Effects of Self-Management Support Program for Patients with Diabetes Mellitus and Hypertension for Delayed Progressive Chronic Kidney Disease Stages 1-3 at Long Hospital, Phrae Province - ประสิทธิผลการสนับสนุนการจัดการตนเองของผู้ป่วยเบาหวานและความดันโลหิตสูง เพื่อชะลอไตเสื่อมจากโรคไตเรื้อรัง (CKD) ระยะที่1-3 โรงพยาบาลลอง อำเภอลอง จังหวัดแพร่

Abstract

Background:  Uncontrolled diabetes mellitus and hypertension can lead to chronic kidney disease Therefore, utilizing self-management support program for patients to control blood sugar and blood pressure can help prevent or delay in progression of chronic kidney disease.

Objective:  To evaluate the effects of self-management support program for patients with diabetes mellitus and hypertension for delayed progressive chronic kidney disease stages 1-3 at Long Hospital, Phrae province.

Study desing:  The sample group of this quasi-experimental research consisted of 36 patients diagnosed with diabetes mellitus and hypertension and chronic kidney disease stages 1-3. The group was given a self-management support program for 12 weeks. The research instruments were 1) knowledge implementation plan 2) self-management handbook in delaying progression of kidney disease 3) self-management diary 4) media slideshow. The instruments for data collection were 1) general information 2) knowledge on kidney disease and self-management support and 3) clinical outcomes of patients undertaking self-management support program. Its contents were examined by three experts and the validity was investigated with Cronbach’s Alpha co-efficient and Kuder-Richardson Method (0.82 and 0.81). Data were subsequently analyzed using descriptive statistics and paired t-test.

Results: The results revealed that at the end of the program, the experimental group had statistically higher knowledge of chronic kidney disease (p<.05). The overall self-management was also higher than before the intervention (t=3.706, p=.001). When considering each aspect, it found that  the result of food intake  and drug use was higher than before the intervention (p<.05) whereas it had no significant difference in the work out and others (p>.05). The research also showed that the patients had statistically significant lower fasting blood sugar, Hemoglobin A1C and serum creatinine (p<.05). While the kidney infiltration showed a significant result (p<.05), Systolic blood pressure, and Diastolic blood pressure  did not differ significantly (p>.05).

Conclusions: The self-management support program for patients withdiabetes mellitus and hypertension can delay progression of chronic kidney disease and help lower Hemoglobin A1C and serum creatinine and blood pressure. It can also be used with other chronic patients.

Keywords: patients with diabetes mellitus and hypertension, chronic kidney disease, self-management