน้ำตาลสะสมในเลือดของผู้เป็นเบาหวานชนิดที่ 2 ที่มีความเสี่ยงต่อการเกิดภาวะแทรกซ้อนที่เท้า

Parinya Kaewsongk; Khemaradee Masingboon; Pawana Keeratiyutawong; Melkus Gail D’Eramo; Wannee Deoisres

Authors

Parinya Kaewsongk
Khemaradee Masingboon
Pawana Keeratiyutawong
Melkus Gail D’Eramo
Wannee Deoisres

Abstract

Foot care behaviors play an important role in preventing of diabetic foot complications. Unfortunately, many diabetes people do not have foot care properly. Simple interrupted time-series design was conducted to test efficacy of self-management support [SMS] program on foot care knowledge, foot care behaviors, perceived social facilitation support, and HbA1c among people with type 2 diabetes at low risk of diabetic foot complications. Forty-two participants from the outpatient diabetes clinic of the Police General Hospital who met inclusion criteria were recruited into the study by simple random sampling. Four-week SMS program was developed based on individual and family self-management theory (Ryan & Sawin, 2009) and empirical studies. Study outcomes including diabetic foot care knowledge, diabetic foot care behaviors, perceived social facilitation support, and HbA1c were measured before receiving SMS program at Time 1 and Time 2 and after receiving the program at Time 3 and Time 4. Outcomes were gathered by questionnaires and blood test of HbA1c. Data were analyzed by descriptive statistics, repeated measure MANOVA, and dependent t-test.

Results revealed that there were significant differences over time for all outcomes variables (F(9,394)=8.39, p<.001). But there were no changes on outcome variable mean scores before receiving SMS program at Time 1 and Time 2. Significant increased mean scores of foot care knowledge, foot care behaviors, and perceived social facilitation support from Time 1 before receiving the program to Time 4 after receiving the program was observed. In addition, HbA1c was significantly decreased from 8.1 % at Time 1 before receiving the program to 7.4 % at Time 4 after receiving the program.

Findings suggest that SMS program is beneficial for type 2 diabetic people at low risk of diabetic foot complications. It would result in increasing perceived social facilitation support, sustaining self-management behaviors, improving glycemic control, and properly performing foot care. Therefore, SMS program should be integrated as a part of routine diabetes nursing care for preventing or delaying diabetic foot complications among this population.

Downloads

Download data is not yet available.

References

Ambroggio, L., Smith, M. J., & Shah, S. S. (2012). Quasi-experimental and interrupted time-series design. Journal of the Pediatric Infectious Disease Society, 1-3.
American Diabetes Association [ADA]. (2013). Standards of medical care in diabetes. Diabetes Care, 36 (suppl 1), S1-S110.
Bell, R. A., Arcury, T. A., Snively, B. M., Smith, S. L., Stafford, J. M., Dohanish, R., & Quandt, S. A. (2005). Diabetes foot self-care practices in a rural triethnic population. Diabetes Educ, 31(1), 75-83.
Burn, N., & Grove, S. K. (2005). The practice of nursing research: Conduct, critique, utilization (5th ed.). Philadelphia: Elsevier’s Health Sciences Right Department.
Caliskan, D., Ozdemir, O., Ocaktan, E., & Idil, A. (2006). Evaluation of awareness of diabetes mellitus and associated factors in four health center areas. Patient Educ, 62(1), 142-147.
Centers for Disease Control and Prevention (CDC). (2014). What podiatrists would like team members to know about foot health and diabetes. Retrieved from http://www.cdc.gov/diabetes/ ndep/pdfs/ppod-guide-podiatrists.pdf
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
Desalu, O. O., Salawu, F. K., Jimoh, A. K., Adekoya, A. O., Busari, O. A., & Olokoba, A. B. (2011). Diabetic foot care: Self-reported knowledge and practice among patients attending three tertiary hospital in Nigeria. Ghana Medical Journal, 45(2), 60-65.
Funnell, M. M., Tang, T. S., & Anderson, R. M. (2007). From DSME to DSMS: Developing empowerment-based diabetes self-management support. Diabetes Spectrum, 20(4), 221-226.
Gondal, M., Bano, U., Moin, S., Afridi, Z., Masood, R., & Ahmed, A. (2007). Evaluation of knowledge and practices of foot care in patients with chronic type 2 diabetes mellitus. JPMI, 21(2), 104-108.
International Diabetes Federation (IDF). (2013). Diabetes in Thailand-2013. Retrieved from http://www.idf.org/membership/wp/thailand.
Jansing, P., & Phopuk, S. (2011). The results of foot screening in diabetic patients at Taphanhin Crown Prince hospital. Buddhachinaraj Medical Journal, 28(2), 163-170.
Keeratiyutawong, P. (2005). A self-management program for improving knowledge, self-care activities, quality of life, and glycosylated HbA1c in Thais with type 2 diabetes mellitus (Doctoral dissertation,Nursing). Faculty of Graduate Studies, Mahidol University, Nakhon Pathom.
Khamseh, M. E., Vatankhah, N., & Baradaran, H. R. (2007). Knowledge and practice of foot care in Iranian people with type 2diabetes. International Wound Journal, 4(4), 298-302.
Kim, H. S., Kim, N. C., & Abu, S. H. (2006). Impact of a nurse short message service intervention for patients with diabetes. Journal of Nursing Care Quality, 21(3), 266-271.
Krittiyawong, S., Ngarmukos, C., Benjasuratwong, Y., Rawdaree, P., Leelawatana, R., Kosachunhanun, N., …, Bunnag, P. (2006). Thailand diabetes registry project: Prevalence and risk factors associated with lower extremity amputation in Thai diabetics. Journal of Medical Association Thailand, 89(suppl 1), S43-S48.
Kurniawan, T., & Petpichetchian, W. (2011). Case study: Evidence-based interventions enhancing diabetic foot care behaviors among hospitalized DM patients. Nurse Media Journal of Nursing, 1(1), 43-53.
Nagelkerk, J., Reick, K., & Meengs, L. (2006). Perceived barriers and effective strategies to diabetes self-management. Journal of Advanced Nursing, 54(2), 151-158.
Naicker, A. S., Ohnmar, H., Choon, S. K., Yee, K. L. C., Naicker, M. S., Das, S., & Roohi, S. A. (2009). A study of risk factors associated with diabetic foot, knowledge and practice of foot care among diabetic patients. International Medical Journal, 16(3), 189-193.
National Institute of Health and Clinical Excellence (NICE). (2004). Clinical guideline 10: Type 2 diabetes: Management of foot problems. Retrieved from http://www.nice.org.uk/ nicemedia/live/1093/29241/29241.pdf
Navicharern, R. (2012). Diabetes self-management, fasting blood sugar and quality of life among type 2 diabetic patients with foot ulcers. Journal of Medical Association Thailand, 9(2), 156-162.
Pereira, D. A., Costa, N. M., Sousa, A. L., Jardim, P. C., & Zanini, C. R. (2012). The effect of educational intervention on the disease knowledge of diabetes mellitus patients. Revista Latino-Americana de Enfermagem, 20(3), 478-485.
Rad, G. S., Bakht, L. A., & Mohebi, S. (2013). Importance of social support in diabetes care. Journal of Education and Health Promotion, 2(62), 1-25.
Rocha, R. M., Zanetti, M. L., & Santos, M. A. (2009). Behavior and knowledge: Basis for prevention of diabetic foot. Acta Paul Enferm, 22(1), 17-23.
Rosland, A., Kieffer, E., Israel, B., Cofield, M., Palmisano, G., Sinco, B., …, Heisler, M. (2008). When is social support important? The association of family support and professional support with specific diabetes self-management behaviors. Journal of General Internal Medicine, 23(12), 1992-1999.
Routley, V. M. (2011). The emerging epidemic of type 2 diabetes: An Asian Pacific perspective. On The Risk, 27(3), 72-76.
Ruangroj, P. (2009). Predictors of foot status among persons with diabetes mellitus at Police General Hospital (Master’s thesis, Adult Nursing). Faculty of Nursing, Burapha University, Chonburi.
Ryan, P., & Sawin, K. J. (2009). The individual and family self-management theory: Background and perspectives on context, process, and outcomes. Nursing Outlook, 57(4), 217-225.
Sae-Sia, W., Maneewat, K., & Kurniawan, T. (2013). Effect of a self-management support program on diabetic foot care behaviors. International Journal of Research in Nursing, 4(1), 14-21.
Sriwijitkamol, A., Moungngern, Y., & Vannaseang, S. (2011). Assessment and prevalences of diabetic complications in 722 Thai type 2 diabetes patients. Journal of the Medical Association of Thailand, 94(suppl 1), S168-S174.
Tang, T. S., Funnell, M. M., Noorulla, S., Oh, M., & Brown, M. B. (2011). Sustaining short-term improvements over the long-term: Results from a 2-year diabetes self-management support [DSMS] intervention. Diabetes Research and Clinical Practice, 95(1), 85-92.
Tsao, T. (2008). Diabetic foot care. In A. Nather (Ed.), Diabetic foot problem (pp. 503-526). Singapore: World Scientific.