Randomized controlled trial of a family-oriented self-management program to improve self-efficacy, glycemic control and quality of life among Thai individuals with Type 2 diabetes. (January 2017)

• Record Type: Journal Article
• Authors: Wichit, Nutchanath; Mnatzaganian, George; Courtney, Mary; Schulz, Paula; Johnson, Maree
• Is Part Of: Diabetes research and clinical practice. Volume 123(2017)
• Page Start: 37
• Page End: 48
• Publication Date: 2017-01
• Subjects: Health outcome -- Family-oriented -- Self-management -- Type 2 diabetes -- Randomized controlled trial; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2016.11.013
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Family-oriented programs improve diabetes self-management and self-efficacy. Better diabetes self-management lowers HbA1C levels and improves quality of life. Sex and BMI are associated with improved self-management behaviors. 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.