The Effects of Nursing Case Management on Self-Care Behaviors, Clinical Outcomes, and Quality of Life Among Community-Dwelling Older Adults with Poorly Controlled Type 2 Diabetes in Thailand.

Abstract

This study evaluated the effectiveness of nursing case management on self-care, clinical outcomes, and quality of life in community-dwelling older adults with poorly controlled type 2 diabetes in Thailand. The research employed a quasi-experimental, single-group, pretest - posttest design. Methods: Twenty-three participants participated in a 12-week nursing case management program, which was tailored to the individual's needs and abilities, as well as their family, community, and healthcare context. Self-care behaviors increased significantly (p = .000) after implementation of the case management program, while waist circumference, fasting capillary blood glucose, and hemoglobin A1c decreased significantly (p = .001, p = .000, p = .003, respectively) from pre-intervention values. Quality of life was significantly better after the program (p = .000) than before. Results suggest that implementing tailored nursing case management could increase self-care behaviors and quality of life while decreasing waist circumference, fasting capillary blood glucose, and hemoglobin A1c in community-dwelling older adults with poorly controlled type 2 diabetes. The effectiveness of nursing case management depends on the healthcare context, the training and expertise of case managers, as well as the patient's needs and preferences. Furthermore, the availability of families and communities can influence the nursing case management outcomes.