DEVELOPMENT OF THE SELF-MANAGEMENT SUPPORTING SYSTEM FOR PATIENTS WITH DIABETIC FOOT ULCER RISK AT NAJAN HEALTH PROMOTING HOSPITAL, KALASIN PROVINCE

Abstract

This action research aimed to study the situation of care provided to the patients who were at risk of diabetic foot ulcers, and to develop a self-management supporting system for them at Najan Health Promoting Hospital in Kalasin. Self-management was used as a conceptual framework. Participants consisted patients with type 2 diabetes and stakeholders 61 person. Data were collected through in-depth interviews, group discussions, observations, and brainstorming. A process of the system development consisted of four steps: 1) studying the situation of care provided to patients who are at risk of diabetic foot ulcers, 2) planning to develop a self-management support system, 3) acting according to the plan, and 4) reflecting the actions and evaluating the outcomes. Perform 2 cycles. The results showed that 46.67 percent of diabetic patients were able to lower their blood glucose levels, and 40 percent of them could keep their blood glucose level in the normal range between 100-125 mg%. Furthermore, 80 percent of the patients reduced their consumption of sticky rice to a proper proportion. All of them stopped using supplementary food or herbs, and did exercises every day. Also, they performed foot care routinely, such as washing their feet, having foot exercise, and applying cream/lotion to prevent dry skin on their feet. In addition, the results of screening for foot ulcers indicated that five patients were at high risk, four patients were at moderate risk, and six patients were at low risk.