Development of a Patient-Family Shared Care Program on Delaying the Progression of Chronic Kidney Disease in Uncontrolled Type 2 Diabetic Patients
Keywords:
Shared Care Program, Chronic Kidney Disease, Type 2 Diabetes Mellitus DiseaseAbstract
This action research aimed to develop and study the effects of a patient-family shared care program on delaying the progression of chronic kidney disease (CKD) in uncontrolled type 2 diabetes mellitus (T2DM) patients. The research comprised 3 phases: 1) the analysis of the situation, 2) the development of the program, and 3) a pilot research to study the program's effects. During phase 1, an assessment of the current situation of diabetic care was performed, as well as reviewing the characteristics of shared-care and resuming the literature. At phase 2, a new program was developed, accordingly with the analysis conclusions. As for the pilot research, a total of 7 participants - one professional nurse from a chronic disease clinic, three uncontrolled T2DM patients, and three family members who cared for the T2DM patients -were purposively selected. The research instruments were patients record forms and semi–structured interviews. The data was analyzed using content analysis. A total of 46 participants – 23 uncontrolled T2DM patients, and 23 family members who cared for patients -- were recruited using the G*Power program and accordingly with inclusion criteria. The research instruments were the newly developed program, blood sugar and blood pressure levels results record forms, and patients home visits record forms. Data were analyzed using descriptive statistics, and paired t-test. The results showed that
1. The shared-care of patients could be divided in 3 areas: a) sharing experience and information between patients and family members who cared for patients, b) finding positive and negative information about their practice, and c) co-planning and co-solving problems. As for the practice of nurses in supporting shared-care of patients, there were 4 intervention areas: a) educating, b) encouraging decision-making in the choice of practices, c) reviewing knowledge, and d) patients visiting.
2. After a 4 -week program implementation, the systolic blood pressure mean was significantly less than before program implementation (p<0.05). There were no statistical differences in the diastolic blood pressure mean, as well as in blood glucose after 8 hours fasting by fingertip peripheral puncture mean.
This new program can contribute to reducing blood pressure in uncontrolled T2DM patients. It is another way to be used in delaying the progression of CKD in uncontrolled T2DM patients.
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