Effectiveness of a Self- and Family Management Support Program among Older People with Diabetic Retinopathy and Visual Impairment: A Randomized Controlled Trial

Authors

  • Piyawadee Thongyost RN, PhD (Candidate), Doctor of Philosophy Program in Faculty of Medicine Ramathibodi Hospital, and Faculty of Nursing, Mahidol University, Thailand.
  • Porntip Malathum Associate Professor, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Renu Pookboonmee Associate Professor, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Mukda Detprapon Assistant Professor, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Pratana Satitvipawee Associate Professor, Division of Biostatistics, Faculty of Public Health, Mahidol University, Thailand.
  • Sudawadee Somboonthanakij Mettapracharak Hospital, Nakhon Pathom Province, Thailand.

DOI:

https://doi.org/10.60099/prijnr.2023.260336

Keywords:

Diabetic retinopathy, Family support, Management program, Older people, Randomized controlled trial, Visual Impairment

Abstract

Diabetic retinopathy is a microvascular complication of diabetes resulting in visual impairment. Controlling the progression of diabetic retinopathy and living with visual impairment are crucial tasks and skills for older people with diabetic retinopathy and visual impairment. This randomized controlled trial investigated the effects of a self- and family management support program on health outcomes of Thai older people with diabetic retinopathy and visual impairment who lived with family members in the community and on family satisfaction. Eighty-four participants were recruited at an eye-specialized hospital in a central province of Thailand and randomly assigned to either the experimental group (n = 42) or the comparison group (n = 42). The experimental group received the intervention program plus usual care, while the comparison group received only usual care. Instruments for data collection included a Demographic Data Form, the Perceived Security in Performance of Daily Life Activities Questionnaire, the Self-Management Behavior Questionnaire, the Sirindhorn National Medical Rehabilitation Center Functional Assessment, the Thai Visual Function Questionnaire 28, and the Family Satisfaction Questionnaire. Data analyses were performed using descriptive statistics, t-test, chi-square, two-way repeated measures ANOVA, and ANCOVA.
 Results showed that the experimental group had significantly more improved perceived security, self-management behavior, HbA1c, visual-related quality of life: performing activities dimension, and family satisfaction than the comparison group at Week 16. However, no significant differences in perceived security, self-management behavior, functional ability, and overall visual-related quality of life were found between the two groups at Week 8. This program be further tested before being implemented into practice. However, it has a potential for healthcare providers to create an intervention program encompassing disease control and skill training for older people with diabetic retinopathy and visual impairment and encourage their families to support them.

References

Bosma EK, van Noorden CJF, Klaassen I. Schlingemann RO. Microvascular complications in the eye diabetic retinopathy. In: Roelofs JJ, Vogt L, editors. Diabetic nephropathy: pathophysiology and clinical aspects. Springer International Publishing; 2019. pp. 305-21.

Lee R, Wong TY, Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye Vis (Lond). 2015 Sep 30;2:17. doi:10.1186/s40662-015-0026-2.

Isipradit S, Sirimaharaj M, Charukamnoetkanok P, Thonginnetra O, Wongsawad W, Sathornsumetee B, Somboonthanakij S, Soomsawasdi P, Jitawatanarat U, Taweebanjongsin W, Arayangkoon E, Arame P, Kobkoonthon C, Pangputhipong P. The first rapid assessment of avoidable blindness (RAAB) in Thailand. PLoS One. 2014 Dec 11;9:12. doi:10.1371/journal.pone.0114245.

Dahlin-Ivanoff S, Sonn U, Svensson E. A health education program for elderly persons with visual impairments and perceived security in the performance of daily occupations: a randomized study. Am J Occup Ther. 2002;56(3):322-30.doi:10.5014/ajot.56.3.322.

Dev MK, Paude N, Joshi ND, Shah DN, Subba S. Psycho-social impact of visual impairment on health-related quality of life among nursing home residents. BMC Health Serv Res. 2014 Aug 15;14:345. doi:10.1186/1472-6963-14-345.

Adigun K, Oluleye TS, Ladipo MM, Olowookere SA. Quality of life in patients with visual impairment in Ibadan: a clinical study in primary care. J Multidiscip Healthc. 2014;7:173-8.doi:10.2147/JMDH.S51359.

International Council of Ophthalmology. Updated 2017 ICO Guidelines for diabetic eye care [Internet]. California: United States of America; 2017. Available from: http://www.icoph.org/downloads /ICO GuidelinesforDiabetic EyeCare.pdf

Yang L, Wu Q, Hao Y, Cui Y, Liang L, Gao L, Yin H. Self-management behavior among patients with diabetic retinopathy in the community: a structural equation model. Qual Life Res. 2017;26(2):359-66. doi:10.1007/s11136-016-1396-1.

Mikhael EM, Hassali MA, Hussain SA. Effectiveness of diabetes self-management educational programs for type 2 diabetes mellitus patients in middle east countries: a systematic review. Diabetes Metab Syndr Obes. 2020;13: 117-38. doi:10.2147/DMSO. S232958.

Tachanivate P, Phraewphiphat R, Tanasanitkul H, Jinnawaso R, Areevut C, Rattanasila R, et al. Effectiveness of diabetes self-management education in Thais with type 2 diabetes. Pacific Rim Int J Nurs Res. 2019;23(1):74-86. Available from: https://he02.tci-Thaijo.org/index.php/PRIJNR/article/view/91968

O’Conor R, Smith SG, Curtis LM, Benavente JY, Vicencio DP, Wolf MS. Mild visual impairment and its impact on self-care among older adults. J Aging Health. 2018;30(3): 327-41. doi:10.1177/0898264316676406.

Corcostegui B, Duran S, Gonzalez-Albarran MG, Hernandez C, Ruiz-Moreno JM, Salvador J, Simo R. Update on diagnosis and treatment of diabetic retinopathy: a consensus guideline of the working group of ocular health (Spanish Society of Diabetes and Spanish Vitreous and Retina Society). J Ophthalmol. 2017 Jun 14;2017:8234186. doi:10.1155/2017/8234186.

Lee A, Piette JD, Heisler M, Janevic M, Langa KM, Rosland AM. Family members’ experiences supporting adults with chronic illness: a national survey. Fam Syst Health. 2017;35(4):463-73. doi:10.1037/fsh0000293.

Grey M, Schulman-Green D, Knafl K, Reynolds NR. A revised self- and family management framework. Nurs Outlook. 2015;63(2):162-70. doi:10.1016/j.outlook.2014.10.003.

Burton AE, Gibson JM, Shaw RL. How do older people with sight loss manage their general health? A qualitative study. Disabil Rehabil. 2016;38(23):2277-85. doi:10.3109/09638288. 2015.1123310.

Garcia-Huidobro D, Bittner M, Brahm P, Puschel K. Family intervention to control type 2 diabetes: a controlled clinical trial. Fam Pract. 2011;28:4-11. doi:10.1093/fampra/cmq069.

Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J. Self-management approaches for people with chronic conditions: a review. Patient Educ Couns. 2002;8:177-87. doi: 10.1016/s0738-3991(02)00032-0.

Kuntawee S. Effects of self-management program and qigong on HbA1c and blood pressure in diabetic retinopathy patients [master’s thesis]. [Bangkok]: Chulalongkorn University; 2007 (in Thai).

Captieux M, Pearce G, Parke HL, Epiphaniou E, Wild S, Taylor SJC, Pinnock H. Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews. BMJ Open. 2018;8:e024262. doi:10.1136/bmjopen-2018-024262.

McBain H, Shipley M, Newman S. The impact of self-monitoring in chronic illness on healthcare utilisation: a systematic review of reviews. BMC Health Serv Res. 2015;15:565. doi:10.1186/s12913-015-1221-5.

Huygens MWJ, Swinkels ICS, de Jong JD, Heijmans MJWM, Friele RD, van Schayck OCP, de Witte LP. Self-monitoring of health data by patients with a chronic disease: does disease controllability matter? BMC Fam Pract. 2017 Mar 20;18(1):40.doi:10.1186/s12875-017-0615-3.

Bailey RR. Goal setting and action planning for health behavior change. Am J Lifestyle Med. 2017 Sep 13;13:6. doi:10.1177/1559827617729634.

Ghasemi A, Moonaghi HK, Mohajer S, Mazlom SR, Shoeibi N. Effect of self-management educational program on vision related quality of life among elderly with visual impairment. Evid Based Care J. 2018;8(1):35-44. doi:10.22038/EBCJ.2018.28999.1717.

Girdler SJ, Boldy DP, Dhaliwal SS, Crowley M, Packer TL. Vision self-management for older adults: a randomized controlled trial. Br J Ophthalmol. 2010;94(2):223-8. doi: 10.1136/bjo.2008.147538.

Rosner B. Fundamentals of biostatistics: study guide. California: Pacific Grove; 2000.

Dahlin-Ivanoff S, Sonn U, Svensson E. Development of an ADL instrument targeting elderly persons with age-related macular degeneration. Disabil Rehabil. 2011;2(2): 69-79. doi:10.1080/096382801750058152.

Brislin RW. Back-translation for cross-cultural research. J Cross-Cult Psychol. 1970;1(3):185-216. doi:10.1177/135910457000100301.

Duangkaew K, Kompayak J, Kaewnimitchai N. Effects of educative supportive nursing system on self-care behaviors fasting plasma glucose and level of diabetic retinopathy in type 2 diabetes mellitus patients. Thammasat Thai J Ophthal. 2016;11(2):34-53 (in Thai).

Suwapan D. The Sirindhon National Medical Rehabilitation Center Functional Assessment [Internet]. Sirindhorn National Medical Rehabilitation Institute: Nonthaburi; 2006 [cited 2022 Aug 11]. Available from: http://www.snmri.go.th/snmri/download/cnpg/SNMRC_ Functional_ Assessment.pdf (in Thai)

Chaiyasong C, Johns NP, Asawaphureekorn S. The Thai Visual Function Questionnaire 28. In: Johns NP, editors. Quality of life in health: assessment and implementation. Khon Kaen University; 2009. pp.183-253 (in Thai).

Suwisith N, Hanucharurnkul S. Development of the Patient Satisfaction with Nursing Care Questionnaire. Rama Nurs J. 2011;17(2):264-77 (in Thai).

Maslakpak MH, Razmara S, Niazkhani Z. Effects of face-to-face and telephone-based family-oriented education on self-care behavior and patient outcomes in type 2 diabetes: a randomized controlled trial. J Diabetes Res. 2017;2017: 8404328. doi:10.1155/2017/8404328.

Whitehead L, Jacob E, Towell A, Abu-qamar M, Cole-Heath A. The role of the family in supporting the self-management of chronic conditions: a qualitative systematic review. J Clin Nurs. 2018;27(1-2):22-30. doi:10.1111/jocn.13775.

Cho MK, Kim MY. Self-management nursing intervention for controlling glucose among diabetes: a systematic review and meta-analysis. Int J Environ Res Public Health. 2021 Dec 3;18:23. doi:10.3390/ijerph182312750.

Thojampa S, Acob JRU. Self-management behavior and its impact to glycated hemoglobin among clients medically diagnosed with diabetes mellitus: a correlational study. Belitung Nurs J. 2020;6(4):111-5. doi:10.33546/bnj.1102.

Rees G, Xie J, Chiang PP, Larizza MF, Marella M, Hassell JB, Keeffe JE, Lamoureux EL. A randomised controlled trial of a self-management programme for low vision implemented in low vision rehabilitation services. Patient Educ Couns. 2015;98(2):174-81. doi:10.1016/j. pec.2014.11.008.

Roets-Merken LM, Zuidema SU, Vernooij-Dassen MJFJ, Teerenstra S, Hermsen PGJM, Kempen GIJM, Graff MJL. Effectiveness of a nurse-supported self-management programme for dual sensory impaired older adults in long-term care: a cluster randomised controlled trial. BMJ Open. 2018;8(1):1-11. doi:10.1136/bmjopen-2017-016674.

Sangboon N, Detprapon M, Monkong S. Adaptation in older persons with visual impairment. Rama Nurs J [Internet]. 2020;25(1):29-42 (in Thai). Available from: https://he02.tci-thaijo.org/index.php/RNJ/article/view/141437

Naef R, Felten SV, Petry H, Ernst J, Massarotto P. Impact of a nurse-led family support intervention on family members’ satisfaction with intensive care and psychological wellbeing: a mixed-methods evaluation. Aust Crit Care. 2021;34(6): 594-603. doi: 10.1016/j.aucc.2020.10.014.

Shelton W, Moore CD, Socaris S, Gao J, Dowling J. The effect of a family support intervention on family satisfaction, length-of-stay, and cost of care in the intensive care unit. Crit Care Med. 2010;38(5):1315-20. doi:10.1097/CCM.0b013e3181d9d9fe.

Downloads

Published

2022-12-14

How to Cite

1.
Piyawadee Thongyost, Porntip Malathum, Renu Pookboonmee, Mukda Detprapon, Pratana Satitvipawee, Sudawadee Somboonthanakij. Effectiveness of a Self- and Family Management Support Program among Older People with Diabetic Retinopathy and Visual Impairment: A Randomized Controlled Trial. PRIJNR [Internet]. 2022 Dec. 14 [cited 2024 Jul. 18];27(1):105-20. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/260336

Issue

Section

Original paper