Effective of a mutual goal setting nursing program for control glycosylated hemoglobin (HbA1c) in uncontrol diabetic patient

Abstract

Background: Diabetes is a chronic non-communicable disease that remains a health problem. Nowadays, the world is giving great importance because it is a disease that cannot be cured, especially uncontrolled diabetes.

Aims: 1) To study the situation, problems, glycosylated hemoglobin (HbA1c) control in uncontrolled diabetic patients in Lablae District, and guidelines for controlling the glycosylated hemoglobin in uncontrolled diabetic patients. 2) To create and examine the elements of a mutual goal-setting nursing program to control the glycosylated hemoglobin (HbA1c) level in patients with uncontrolled diabetes mellitus. 3) To trial and study the results of using a mutual goal-setting nursing program to control the glycosylated hemoglobin (HbA1c) level in patients with uncontrolled diabetes mellitus. 4) To assess stakeholder satisfaction with the use of a mutual goal-setting nursing program to control the glycosylated hemoglobin (HbA1c) level in patients with uncontrolled diabetes mellitus. 

Methods: This study is research and development. Objective number 1 is used to summarize the work results for the year 2023 of Lablae Hospital, literature review, and participation of health teams and patients. Data recording and semi-structured interviews and data were analyzed using percentage, mean, and standard deviation. Statistical analysis: Pearson's correlation coefficient, content analysis, document analysis. Objective number 2 used a literature review and evaluated the quality of (draft) program components. Analyze data by content analysis and document analysis Percentage average and standard deviation. Objective number 3 used a quasi-experimental design. Data were analyzed by percentage, mean, standard deviation, and F statistic in ANOVA of repeated measures experimental plan and t-test statistic. The study of objective number 4 Uses a stakeholder satisfaction questionnaire using percentage, mean, and standard deviation.

Results: Situation and Problems to Control the glycosylated hemoglobin (HbA1c) level in patients with uncontrolled diabetes mellitus in Laplace District not yet passed the indicators. A survey research study found that there are leading factors, contributing factors, and additional factors of health literacy in patients with uncontrolled diabetes. It affects nursing practice by setting common goals. Stakeholders must participate in creating guidelines for controlling cumulative average blood sugar levels in patients with uncontrolled diabetes. The guidelines obtained from participation consist of 4 steps: condition assessment, planning, implementation, and evaluation. The results of creating the elements of the program were the 8th sub-components, namely: having purposeful interactions; Evaluation aspect In terms of decision-making skills; Problem determination together; The selection of procedures planning/goal setting; In terms of following the chosen method/modifying self-management behavior according to the set goals and evaluating success according to the goals. Each component can used to (draft) a nursing program that sets a common goal to control the average cumulative sugar level in patients with uncontrolled diabetes.