Results of the Development of a Nursing Model for Case Management and Self - regulation of Patients with Type 2 Diabetes into Remission of Diabetes

Abstract

This study is quasi-experimental research aimed to assess the effectiveness of developing a nursing model for case management and self-regulation of type 2 diabetic patients towards achieving remission. The sample group of diabetic patients was selected using simple random sampling. Selection criteria were determined through a matching method. Employing the principle of 'The Max Min Con Principle' and meeting the specified criteria, the participants were divided into an experimental group of 30 individuals and a control group of 30 individuals. The experimental group received care according to a 6-step case management model: (1) Identifying and selecting patients (2) Assessing and diagnosing problems (3) Planning interventions (4) Implementing planned interventions (5) Evaluating case management outcomes (6) Supervising the case management process. The control group received care based on the standard diabetes clinic service model. The study was conducted from November 2022 to October 2023, spanning a total period of 1 year. Data analysis included examining general information, health behavior, and accumulated blood sugar levels (A1C) using counts, percentages, means, and standard deviations. The accumulated blood sugar levels (A1C) of the experimental and control groups were compared using paired t-tests and independent t-tests. The results of the study revealed that, after participation, the experimental group exhibited lower average scores in consuming sweet, fatty, and salty foods compared to the control group. Specifically, the consumption of sweet foods had lower average scores in the experimental group, with a mean of 6.33 (S.D. = 1.09) and 7.47 (S.D. = 1.46), respectively. In terms of exercise and drug use, the experimental group had average exercise scores at a high level, with a mean of 3.54 (S.D. = 6.31) and 3.00 (S.D. = 1.98), respectively; the control group had average exercise scores at a moderate level, with a mean of 3.10 (S.D. = 7.02) and 2.02 (S.D. = 2.29), respectively. Both groups demonstrated normal levels of mental strength. The accumulated blood sugar level (A1C) was found to be < 6.5% without medication, indicating diabetes remission. Specifically, the experimental group had 8 individuals (26.66%) meeting this criterion, whereas the control group had 2 individuals (6.66%). Comparing the mean A1C, the experimental group exhibited a greater decrease than the control group, with an average of 6.3 (S.D. = 0.46) and 6.6 (S.D. = 0.65), with a significant difference at the 0.05 level. Patients with type 2 diabetes could control their blood sugar level according to standard criteria without drug use if they could reduce the risk of food especially salty food and exercise regularly, including receiving regular reminders from both the health team and family members.