Development of Self-management Guidelines for Patients with Type 2 Diabetes in the Semi-urban, Semi-rural Community
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Abstract
Objective: This action research aimed to describe the self-management situation of diabetic patients and develop self-management guidelines for patients with type 2 diabetes in the semi-urban, semi-rural community. Methods: The diabetic patients’ self-management situation was analyzed from the data collected from 57 diabetic patients using a record form and a self-management questionnaire and focus group discussions of nurses and village health volunteers: 4 people in each group. The development of guidelines for self-management support among 15 diabetic patients was operated by applying the 6 steps of selfmanagement of Creer: 1) goal selection, 2) information collection, 3) information processing and evaluation, 4) decision making, 5) action and 6) self- reaction. Results: The majority of diabetic patients aged between 61-70 years (49.10%) and were mostly females (77.20%). The mean of fasting blood sugar (FBS) level was 184.93 mg/dL (SD = 36.20). These diabetic patients had the following complications: diabetic retinopathy
(24.60%), decreased glomerular filtration rate (26.30%) and diabetic foot (12.30%). The guidelines for supporting self-management of diabetic patients, nurses had a meeting with the patients to set goals on physical activities, diet, stress reduction and promotion of knowledge. The caregivers were the supporters of the activities and gave the patients reinforcement. The Village Health Volunteers (VHVs) monitored and supported the activities at home and reinforced the patients. It was also found that the mean of all selfmanagement behaviors after participating in this process (M = 3.63, SD =.21) was significantly higher than before participating in the process (M=2.88, SD=.26) at the level of 0.05, and FBS after participating in the process (M = 169.67 mg/dL, SD=29.45) was significantly lower than before participating in the process (M = 184.93, SD=36.20) at the level of 0.05. Conclusion: Self-management on food should be developed for patients with type 2 diabetes.
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