The Caring System Development for Diabetic Patients with Missed Appointments, Phrasaeng Hospital

Abstract

Introduction Diabetes is a condition that requires continuous care. Missed appointments can cause uncontrolled blood sugar levels, resulting in complications. Therefore, hospitals should develop an effective care system for diabetic patients who miss appointments. 

Objectives 1) To develop a care system for diabetic patients who miss appointments, 2) To compare knowledge about diabetes, self-care behaviors, and blood sugar levels in diabetic patients who miss appointments before and after the program, 3) To compare knowledge about diabetes, self-care behaviors, and blood sugar levels between the control and the experimental groups, and 4) To compare satisfaction with the caring system for diabetic patients who miss appointments between the control and the experimental groups. 

Design Action research 

Methodology The participants consisted of 1) A task force for developing the care system for diabetic patients who miss appointments at Phrasaeng Hospital’s diabetes clinic, including 2 physicians and 5 nurses, and 2) 90 diabetic patients who missed appointments with uncontrolled blood sugar levels. Participants were selected according to the inclusion criteria and assigned to an experimental and control group, each consisting of 45 patients. The experimental group received the newly developed care system for missed appointments, while the control group received traditional care. The research instruments included focus group discussion guidelines, the developed caring system for diabetic patients with missed appointments, a personal information questionnaire, a diabetes knowledge questionnaire, a self-care behavior questionnaire, a satisfaction questionnaire regarding the diabetes care system, and a blood sugar level record form. Data were collected from September to December 2023 and divided into four phases: 1) Planning, 2) Implementing through system development, 3) Observing through system application, and 4) Reflecting on the implementation outcomes. Data analysis employed descriptive statistics, Chi-square test, Paired t-test, and Independent t-test. 

Results The newly developed system for managing diabetic patients who miss appointments consists of four components: 1) Appointment reminders, 2) Medical care and education, 3) Monitoring and encouragement, and 4) Experience sharing. The results of using the newly developed system revealed that, after the program, the experimental group had greater knowledge about diabetes (M = 11.9, SD = 1.8) compared to before the program (M = 8.9, SD = 2.0) and significantly more than the control group (M = 9.2, SD = 2.1) (t = -11.667 and 6.344, p < .001). Additionally, the overall self-care behaviors of the experimental group (M = 66.0, SD = 6.2) were higher than before the program (M = 56.1, SD = 7.0) and significantly greater than the control group (M = 56.7, SD = 7.6) (t = -16.371 and 6.290, p < .001). Blood sugar levels in the experimental group (M = 127.8, SD = 27.3) were lower than before the program (M = 173.7, SD = 48.9) and significantly lower than those in the control group (M = 192.1, SD = 51.9) (t = 7.341 and -7.336, p < .001). Moreover, the experimental group reported higher satisfaction (M = 34.7, SD = 1.6) compared to the control group (M = 30.6, SD = 3.4) with statistical significance (t = 7.145, p < .001). 

Recommendation The newly developed caring system for diabetic patients who miss appointments has proven to be effective, and patients have greater satisfaction compared to the traditional system. Therefore, it should be routinely implemented and expanded.