Development of a Care Model for Patients with Type 2 Diabetes Mellitus with Good Glycemic Control Using Community Digital Health Stations in Mueang Sa Kaeo District, Sa Kaeo Province.

Abstract

      This study aimed to: (1) investigate the problems related to self-care and glycemic control among patients with type 2 diabetes mellitus (T2DM); (2) develop a care model for patients with T2DM using community digital health stations; and (3) evaluate the effectiveness of the developed care model in terms of diabetes-related knowledge, self-regulation, self-care, health behaviors, and glycemic control indicators, including fasting blood glucose (FBS) and glycated hemoglobin (HbA1c). The study was conducted in three phases: situation and problem analysis, development of the care model, and evaluation of the model's effectiveness. The care model was developed based on Orem's Self-Care Theory and the Health Belief Model, integrated with digital health technology. The participants were 100 patients with T2DM who had good glycemic control. They were equally allocated into an experimental group and a control group, with 50 participants in each group. The experimental group received the newly developed care model, whereas the control group received usual care. The intervention was implemented over a 12-week period. Data were analyzed using percentage, mean, standard deviation, paired t-test, and independent t-test.

      The findings revealed that, after receiving the care model, the experimental group demonstrated significant improvements in all measured outcomes. The mean diabetes-related knowledge score increased from 8.06 to 10.58, with a mean difference of 2.52 points. The mean self-regulation score increased from 38.40 to 50.14, with a mean difference of 11.74 points. The mean self-care score increased from 30.02 to 39.80, with a mean difference of 9.78 points. The mean health behavior score increased from 28.90 to 39.04, with a mean difference of 10.14 points. All changes were statistically significant at p < 0.001. Post-intervention comparisons between groups also showed that the experimental group had significantly higher mean scores for diabetes-related knowledge, self-regulation, self-care, and health behaviors than the control group. Regarding glycemic control, the mean FBS level in the experimental group decreased from 144.98 mg/dL to 125.72 mg/dL, while the mean HbA1c level decreased from 7.34% to 6.63%. Both reductions were statistically significant at p < 0.001. Following the intervention, the experimental group had a lower mean FBS level than the control group (125.72 vs. 137.74 mg/dL), with a mean difference of −12.02 mg/dL. Similarly, the mean HbA1c level was lower in the experimental group than in the control group (6.63% vs. 7.28%), with a mean difference of −0.65%. These between-group differences were statistically significant at p < 0.001. In addition, overall satisfaction with the care model among participants in the experimental group was rated at the highest level (Mean = 4.98, SD = 0.08).