Development of a Dietary Education Program for Behavior Modification Affecting Glycated Hemoglobin (HbA1c) Levels in Type 2 Diabetes Patients at Thong Saen Khan Hospital
Keywords:
Type 2 diabetes mellitus, Carbohydrate counting, Self-efficacyAbstract
This quasi-experimental study, using a two-group pretest-posttest design, aimed to investigate the effects of a dietary behavior modification program emphasizing carbohydrate counting, combined with Self-Efficacy Theory, on self-efficacy, dietary behaviors, and glycated hemoglobin (HbA1c) levels among patients with type 2 diabetes mellitus (T2DM). The participants were 60 T2DM patients receiving services at Thong Saen Khan Hospital, Uttaradit Province. They were selected via purposive sampling and assigned to either an experimental group or a comparison group, with 30 participants in each. The experimental group participated in a behavior modification program based on Bandura’s social learning theory, comprising carbohydrate-counting skill training, modeling, and telephone support for 12 weeks, while the comparison group received routine nursing care. Data were analyzed using descriptive statistics, paired t-tests, and independent t-tests.
The findings revealed that after the 12-week intervention, the experimental group demonstrated significantly higher mean scores for self-efficacy and dietary behaviors compared to baseline and the comparison group (p < .001). Furthermore, the experimental group’s HbA1c levels significantly decreased from 8.42% to 7.18% compared to baseline (p = .001) and were significantly lower than those of the comparison group. In conclusion, the behavior modification program focusing on carbohydrate counting and self-efficacy enhancement is effective in increasing confidence, improving eating behaviors, and concretely reducing cumulative blood glucose levels. Therefore, the carbohydrate counting approach should be promoted and integrated into health education for diabetic patients to achieve sustainable disease control.
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