Effects of an Education Program-Based on the Common Sense Model on Illness Perceptions, Knowledge, and Self-efficacy among Patients with Type 2 Diabetes Mellitus in Cambodia

Main Article Content

Mao Eam
Pattama Surit


          Purpose: This study was to examine the effects of an education program-based on the Common Sense Model on illness perceptions, knowledge, and self-efficacy among patients with type 2 diabetes mellitus.

          Design: Quasi-experimental study with pretest and posttest control group design.

          Methods: The sample was patients with type 2 diabetes mellitus who were living in 12 villages under health services of a health center. The villages were randomly assigned to the control and experimental groups. The simple random sampling technique with paired matching method were used for selecting subjects in the villages.  Consequently, 36 participants made up each group. The intervention group was invited in a one day education program, whereas, the control group received routine care. The outcomes were evaluated by using the demographic data and illness information, Brief Illness Perception Questionnaire, the 24-item version of Diabetes Knowledge Questionnaire, and the Thai version of Diabetes Management Self-Efficacy Scale. The intervention instruments were developed by the researchers based on the literature review. Paired t-test and independent t-test were used for data analysis.

          Main findings: The result showed that the participants in the intervention group who received the education program had statistically significant higher mean scores of illness perceptions, knowledge, and self-efficacy than before, and those in the control group who received usual care (all p’s < .05).

          Conclusion and recommendations: The findings of the study illustrated that an education program-based on the Common Sense Model could improve illness perceptions, knowledge, and self-efficacy among patients with type 2 diabetes mellitus. This program should be approached for discharge plan to provide accurate perceptions, proper knowledge, and confidence to take care among patients with type 2 diabetes mellitus.

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How to Cite
Eam, M., & Surit, P. (2019). Effects of an Education Program-Based on the Common Sense Model on Illness Perceptions, Knowledge, and Self-efficacy among Patients with Type 2 Diabetes Mellitus in Cambodia. Nursing Science Journal of Thailand, 37(4), 20–31. Retrieved from https://he02.tci-thaijo.org/index.php/ns/article/view/207560
Research Papers


1. World Health Organization. Diabetes [Internet] Geneva, Switzerland: WHO; 2018 [cited 2019 Jul 03]. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes.

2. International Diabetes Federation. IDF diabetes atlas [Internet]. 7th ed. Brussels: Karakas Print; 2015 [cited 2019 Jun 30]. Available from: https://www.oedg.at/pdf/1606_IDF_Atlas_2015_UK.pdf.

3. Ministry of Health. Cambodia health report for 2018 [Internet]. Phnom Penh: Ministry of Health; 2018 [cited 2019 Jul 03]; Available from http://moh.gov.kh/content/uploads/2017/05/MOH-Report-Kh-V6.pdf.

4. Jung CH, Kim KJ, Lee YK, Kwon JH, Lee BW, Kwon HS, et al. The glycemic status of diabetes in an urban area of Cambodia. Diabetes Res Clin Pract. 2014;104(2):e34-7. doi: 10.1016/j.diabres.2014.02.008.

5. Thomas B, van Pelt M, Mehrotra R, Robinson-Cohen C, LoGerfo J. An estimation of the prevalence and progression of chronic kidney disease in a rural diabetic cambodian population. PLoS One. 2014;9(1):e86123. doi: 10.1371/journal.pone.0086123.

6. Raguenaud ME, Isaakidis P, Reid T, Chy S, Keuky L, Arellano G, et al. Treating 4,000 diabetic patients in Cambodia, a high-prevalence but resource-limited setting: a 5-year study. BMC Med. 2009;7:33. doi: 10.1186/1741-7015-7-33.

7. Harvey JN, Lawson VL. The importance of health belief models in determining self-care behaviour in diabetes. Diabet Med. 2009;26(1):5-13. doi: 10.1111/j.1464-5491.2008.02628.x.

8. Leventhal H, Brissette I, Leventhal EA. The common-sense model of self-regulation of health and illness. In: Cameron LD, Leventhal H, editors. The self-regulation of health and illness behaviour. London: Routledge; 2003. p.42-65.

9. Leventhal H, Philippips LA, Burns E. The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management. J Behav Med. 2016;39(6):935-46. doi: 10.1007/s10865-016-9782-2.

10. Ashur ST, Shah SA, Bosseri S, Morisky DE, Shamsuddin K. Illness perceptions of Libyans with T2DM and their influence on medication adherence: a study in a diabetes center in Tripoli. Libyan J Med. 2015;10:29797. doi: 10.3402/ljm.v10.29797.

11. Cambridge University Press. Knowledge [Internet]. Cambridge: Cambridge University Press; 2018 [cited 2018 Nov 28]. Available from: https://www.cambridge.org/lk/education/subject/general-knowledge.

12. Sousa VD, Zauszniewski JA, Musil CM, McDonald PE, Milligan SE. Testing a conceptual framework for diabetes self-care management. Res Theory Nurs Pract. 2004;18(4):293-316.

13. Al-Qazaz HKh, Sulaiman SA, Hassali MA, Shafie AA, Sundram S, Al-Nuri R, et al. Diabetes knowledge, medication adherence and glycemic control among patients with type 2 diabetes. Int J Clin Pharm. 2011;33(6):1028-35. doi: 10.1007/s11096-011-9582-2.

14. Bandura A. Self-efficacy: the exercise of control. New York: W. H. Freeman and Company; 1997. 604 p.

15. Williams BW, Kessler HA, Williams MV. Relationship among practice change, motivation, and self-efficacy. J Contin Educ Health Prof. 2014;34 Suppl 1:S5-10. doi: 10.1002/chp.21235.

16. Beckerle CM, Lavin MA. Association of self-efficacy and self-care with glycemic control in diabetes. Diabetes Spectrum. 2013;26(3):172-8. doi: 10.2337/diaspect.26.3.172.

17. Keogh KM, Smith SM, White P, McGilloway S, Kelly A, Gibney J, et al. Psychological family intervention for poorly controlled type 2 diabetes. Am J Manag Care. 2011;17(2):105-13.

18. Wattanakorn K, Deenan A, Puapan S, Schneider JK. Effects of an eating behaviour modification program on Thai people with diabetes and obesity: a randomised clinical trial. Pac Rim Int J Nurs Res Thail. 2013;17(4):356-70.

19. Wichit N, Mnatzaganian G, Courtney M, Schulz P, Johnson M. Randomized controlled trial of a family-oriented self-management program to improve self-efficacy, glycemic control and quality of life among Thai individuals with Type 2 diabetes. Diabetes Res Clin Pract. 2017;123:37-48. doi: 10.1016/j.diabres.2016.11.013.

20. Strauss SM, Rosedale MT, Kaur N. Illness perceptions among adults at risk for diabetes. Diabetes Educ. 2015;41(2):195-202. doi: 10.1177/0145721715569003.

21. Boonsatean W, Carlsson A, Östman M, Rosner ID. Living with diabetes: experiences of inner and outer sources of beliefs in women with low socioeconomic status. Glob J Health Sci. 2015;8(8)54203. doi: 10.5539/gjhs.v8n8p200.

22. Abubakari AR, Cousins R, Thomas C, Sharma D, Naderali EK. Sociodemographic and clinical predictors of self-management among people with poorly controlled type 1 and type 2 diabetes: the role of illness perceptions and self-efficacy. J Diabetes Res. 2016;2016:6708164. doi: 10.1155/2016/6708164.

23. Glass GV, McGaw B, Smith ML. Meta-analysis in social research. Beverly Hills, CA: Sage; 1981. 279 p.

24. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988. 567 p.

25. Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60(6):631-7. doi: 10.1016/j.jpsychores.2005.10.020.

26. Garcia AA, Villagomez ET, Brown SA, Kouzekanani K, Hanis CL. The starr county diabetes education study: development of the Spanish-language diabetes knowledge questionnaire. Diabetes Care. 2001;24(1):16-21. doi: 10.2337/diacare.24.1.16.

27. Sangruangake M, Jirapornkul C, Hurst C. Psychometric properties of diabetes management self-efficacy in Thai type 2 diabetes mellitus patients: a multicenter study. Int J Endocrinol. 2017;2017:2503156. doi: 10.1155/2017/2503156.

28. Khunti K, Gray LJ, Skinner T, Carey ME, Realf K, Dallosso H, et al. Effectiveness of a diabetes education and self management programme (DESMOND) for people with newly diagnosed type 2 diabetes mellitus: three year follow-up of a cluster randomised controlled trial in primary care. BMJ. 2012;344:e2333. doi: 10.1136/bmj.e2333.