Outcome comparison after group counseling in diabetic patients with early stage chronic kidney disease, Powaai Primary Care Cluster(PCC), Suratthani Hospital

Abstract

              Background : Diabetic incidence continuously increases every year. In 2017, there were approximately 415 million diabetic patients worldwide, and 5 million diabetic patients in Thailand. Diabetic nephropathy is an important major complication, and 37.5 percent of chronic kidney disease(CKD) etiology relates to diabetes. Early stage CKD is asymptomatic, which patients may not aware of its progression and finally end up with dialysis. Raising patients’ awareness by group counseling may help prevent the severity of CKD.
              Objective : To compare the results of group counseling in diabetic patients with early stage CKD.
              Method: Quasi-experimental study was conducted at Powaai PCC during March 1stand December 31st 2018. Thirty-six diabetic patients with early stage CKD (stage II-III) were randomly selected and divided into 4 groups. Questionnaires were used to evaluate the results of group counseling at prior, immediate after, and 1 month after the group counseling. The questionnaires consist of 5 parts: general information, family information, knowledges,
attitude and self-care technics for diabetic patients with CKD. Blood sugar levels were checked prior and at the end of study. The group counseling process included: 1) patient education on diabetes care with renal complication, 2) low-glycemic index foods, 3) video demonstration about kidney function and dialysis. Interactive communication was used during group counseling.
              Result: The study result shows that knowledges and attitude scores of the participants were immediately increased after counseling. These scores were decreased 1 month afterward; however, the scores at 1 month were not less than the scores prior to the trial. The average self-care scores of pre and post counseling were 21.75 and 23.27, respectively. The mean of difference of these scores increased significantly(P<0.01). The average blood sugar levels of pre and post counseling were 159.64 mg% and 154.08 mg%, respectively, which the mean of difference of these levels decreased significantly (P<0.01).
              Conclusions: After groups counseling, the remaining of patients’ knowledges, attitude, and self-care showed decreasing at 1 month after counseling; therefore, patients should be educated regularly.