Effectiveness of Care for Patients with Diabetes Mellitus and Chronic kidney disease stage 2-4 with Case Management at Nam Nao Hospital Health Networks, Phetchabun Province.

Abstract

              This Quasi-experimental research aimed to examine the effectiveness of caring for uncontrolled diabetic patients with chronic kidney disease in stage 2 - 4 with case management at Namnao Hospital Health Networks, Phetchabun province. One group design was measured by before and after experiment of knowledge and health status. Research samples were 39 diabetic patients participating in the self-management program. Data were collected by the demographic characteristic, patient-self management knowledge and their health status. Data were analyzed by frequencies, percentages, mean, standard deviation and independent t test and Wilcoxon Signed Ranks Test. The findings illustrated that the eGFR after participating in the program was significantly higher than before. In the CKD stage, there was the significant lower rate of creatinine and HbA1C. The knowledge scores were significantly high. Systolic blood pressure was slightly increases, whereas Diastolic blood pressure was significantly decreased. BMI and FBS were decreased. Cholesterol and triglyceride were slightly increased. LDL was significantly increased, while HDL was significantly decreased. This program may expand to all diabetic patients with chronic kidney disease stage 2-4. Health personnel should find an appropriate way for enhancing knowledge of those patients. Patients who stop taking lipid-lowering drugs should be followed up every 3-6 months. Further research and innovation may be necessary in order to provide effective care for the patients.