The Model of Self-management for Children with Thalassemia

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Siriyupa Sananreangsak
Narumon Teerarungsikul
Photjanart Sarapat
Maneeporn Pinyo


This study was designed to develop a model of self-management for children with thalassemia.
Participants were selected from in-patient and out-patient clinics in an Eastern regional hospital. This
research had two development/design phases: 1) Analysis of the situation -- qualitative data were
collected from in-depth interviews with 11 children, then 88 children were selected by purposive
sampling and quantitative data were collected via a health literacy questionnaire, medical adherence
questionnaire, and self-management behaviors questionnaire; 2) Model development – based on
analysis and synthesis of phase I data. Data were analyzed by descriptive statistics, stepwise multiple
regression, and content analysis.
Phase I qualitative data revealed that major themes of the self-management experiences of
children with thalassemia were: 1) Self-management for daily life; 2) Self-management for emotional
problems, and; 3) self-management support. The quantitative data showed medical adherence and
health literacy together accounted for 17.4% of the variance. The self-management model that emerged
consisted of: 1) Input, including child’s perspective of self-management, medical adherence, health
literacy and self-management behaviors, and family and health care team aspects; 2) Process,
consisting of readiness, developing ability of self-management, and self-management support, and;
3) Output, defined as child’s health status and quality of life.
The self-management model could be used to guide self-management program development
for children with thalassemia. The key successes derived from collaboration between family and health
care providers make the model possible and sustainable.


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