Effects of a Telephone Symptom Monitoring Program on Knowledge, Self-Care Skills, and Satisfaction among Patients with Diabetic Macular Edema Receiving Intravitreal Injections as Outpatients at Udon Thani hospital

Abstract

This quasi-experimental study aimed to evaluate the effects of a telephone symptom monitoring program on knowledge, self-care skills, and satisfaction among patients with diabetic macular edema receiving intravitreal Injections as outpatients. The study was conducted at the Eye Clinic, Udonthani Hospital. The program was developed based on Orem’s Self-Care Theory and nursing care principles before, during, and after intravitreal injection procedures, with the integration of digital technology to support nursing education and follow-up care. The sample consisted of 32 patients with diabetic retinopathy complicated by diabetic macular edema, selected through purposive sampling according to the inclusion criteria. Data were collected between September and November 2024. Research instruments included questionnaires assessing knowledge, self-care skills, and satisfaction, which were validated for content validity and reliability. Data were analyzed using descriptive statistics and paired t-tests

          The findings demonstrated that, the participants had a mean age of 56.78 years, with a nearly equal proportion of males and females. Most participants had comorbidities, including hypertension (68.8%) and hyperlipidemia (59.4%). In addition, 65.5% were overweight or obese based on body mass index (BMI), and many had elevated fasting blood sugar (FBS) and HbA1c levels. After receiving the Telephone Symptom Monitoring Program, the mean knowledge score increased from 8.09 to 9.75 (p < 0.001), self-care skills improved from 8.44 to 9.72 (p<0.01), and satisfaction scores increased from 19.84 to 28.72 (p < 0.001). These findings indicate that the program effectively enhanced patients’ understanding of the disease, improved their self-care abilities, and increased satisfaction with the care provided.

          Recommendations: The Telephone Symptom Monitoring Program should be integrated into routine care for ophthalmic patients undergoing outpatient procedures to support continuous monitoring, improve access to care, and reduce complications related to the disease and treatment. Future studies should compare the effectiveness of telephone follow-up with other digital communication channels, such as video calls or mobile applications, to develop more efficient and sustainable patient care approaches.