Effects of a Self-Management Nursing Support Program with Health Care Volunteers for Insulin Dependent Type 2 Diabetes Mellitus Patients

Abstract

Type 2 diabetes mellitus (DM) is a major public health problem worldwide. This quasi-experimental research aimed to examine the effects of a self-management program among patients with Type 2 DM on self-management efficacy, food consumption behavior, and HbA1C concentration, by applying the self-management concept of Kanfer and Gaelick-Buys and social support from healthcare volunteers. The sample group was Type 2 DM patients treated with insulin injections in the primary care unit, Thepparat Hospital, Nakhon Ratchasima province, Thailand. Systematic sampling of 25 people was used for obtaining the experimental group and the comparison group. The experimental group was encouraged to perform self-management by nurses and support from healthcare volunteers for 12 weeks. The program consisted of the self-management of blood sugar levels three times and was visited by healthcare volunteers every 3 days a week. Data were collected by interview questionnaire before and after the intervention at week 8 and week 12. HbA1C was also measured before and after the intervention at week 12. This research was approved by the Ethical Committee for Human Research of the Faculty of Public Health, Mahidol University, Thailand (MUPH 2021-080). The results showed that after the intervention in the 8^th and 12^th week, the experimental group was statistically significantly higher in self-efficacy (M<inf>8th</inf> 26.64 ± 2.25; M<inf>12th</inf> 38.68 ± 2.39) and consumption behavior scores (M<inf>8th</inf> 24.52 ± 2.22; M<inf>12th</inf> 35.00 ± 3.07) than before the intervention (M pre 22.52 ± 4.13; M<inf>pre</inf> 21.12 ± 2.19, respectively) and it was better than the comparison group (p < 0.05). After the intervention in the 12th week, the experimental group had a statistically significant decrease in HbA1C (M<inf>12th</inf> 9.28 ± 1.07) than before the intervention (M<inf>pre</inf> 10.19 ± 2.53) and lower than the comparison group (p < 0.05). This finding suggested that community nurse practitioners or nurses at Diabetes C l i n i c s can apply this program to enhance insulin-dependent Type 2 DM patients to perform self-management and educate healthcare volunteers to support them while patients stay in the community.