Diabetes is a severe health problem in Thailand and patient self-management is a key to successful treatment. Self-management helps patients to control their disease, prevent complications, and enhance quality of life. The purpose of this study, then, was to test the effect of a new self-management program on knowledge, self-care activities, quality of life, and glycosylated HbA1c (GHb) in patients with type 2 diabetes mellitus. Orem’s self-care theory and cognitive behavioral therapy provided the theoretical framework of this study. Eighty-one subjects with type 2 diabetes at a community hospital in Thailand were randomly assigned to either the self-management or the control group. Both groups received five videotapes, a set of written diabetes materials, and the usual diabetes education program. They also received follow-up phone calls at three and five months. However, the self-management group also attended five sessions which focused on improving cognitive processes and skills in diabetes care. Several combined methods such as teaching, support, discussion, exercise assignments, and skill training were used in each session. Data were collected at pre-intervention, three, and six months analyzed by repeated measures ANOVA and repeated measures ANCOVA. The results indicated that the subjects in the self-management group had higher mean scores of knowledge, self-care activities, and quality of life than the control group at three and six months. The mean GHb levels in the self-management group were lower than in the control group at three and six months but the differences were not statistically significant. However, the GHb results showed clinical significance. The percentage GHb decrease and average GHb change in the self-management group were higher than in the control group. The study findings show the effectiveness of this diabetes self-management program for improving both physiological and psychological outcomes. Therefore, implementing this program at community hospitals is recommended.

Ph.D. NURSING (INTER) สถาบันบัณฑิตพัฒนบริหารศาสตร์ ปี 2548

of, Diabetes, Quality, life, SELF-CARE, TYPE 2, SELF-MANAGEMENT, GLYCOSYLATED, HbA1c