The Development of Guideline to Support Self-Care Management among Elderly Patients with Type 2 Diabetes Mellitus in a Community
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Abstract
This research and development study aimed to develop and evaluate the guideline to support self-care management among elderly patients with type 2 diabetes mellitus (T2DM) in a community. The study was divided into three phases. The first phase was the health situation study. Sample were 194 elderly patients with T2DM. Informants were six elderly patients with T2DM. The second phase was the development of guideline to support self-care management. There were eight Informants including health professionals, representative of local government organization, community leaders, and elderly patients with T2DM. The third phase was the guideline implementation and evaluation. Thirty elderly patients with T2DM were selected into the experimental group. There were ten village health volunteers (VHVs) acting as a patient’s supporter in a community. Data were collected by using questionnaires and guidelines for in-depth interview and focus group discussions. Descriptive statistics and the Paired t-test were used to analyze quantitative data. Content analysis was used to interpret qualitative data.
The results in first phase revealed the five dimensions of self-care management behaviors among elderly patients with T2DM. The mental health/stress management dimension was at high level by 63.1%. The exercise/physical activity (61.5%), health-care utilization (71.5%), and health responsibility dimensions (43.6%) were at moderate level. The healthy diet dimension was at low level by 77.7%. In second phase, the guideline to support self-care management consisted of two components: self-care management supported by VHVs and developing self-care management skills. The third phase found that the experimental group's post-test total mean score on self-care management was significantly higher than the pre-test total mean score (p-value < 0.05).
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