The Development of a Self-Management Support Model for Non-Communicable Disease Prevention among People at Risk of Chronic Illness: Bangkaja, Muang District, Chanthaburi Province

Abstract

Background: The people at risk of non-communicable diseases are likely to develop the disease within a short period of time if they do not change their inappropriate behaviors. Therefore, the development of a self-management support model to prevent the diseases is necessary.

Objective: To develop a self-management support model to prevent non-communicable diseases for at-risk groups and evaluating the effectiveness of the model.

Materials and methods: This study is research and development. The sample group comprised 45 people at risk of diabetes and/or hypertension at Bangkaja Health Promoting Hospital, Muang District, Chanthaburi Province. They were selected using purposive sampling based on the research criteria. The research was conducted during February-August 2018. The research instruments were composed of a self-management in disease prevention questionnaire, medical equipment for lipid profile and blood sugar investigation, a sphygmomanometer, a stadiometer, and a tape measure used in testing for psychometric and biometric properties. Data were analyzed using descriptive statistics: Repeated Measure ANOVA, Bonferroni, Paired t-test, Wilcoxon signed rank test. The qualitative data were analyzed using constant comparative study and were tested using triangulation techniques.

Results: The development of a self-management support model for non-communicable disease prevention among people at risk in this study consisted of four processes including: 1) Exploring the lifestyle, problems and health risk behaviors of people in at-risk groups; 2) Collaborative goal setting and health behavior modification planning to decrease risks; 3) Self-management training of disease prevention and self-regulation to attain the goals, and 4) Reflecting on the practice and rethinking the new methods to attain the goals. The model evaluation at 3 months revealed that the mean scores of self-management behaviors for disease prevention were statistically higher than the baseline (p = 0.031), the fasting blood sugar and systolic blood pressure were statistically lower than the baseline (p = 0.016, and p = 0.002, respectively), whereas the diastolic pressure, waist circumference, and body mass index were not statistically different (p = 0.286, p = 0.077, and p = 0.500, respectively). At 6 months, the results revealed that the mean score of self-management behaviors was statistically significantly higher than the baseline (p = 0.007). In addition, the fasting blood sugar, systolic blood pressure, waist circumference, body mass index, and cardiovascular disease risk were statistically lower than the baseline (p = 0.048, p < 0.001, p = 0.009, p = 0.016, and p < 0.001, respectively), whereas the diastolic blood pressure was lower than the baseline without statistical significance (p = 0.500).

Conclusion: The results suggest that the model in this study can be used for promoting behavior change among people at risk of chronic illness in the community in order to prevent or reduce the risk of chronic illness. In addition, self-regulated stimulation is needed for maintaining the behavior changes.