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Randomized controlled trial of a family-orientated self-management program to improve self-efficacy, glycemic control, and quality of life among Thai individuals with Type 2 Diabetes
Wichit, Nutchanath Mnatzaganian, George Courtney, Mary Schulz, Paula Johnson, Maree
Wichit, Nutchanath
Mnatzaganian, George
Courtney, Mary
Schulz, Paula
Johnson, Maree
Abstract
Aims: We evaluated a theoretically-derived family-oriented intervention aimed to improve self-efficacy, self-management, glycemic control and quality of life in individuals living with Type 2 diabetes in Thailand. Methods: In a single-blinded randomized controlled trial, 140 volunteer individuals with Type 2 diabetes, recruited from a diabetes clinic in rural Thailand, were randomly allocated to intervention and control arms. Those in the intervention arm received routine care plus a family-oriented program that included education classes, group discussions, a home visit, and a telephone follow-up while the control arm only received routine care. Improvement in outcomes over time (baseline, Week 3, and Week 13 following intervention) was evaluated using Generalized Estimating Equations multivariable analyses. Results: Except for age, no between-group significant differences were observed in all other baseline characteristics. Diabetes self-efficacy, self-management, and quality of life improved in the intervention arm but no improvement was observed in the controls. In the risk-adjusted multivariable models, compared to the controls, the intervention arm had significantly better self-efficacy, self-management, outcome expectations, and diabetes knowledge (p < 0.001, in each). Participation in the intervention increased the diabetes self-management score by 14.3 points (β = 14.3, (95% CI 10.7–17.9), p < 0.001). Self-management was better in leaner patients and in females. No between-group differences were seen in quality of life or glycemic control, however, in the risk-adjusted multivariable models, higher self-management scores were associated with significantly decreased HbA1c levels (p < 0.001) and improved patient quality of life (p < 0.05) (irrespective of group membership). Conclusions: Our family-oriented program improved patients’ self-efficacy and self-management, which in turn could decrease HbA1c levels.
Keywords
health outcome, family-oriented, self-management, Type 2 diabetes, randomized controlled trial
Date
2017
Type
Journal article
Journal
Diabetes Research and Clinical Practice
Book
Volume
123
Issue
1
Page Range
37-48
Article Number
ACU Department
School of Nursing, Midwifery and Paramedicine
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Source URL
Event URL
Open Access Status
Open access
License
CC BY-NC-ND 4.0
File Access
Open