The effect of a diet program for working-age diabetic patients with uncontrolled glycemia levels: A case study in Lom Sak District of Phetchabun Province

Abstract

Background: Diabetes is a chronic non-communicable disease that remains a health problem. All over the world, be given great importance, especially diabetes in working-age people who cannot control their sugar levels because it will cause various complications as a result. Important factors are related to eating habits, especially the people's way of life food.

Aim: The main objective of this research was to study the effectiveness of the food program for working-age diabetic patients who cannot control their sugar levels: a case study of Lom Sak District of Phetchabun Province. 

Methods: This study is research and development that is conducted in four steps: 1) basic information and program development guidelines study, 2) creating and studying program quality, 3) experimenting and studying the results of using the program, and 4) studying satisfaction with using the program. The sample groups in steps 1 and 2 selected specific types that consisted of a multidisciplinary team of 8 samples and public health volunteers with diabetes 13 samples. The tools used in this step of research are 1) a cumulative blood sugar form, 2) a questionnaire, and 3) a focus group discussion to draw up the format of the program. The sample group in steps 3 and 4 was 60 working-age diabetic patients who had uncontrolled blood sugar levels and received treatment at the family doctor's clinic of Lom Sak Hospital selected specifically were randomly assigned into an experimental group and a control group, 30 samples per group. The experimental group received a developed food program with four activities, followed up continuously for three months, and the control group received pre-development services. The research tools include 1) a self-efficacy confidence assessment in performing food self-management behaviors, 2) an assessment of self-management behavior practices, 3) a blood sugar form, and 4) a questionnaire about satisfaction with using the program. Data were analyzed using mean (X), standard deviation (S.D.), pair sample t-test, and independent t-test statistics.

Results: 1) Results of cumulative blood sugar control data of working-age diabetic patients who came to receive treatment at the family doctor's clinic of Lomsak Hospital, only 35.54 % of patients with good blood sugar control still did not meet the target criteria. Stakeholders must participate in creating guidelines for controlling blood sugar levels in working-age diabetic patients who cannot control their blood sugar levels. There are guidelines for program development. From the concept of self-efficacy belief theory (Bandura,1977) and the concept of self-management in patients with chronic diseases (Creer, 2000) 2) A food program for working-age diabetic patients who cannot control their sugar levels has five main components: 2.1) Principles, 2.2) Objectives, 2.3) Content, 2.4) Process, and 2.5) Measurement and Evaluation. The process section 2.4 consists of 9 sub-steps: (1) observing the experiences of others and exchanging knowledge from the model, (2) collecting data and recording one's data, (3) processing and analyzing Information, (4) physical and mental conditions, (5) persuasive speaking, (6) decision-making, (7) goal setting, (8) taking action, and (9) reflecting on problems and obstacles and the result of the inspection of the quality of the food programs developed by experts was at good level. 3) The results of the experiment and study of the use of the food program found that the experimental group had an average score of perception of food consumption practices and practicing food self-management behaviors Higher than before the experiment with statistical significance at the .05 level and the mean accumulated blood sugar level was lower than before the experiment and lower than the control group The efficiency of controlling accumulated blood sugar levels is close to the threshold of statistical significance at the .05 level, and 4) the result of the study of satisfaction with the developed program was at a high level.

Conclusions: Promoting self-management with a food program for working-age diabetic patients who are uncontrolled, their sugar levels have increased effective awareness of food self-management until they can practice food consumption according to lifestyle. As a result, the accumulated sugar level in the blood will decrease to an appropriate level according to the practice period.