This action research aimed to investigate the effectiveness of a model of self-care promotion for blood sugar control among type 2 diabetic patients. The sample comprised 32 patients aged 30 years or older who were clinically diagnosed with non-insulin-dependent diabetes mellitus, and who received medical services at Songklanagarind Hospital, Songkhla province, Thailand. Data were collected via in-depth interviews, focus groups, and observation. The data were examined by triangulation technique and analyzed with classification, interpretation, and conclusion methodologies.
The results demonstrated the sample perceived diabetes to be associated with genetics, aging, and inappropriate health behaviors; it could happen to anybody, and was a socially acceptable disease. They were aware that the symptoms included fatigue, polyuria, and death in severe cases. Regarding self-care behavior, some of the subjects could not control their diets at all times; they ate sweet, high-fat, and low-fiber foods. They ate inconsistently and too much dinner. Most of the subjects did not exercise regularly. The sample reported incorrect medication behavior, including inconsistently taking medication, forgetting to take medication, buying medication, and stopping medication on their own volition. They also had a high mental stress level. The factors affecting their health behaviors were satisfaction with the taste, lack of self-control, feeling of alienation when exercising, inappropriate time and stress management, incorrect knowledge and understanding, negative family support, conflicting lifestyle, lack of sociocultural support, nonbeneficial occupation, lack of health-service system encouragement and health limitations.
The self-care promotion model for blood-sugar control of the diabetic patient consisted of 15 strategies. For nurses, it included creating good human relations, creating knowledge and skills, creating a suitable environment for learning, promoting mental and emotional balance, and continuous support. For patients, it included awareness, intention, initiation, consciousness,and continuity. For relatives, it included caring, eating a low sweet and low-salt diet, exercising, sharing ideas, and equanimity. At the end of the project, the subjects were able to have better behaviors, including eating proper diet, taking medication regularly, increasing exercise, and adjusting stress management appropriately. The mean score of fasting plasma glucose (FPG) and  hemoglobin A1C (HbA1C) showed a significant decrease (p < .05 and p < .001, respectively) after participation in the project. The result of this study confirmed a model of self-care promotion of blood sugar control in type 2 diabetic patients which emphasized collaboration among stakeholders, especially patients, relatives and nurses in a holistic care atmosphere.