Effectiveness of Case Management on Blood Sugar, Blood Pressure, and Health Behavior in Individuals with Both Diabetes and Hypertension
Keywords:
Health behavior, Diabetes mellitus, Hypertension, Case managementAbstract
Achieving and maintaining target blood glucose and blood pressure levels is crucial in preventing severe complications for patients with both diabetes and hypertension. However, managing these conditions can be complex. Case management is a widely used approach for managing complex care. This quasi-experimental study investigated the effectiveness of case management on blood glucose, blood pressure, and health behavior in 30 patients with both diabetes and hypertension at a sub-district health promoting hospital between March and May 2024. The instruments used in the experiment included: 1) a 10-week case management program for patients with diabetes and hypertension, adapted from the Case Management Society of America; 2) a patient self-care handbook; 3) a home visit record form; 4) a record form for blood glucose and blood pressure monitoring results; and 5) a blood pressure monitor. The instruments for data collection comprised: 1) a personal information questionnaire, and 2) a health behavior assessment scale, with an overall Cronbach’s alpha coefficient of 0.78. Data were analyzed using descriptive statistics and paired t-tests.
The results revealed a significant decrease in mean systolic blood pressure among the participants after receiving case management (p < .001). Additionally, there was a significant increase in exercise behavior scores (p < .05). However, no significant differences were found in mean blood sugar levels, diastolic blood pressure, overall health behavior, emotional management, and medication adherence.
Case management was effective in reducing systolic blood pressure and enhancing exercise habits among diabetic and hypertensive patients. Therefore, health personnel can apply this model to improve the quality of care for this patient group.
References
Aekplakorn, W. (Ed.). (2009). The 4th national health examination survey report, year 2008-2009. The Graphico Systems. (in Thai)
Aekplakorn, W. (Ed.). (2016). The 5th national health examination survey report, year 2014. Aksorn Graphic and Design. (in Thai)
Aekplakorn, W. (Ed.). (2021). The 6th national health examination survey report, year 2019-2020. Aksorn Graphic and Design. (in Thai)
Ban Nam Khong Sub-District Health Promoting Hospital. (2023). Report on patients with chronic non-communicable diseases. [Unpublished report]. Ban Nam Khong Sub-District Health Promoting Hospital. (in Thai)
Case Management Society of America (CMSA). (2016). Standards of practice for case management. Case Management Society of America (CMSA).
Chaimai, A., & Fukfon, K. (2018). Nursing case management for people with type 2 pre-diabetes mellitus in community. Nursing Public Health and Education Journal, 19(2), 17-28. https://he01.tci-thaijo.org/index.php/bcnpy/article/view/133951 (in Thai)
Chaimai, A., Piaseu, N., & Mekwiwatanawon, C. (2017). Effects of nursing case management of Buddhist monks at risk for type 2 diabetes: A randomized controlled trial. Pacific Rim International Journal of Nursing Research, 21(4), 305-316.
Chaiyarit, A. (2020). Case management program on levels of fasting plasma glucose among type 2 diabetes mellitus patients. Journal of The Royal Thai Army Nurses, 21(2), 213-221. (in Thai)
Chaiyarit, A., & Jangsombatsiri, W. (2017). Significant roles of nurse case manager to improve quality of care for chronically ill patients: Diabetes and hypertensive patients. Nursing Journal, 44(4), 195-205. (in Thai)
Diabetes Association of Thailand under The Patronage of Her Royal Highness Princess Maha Chakri Sirindhorn. (2023). Clinical practice guideline for diabetes 2023. Srimuang Pringting. (in Thai)
Edelman, D., Dolor, R. J., Coffman, C. J., Pereira, K. C., Granger, B. B., Lindquist, J. H., Neary, A. M., Harris, A. J., & Bosworth, H. B. (2015). Nurse-led behavioral management of diabetes and hypertension in community practices: A randomized trial. Journal of General Internal Medicine, 30(5), 626-633. https://doi.org/10.1007/s11606-014-3154-9
Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191. https://doi.org/10.3758/bf03193146
Jia, G., & Sowers, J. R. (2021). Hypertension in diabetes: An update of basic mechanisms and clinical disease. Hypertension, 78(5), 1197-1205. https://doi.org/10.1161/HYPERTENSIONAHA.121.17981
Juncharoen, K., Rianrakwong, P., Phanasnachi, W., Sripon, P., Phonkanya, W., Thiankul, S., Jaiphong, P., Udong, N., Matkhoksung, N., Wannalai, P., Daengbua, P., Naksen, K., & Srisombat, P. (2023). Factors influence blood glucose level of type 2 DM patient in public health center, Eastern Bangkok area. Journal of the Bangkok Health Office, 1(2), 16-28. (in Thai)
Khousakulrat, S. (2024). Nursing care of diabetic patients with uncontrolled blood sugar with complications: Comparison of two case studies. Journal of Environmental and Community Health, 9(2), 127-136. https://he03.tci-thaijo.org/index.php/ech/article/view/2455 (in Thai)
Kosonjit, R., & Noimuenwai, P. (2017). Effectiveness of case management in patients with diabetic mellitus at Pak Phli Hospital, Nakhon Nayok Province. Nursing Journal, 44(1), 26-38. (in Thai)
McFarlane, S. I., Jacober, S. J., Winer, N., Kaur, J., Castro, J. P., Wui, M. A., Gliwa, A. Von Gizycki, H., & Sowers, J. R. (2002). Control of cardiovascular risk factors in patients with diabetes and hypertension at urban academic medical centers. Diabetes Care, 25(4), 718-723. https://doi.org/10.2337/diacare.25.4.718
Ministry of Public Health. (2016). Practical guidelines for reducing chronic kidney disease (CKD) in patients with diabetes and hypertensive. The War Veterans Organization of Thailand Under Royal Patronage His majesty the King Press. (in Thai)
Norrasan, S., & Wattananon, W. (2017). Nurse case manager: Roles of providing elderly dependent care in community. Journal of Nursing Science & Health, 40(2), 138-145. (in Thai)
Peerawankul, N. (2022). Self–care behavior of type 2 diabetes patients at Prankratai Hospital, Kamphaeng Phet Province. Science and Technology Northern Journal, 3(3), 38-55. https://he03.tci-thaijo.org/index.php/scintc/article/view/1073 (in Thai)
Piadsoongnern, K. (2018). The development of health behaviors in hypertension patient in Kut Taphet Sub district, Lam Sonthi District: Lopburi Province. Journal of Health Research and Development, 4(2), 26-39. (in Thai)
Rattanaurai, U., & Songbutr, P. (2019). Effects of case management program on uncontrolled diabetes mellitus patients. Journal of Health Science, 28(Special Issue), 146-151. (in Thai)
Sindhu, S. (Ed.). (2022). Nursing care for chronic disease: Hypertension & heart failure. Woo Hing Press. (in Thai)
Suppachotchai, P. (2024). Result of patient care model at Subdistrict Health Promoting Hospital Nakhon Chai Si Hospital service network. Journal of Environmental and Community Health, 9(2), 659-667. https://he03.tci-thaijo.org/index.php/ech/article/view/2541/1916 (in Thai)
Taaon, C., Kraithaworn, P., & Piaseu, N. (2024). The effects of nursing case management on self-care behaviors, clinical outcomes, and quality of life among community-dwelling older adults with poorly controlled type 2 diabetes in Thailand. Journal of Community Health Nursing, 41(1), 11-20. https://doi.org/10.1080/07370016.2023.2266433
Taengtim, T., Amnatsatsue, K., & Kerdmongkol, P. (2022). Effects of case management program for older adults with hypertension and chronic renal failure at a primary care unit. Journal of Nursing and Health Science Research, 14(2), 114-127. (in Thai)
Thai Hypertension Society. (2019). 2019 Thai guidelines on the treatment of hypertension. Trick Think. (in Thai)
Thaneerat, T., Phakaihran, W., Nakakes, M., Rerngwichittra, S., Chittakot, Y., Kongkanoi, K., & Ounjit, K. (Eds.). (2022). A caring handbook for patients with hypertension using integrated medicine. Department of Thai Traditional and Alternative Medicine. https://shorturl.asia/rR8JC (in Thai)
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 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
