Effects of Case Management Program on Uncontrolled Diabetes Mellitus Patients - ผลของโปรแกรมจัดการผู้ป่วยรายกรณี ในผู้ป่วยโรคเบาหวานที่ควบคุมระดับน้ำตาลไม่ได้

Abstract

Targeted treatment of diabetes aims to reduce or delay complications. By controlling blood sugar levels to normal with proper health behavior, so self-care is importance. A quasi-experimental group was used to evaluate the effects of a case management program in uncontrolled diabetes mellitus patients. Thirty-eight samples were randomly selected from a total of 72 diabetes patients with HbA1c more than 7% who were under the responsibility of Bansuan Health Promotion Hospital, Mueang District, Phatthalung Province. The duration of this research was 12 weeks. Case management program consists of the following activities: (1) creatiion of a multidisciplinary team was by the researchers as case managers, (2) development of patient care plan, (3) provision of patient care according to the patient care plan, (4) team meetings to adjust patient care plans to suit individual problems, (5) patient education for behavior modification, (6) patient support by home visits, and (7) motivation to change behaviors, such as appreciation. Self-care behavior data and HbA1c results were collected for comparison before and after the case management program. Data were analyzed by using means, standard deviation and paired t-test. The results were as follow: (1) The average score of self-care behaviors of uncontrolled diabetes mellitus patients before entering the case management program was 3.22 (SD=0.19). After the 12-week program, the mean score of self-care behavior significantly increased to 3.35 (SD=0.15) (p<0.05); (2) the HbA1c before entering the case management program was 8.97%, and significantly reduced to 7.39% after the program (p<0.05). The results suggested that case management program was effective and should be implemented in full service units together with the capacity building for nurses who could carry out diabetes care in order to gian more knowledge and understanding in patient case management. This would help improving diabetics control or slowing down the complications.