Effects of an Individual and Family Self-Management Program on Self-Management Behaviors and Hemoglobin A1C Level Among Older Adults with Uncontrolled Diabetes Mellitus: A Randomized Controlled Trial
Keywords:
Hemoglobin A1C level, Individual and family self-management, Older adults, Self-management behaviors, Uncontrolled diabetes mellitusAbstract
Uncontrolled diabetes mellitus in older adults requires effective self-management strategies involving both the patients and their families. This randomized controlled trial (RCT) aimed to examine the effects of the Individual and Family Self-Management Program (IFSMP) on self-management behaviors (SMB) and hemoglobin A1C levels (HbA1C) among older adults with uncontrolled diabetes mellitus. The participants were 52 older adults with uncontrolled diabetes mellitus attending San Na Meng Municipal Public Health Service Center and Ban Pa Kang Subdistrict Health Promoting Hospital in San Sai District, Chiang Mai Province (26 each in the experimental and control groups). The experimental group received the IFSMP for 4 weeks. The data were analyzed using descriptive statistics, independent t-tests, paired t-tests, chi-square, and McNemar tests.
The study results found that the mean self-management behavior scores of participants in the experimental group significantly increased after participating in the program (M = 111.30, SD = 5.14) compared to before participating in the program (M = 81.26, SD = 8.27, t = -14.159, p < .001) and compared to the control group (M = 79.92, SD = 7.71, t = 17.37, p < .001). The proportion of older adults who could control their HbA1C levels after participating in the program was significantly higher than before the program (p < .001) and compared to the control group (p < .001).
This study demonstrates the effectiveness of the IFSMP. Therefore, health professionals can apply this program to improve SMB in older adults with uncontrolled diabetes mellitus, thereby decreasing HbA1C levels.
References
Adu, M. D., Malabu, U. H., Malau-Aduli, A. E. O., & Malau-Aduli, B. S. (2020). The development of my care hub mobile phone app to support self-management in Australians with type 1 or type 2 diabetes. Scientific Reports, 10(1), 7. https://doi.org/10.1038/s41598-019-56411-0
Aekplakorn, W. (Ed.). (2021). National health examination surveys (6th ed.). Augson Graphic and Design. (in Thai)
Ahmad, N. A., Abd Rauf, M. F., Mohd Zaid, N. N., Zainal, A., Tengku Shahdan, T. S., & Abdul Razak, F. H. (2022). Effectiveness of instructional strategies designed for older adults in learning digital technologies: A systematic literature review. SN Computer Science, 3(2), 130. https://doi.org/10.1007/s42979-022-01016-0
Albikawi, Z. F., Petro-Nustas, W., & Abuadas, M. (2015). The effect of diabetes self efficacy enhancing intervention on diabetes self care management behaviors among Jordanian type two diabetes patients. International Journal of Scientific Research, 2(4), 1-15.
Centers for Disease Control and Prevention. (2024). National diabetes statistics report. https://www.cdc.gov/diabetes/php/data-research/index.html
Chentli, F., Azzoug, S., & Mahgoun, S. (2015). Diabetes mellitus in elderly. Indian Journal of Endocrinology and Metabolism, 19(6), 744-752. https://doi.org/10.4103/2230-8210.167553
Chiang Mai Province Public Health Office. (2018). Elderly screening form in community level [document file]. Chiang Mai Province Public Health Office.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
Department of Medical Services, Ministry of Public Health. (2015). Guide for the elderlyscreening/ assessment (2nd ed.). War Veterans Organization Office of Printing Mill. https://dmscaretools.dms.go.th/geriatric/download/DMS_Aging_screening.pdf (in Thai)
Dorji, S., Deenan, A., & Masingboon, K. (2017). Prediction of glycated hemoglobin (HbA1c) using physical activity, eating behavior and medication adherence in bhutanese patients with type 2 diabetes. Thai Pharmaceutical and Health Science Journal, 12(4), 166-175.
Fitzpatrick, S. L., Golden, S. H., Stewart, K., Sutherland, J., DeGross, S., Brown, T., Wang, N. Y., Allen, J., Cooper, L. A., & Hill-Briggs, F. (2016). Effect of DECIDE (Decision-making Education for Choices In Diabetes Everyday) program delivery modalities on clinical and behavioral outcomes in urban african americans with type 2 diabetes: A randomized trial. Diabetes Care, 39(12), 2149–2157. https://doi.org/10.2337/dc16-0941
Jalilian, F., Motlagh, F. Z., Solhi, M., & Gharibnavaz, H. (2014). Effectiveness of self-management promotion educational program among diabetic patients based on health belief model. Journal of Education and Health Promotion, 3, 14. https://doi.org/10.4103/2277-9531.127580
Jiang, T., Liu, C., Jiang, P., Cheng, W., Sun, X., Yuan, J., Wang, Q., Wang, Y., Hong, S., Shen, H., Zhu, D., Zhang, Y., Dai, F., Hang, J., Li, J., Hu, H., & Zhang, Q. (2023). The effect of diabetes management shared care clinic on glycated hemoglobin A1c compliance and self-management abilities in patients with type 2 diabetes mellitus. International Journal of Clinical Practice, 2023(1), 2493634. https://doi.org/10.1155/2023/2493634
Kaveh, M. H., Montazer, M., Karimi, M., & Hassanzadeh, J. (2022). Effects of a theory-based training program with follow-up home visits on self-management behavior, glycemic index, and quality of life among Iranian patients with type 2 diabetes mellitus. BMC Public Health, 22(1), 1559. https://doi.org/10.1186/s12889-022-13959-3
Ministry of Public Health. (2022). Mortality rate from diabetes. https://hdc.moph.go.th/center/public/standard-report-detail/589248f2516fbb85d4a4a5605c3ca1c4
Naik, A. D., Palmer, N., Petersen, N. J., Street, R. L., Jr, Rao, R., Suarez-Almazor, M., & Haidet, P. (2011). Comparative effectiveness of goal setting in diabetes mellitus group clinics: Randomized clinical trial. Archives of Internal Medicine, 171(5), 453–459. https://doi.org/10.1001/archinternmed.2011.70
Nejhaddadgar, N., Darabi, F., Rohban, A., Solhi, M., & kheire, M. (2019). The effectiveness of self-management program for people with type 2 diabetes mellitus based on PRECEDE-PROCEDE model. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 13(1), 440-443. https://doi.org/10.1016/j.dsx.2018.08.016
Nguyen Viet, H., Chamroonsawasdi, K., Vatanasomboom, P., & Chottanapund, S. (2020). Effectiveness of a family support coaching program on diabetes mellitus self-management to improve health outcomes among Thai patients with uncontrolled type 2 diabetes: A quasi-experimental study. Journal of Public Health and Development, 18(3), 64-83.
Public Health Laboratory Office, Laboratory of Bangkok Metropolis Administration. (2017). What is HbA1c? https://shorturl.asia/2H5hR
Ryan, P., & Sawin, K. J. (2009). The individual and family self-management theory: Background and perspectives on context, process, and outcomes. Nursing Outlook, 57(4), 217–225.e6. https://doi.org/10.1016/j.outlook.2008.10.004
Sriyasak, A., Sarakshetrin A., Tongphet, J., Ket-in, V., Utaitum, N., Mookui, S., & Meesub, T. (2021). The development of health literacy for health management of older adults with diabetes and hypertension in primary care cluster context: Case study in Phetchaburi Province. Journal of Health Systems Research, 15(2), 155-173. (in Thai)
Tevfik, F. K., & Bektaş, M. Y. (2009). The effects of an emotional intelligence skills training program on anxiety, burnout and glycemic control in type 2 diabetes mellitus patients. Turkiye Klinikleri Journal of Medical Sciences, 29(1), 16-24.
Vos, R. C., van Heusden, L., Eikelenboom, N. W. D., & Rutten, G. (2019). Theory-based diabetes self-management education with pre-selection of participants: A randomized controlled trial with 2.5 years' follow-up (ELDES Study). Diabetic Medicine, 36(7), 827-835. https://doi.org/10.1111/dme.13907
Wisarapun, N., Mongkolmafai, J., Santo, N., & Kankarn, W. (2020). The effectiveness of self-and family management of patients with type II diabetes and hypertension in community health center. Journal of Nursing and Health Care, 38(4), 102–111. (in Thai)
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Nursing Journal CMU
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารพยาบาลสาร
ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับมหาวิทยาลัยเชียงใหม่ และคณาจารย์ท่านอื่นๆในมหาวิทยาลัยฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใด ๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว
