Effects of Nursing Case Management of Buddhist Monks at Risk for Type 2 Diabetes: A Randomized Controlled Trial
Keywords:
Body Mass Index, Buddhist Monks, Clinical Outcomes, Fasting Blood Glucose, Nursing Case Management, Thailand, Type 2 Diabetes Mellitus, Waist CircumferenceAbstract
Buddhist Monks in Thailand are at risk of type 2 diabetes because of difficulties in their lifestyle modification and require nursing management, for they consume foods containing high fat, sugar, and calories, commonly offered by people for merit making. This randomized controlled trial tested the effectiveness of the Nursing Case Management Program for Diabetes Prevention on their health behaviors and clinical outcomes. A total of 50 participants at risk for type 2 diabetes in a northern region of Thailand met the inclusion criteria. The participants from 50 different temples were randomly assigned into an experimental group (n=25) receiving a 12-week nursing case management program in addition to routine care and a control group (n=25) receiving only routine care. Health behaviors, fasting blood glucose, body mass index, and waist circumference were measured at baseline and week-12 after the program. Data were analyzed using descriptive statistics, Chi-square test, Independent t-test, and Paired t-test.
The results revealed that the experimental group after receiving the program had significantly higher health behaviors and lower clinical outcomes than those before receiving the program. Differences in health behaviors and clinical outcomes were significantly higher in the experimental group than those in the control group. Results suggest that the Nursing Case Management Program for Diabetes Prevention using lifestyle modification strategies should be applied in monks with clinical management monitoring to prevent or reduce the incidence of type 2 diabetes. However further testing of the Program is warranted with different samples of monks, preferably in longitudinal studies.
References
1. IDF. [Internet]. IDF Diabetes Atlas. 2015. [cited 2016 Jul 9]. Available from: https://www.diabetesatlas.org/.
2. Akephalakorn V, Pakchareon H, Thaikla K, Satiannophakao W. Thailand health survey by physical examination. Bangkok: Aksorn Graphic & Design;2014. [in Thai].
3. Thanamai W, Pachotikan C, Techangam S, Buasri C, Kurasri D. Practice guideline for nutritional therapy in monks with type 2 diabetes mellitus. Bangkok: Sinthawee Press; 2009.
4. Angkatavanich J, Wisetrit W, Sangtien A, Somyuranakul P. Life style, food characteristics and nutritional status of Thai monks and in 4 rural regions of Thailand. Bangkok: Choraka Press; 2014.
5. Sangdit P, Suksawas S, Nawapongpaween K. Health status of Buddhist monks in Thailand. Bangkok: The Priest Hospital; 2014.
6. Phayao Public Health Office. NCD database system of Phayao Province. [internet]. 2015. [cited 2015 February 7]. Available from: https://www.pyomoph.go.th/chronic/ index.php
7. Mullahy CM, Jensen DM. The Case Manager’s Handbook. Massachusetts: Jones and Bartlett. 2004
8. Offredy M, Bunn F, Morgan J. Case management in long term conditions: An inconsistent journey? Br J Community Nurs. 2009;14(6):252-257.
9. White P,Hall ME. Mapping the literature of case management nursing. Journal of the Medical Library Association: JMLA. 2006;94(2 Suppl):99-106.
10. Sindhu S, Wongrot P.Case Management of Patients with Diabetes Mellitus and Hypertension. Bangkok: Wattana Publication. 2014.
11. Egede1 LE, Strom JL, Fernandes J, Knapp RG, Rojugbokan A. Effectiveness of technology-assisted case management in low income adults with type 2 diabetes (TACM-DM): study protocol for a randomized controlled trial.BioMed Central.2011. DOI: 10.1186/1745-6215-12-231
12. Ercan-Fang N, Gujral K, Greer N, Ishani A. Providers’ perspective on diabetes case management: a descriptive study. Am J Manag Care. 2013;19(1):29-32.
13. Al-Dossary RN, Kitsantas P. The impact of diabetes nurse case management on hemoglobin A1c (HgbA1c) and self-efficacy of patients with type 2 diabetes: A systematic review. J Clin Res Gov. 2014;3 (1): 9-15.
14. Gabbay, RA, Anel-Tiangco RM, Dellasega C, Mauger DT, Adelman A, Van Horn DH. Diabetes nurse case management and motivational interviewing for change (DYNAMIC): Results of a 2-year randomized controlled pragmatic trial. J Diabetes. 2013; 5(3):349-357.
15. Ishani A, Greer N, Taylor BC, Kubes L, Cole P, Atwood M, et al. Effect of nurse case management compared with usual care on controlling cardiovascular risk factors in patients with diabetes: A randomized controlled trial. Diabetes Care. 2011;34(8):1689-1694.
16. Taylor CB, Miller NH, Reilly KR, Greenwald G, Cunning D, Deeter A, et al. Evaluation of a nurse-care management system to improve outcomes in patients with complicated diabetes. Diabetes Care. 2003;26(4):1058-1063.
17. Angkatavanich J. Role-model Monks: Better nutrition promotes longer life[internet]. Thailand: Chulalongkorn University;2012 [cited2015 February 7]. Available from: https://www.research.chula.ac.th/web/cu_online/2555/ vol_25_01.html
18. Sila J, Kaewsribut N, Thipornpan K, Srilamai T, Romsri N. Self-care behaviors of monks with diabetes mellitus of Chum Phae Hospital in 2011. Khon Kean: Boromarajonani College of Nursing Khon Kaen; 2011.
19. Chatvarat P. Factors related to health behavior of monks living in Maung Phayao District, Phayao Province. Phayao: Boromarajonani College of Nursing Phayao; 2010.
20. Apiwanno P. Self-care behaviors of monks in Phrae Province [master’s thesis]. [Phrae]: Mahachulalongkorn rajavidyalaya University, Phrae Campus; 2011.
21. Suthiwatjano S. Health behaviors of monks in Pung Khon District, Sakonnakorn Province [master’s thesis]. [Bangkok]: Mahachulalongkornrajavidyalaya University; 2013.
22. Srimanee S, Matwangkul C, Poomrittikul P, Chancharoen K, Hongkrilert N, Somnukul N. Factors related to dietary behaviors of monks and food offering behaviors people in Phasicharoen District, Bangkok. Bangkok; 2013.
23. Pongnoomkul A, Saneha J, Phanitrat R, Kusuma N Ayuthaya K, Sangkapong T. Eating behaviors of monks in Bangkoknoi District, Bangkok. Bangkok: Mahidol University; 2011.
24. Himathongkham T. Diabetes Mellitus. Bangkok: Wittayapat; 2007.
25. Lohitthai S. Effects of health promotion program on health belief perception and preventive behaviors in first degree relatives of persons with type 2 diabetes mellitus[master’s thesis]. [Bangkok]. Faculty of Medicine, Ramathibodi Hospital, Mahidol University; 2010.
26. Akephalakorn V, Porapakkam Y, Thanipanitchakul S, Pakchareon H, Satiannophakao W, Thaikla K. Thailand health survey. Nontaburi: The Graphico System;2009.
27. Ganz ML, Wintfeld N, Li Q, Alas V, Langer J, Hammer M. The association of body mass index with the risk of type 2 diabetes: a case-control study nested in an electronic health records system in the United States. Diabetology & metabolic syndrome. 2014;6(1):1-8.
28. Diabetic Association of Thailand. Clinical practice guideline for diabetes 2014. Bangkok: Srimaungkan; 2014.
29. Kuramasuwan B, Howteerakul N, Suwannapong N, Rawdaree P. Diabetes, impaired fasting glucose, daily life activities, food and beverage consumption among Buddhist monks in Chanthaburi Province, Thailand. International Journal Of Diabetes In Developing Countries. 2013: 33(1);23-28.
30. Fukfon K, Pragodpol P. Outcomes of nursing case management for patients with hypertension and diabetes mellitus. Nontaburi: Yuththarin Press; 2014.
31. Sutherland D, Hayter M. Structured review: evaluating the effectiveness of nurse case managers in improving health outcomes in three major chronic diseases.J of Clin Nursing.2009;18(21):2978-2992.
32. Welch G, Garb J, Zagarins S, Lendel I, & Gabbay RA. Nurse diabetescase management interventions and blood glucose control: Results of a meta-analysis. Diabetes Research in Clinical Practice. 2010;88(1):1-6.
33. PartiprajakS, Hanucharurnkul S, Piaseu N, Brooten D, & Nityasuddhi D. Outcomes of an advanced practice nurse-led type-2 diabetes support group. Pacific Rim International Journal of Nursing Research. 2011; 15(4): 288-304.
34. Ishani A, Greer N, Taylor BC, Kubes L, Cole P, Atwood M, Clothier B, Ercan-Fang N. Effect of nurse case management compared with usual care on controlling cardiovascular risk factors in patients with diabetes: A randomized controlled trial. Diabetes Care. 2011; 34(8):1689-1694.
35. Angkatavanich J. Media of Thai monks stay clear from diseases: Nutritional integration to Thai monks’ life styles. Bangkok: Department of Nutrition and Dietetics, Faculty of Allied Health Science, Chulalongkorn University; 2016.
36. Taylor C. The impact of nursing case management on women with diabetes in pregnancy. JOGNN. 2012; 41(Suppl 1):S131–S132.
37. Shojania KG, Ranji SR, McDonald KM, Jeremy M, Grimshaw CHChB, Sundaram V, et al. Effects of quality improvement strategies for type 2 diabetes on glycemic control: A meta-regression analysis. The Journal of the American Medical Association.2006;296(4):427- 440.
38. Sujitwanich N, Bausri J, Tantiveas M, Leelayuwatanakul S,Kocthanan A, Jintaridth P. The effectiveness of diabetic mellitus diet-counseling to monks with type 2 diabetes mellitus in Priest Hospital. Thammasat Medical Journal. 2011;11(3): 409-419.
39. Zenga Z, Shuaia T, Yia LJ, Wangb Y, Songc GM. Effect of case management on patients with type 2 diabetes mellitus: a meta-analysis. Chinese Nursing Research. 2016;3(2):71-76.
40. Ma J, Berra K, Haskell WL, Klieman L, Hyde S, Smith MW, et al. Case management to reduce cardiovascular risk in a county healthcare system. Archive Internal Medicine. 2009;169(21):1988–1995.
2. Akephalakorn V, Pakchareon H, Thaikla K, Satiannophakao W. Thailand health survey by physical examination. Bangkok: Aksorn Graphic & Design;2014. [in Thai].
3. Thanamai W, Pachotikan C, Techangam S, Buasri C, Kurasri D. Practice guideline for nutritional therapy in monks with type 2 diabetes mellitus. Bangkok: Sinthawee Press; 2009.
4. Angkatavanich J, Wisetrit W, Sangtien A, Somyuranakul P. Life style, food characteristics and nutritional status of Thai monks and in 4 rural regions of Thailand. Bangkok: Choraka Press; 2014.
5. Sangdit P, Suksawas S, Nawapongpaween K. Health status of Buddhist monks in Thailand. Bangkok: The Priest Hospital; 2014.
6. Phayao Public Health Office. NCD database system of Phayao Province. [internet]. 2015. [cited 2015 February 7]. Available from: https://www.pyomoph.go.th/chronic/ index.php
7. Mullahy CM, Jensen DM. The Case Manager’s Handbook. Massachusetts: Jones and Bartlett. 2004
8. Offredy M, Bunn F, Morgan J. Case management in long term conditions: An inconsistent journey? Br J Community Nurs. 2009;14(6):252-257.
9. White P,Hall ME. Mapping the literature of case management nursing. Journal of the Medical Library Association: JMLA. 2006;94(2 Suppl):99-106.
10. Sindhu S, Wongrot P.Case Management of Patients with Diabetes Mellitus and Hypertension. Bangkok: Wattana Publication. 2014.
11. Egede1 LE, Strom JL, Fernandes J, Knapp RG, Rojugbokan A. Effectiveness of technology-assisted case management in low income adults with type 2 diabetes (TACM-DM): study protocol for a randomized controlled trial.BioMed Central.2011. DOI: 10.1186/1745-6215-12-231
12. Ercan-Fang N, Gujral K, Greer N, Ishani A. Providers’ perspective on diabetes case management: a descriptive study. Am J Manag Care. 2013;19(1):29-32.
13. Al-Dossary RN, Kitsantas P. The impact of diabetes nurse case management on hemoglobin A1c (HgbA1c) and self-efficacy of patients with type 2 diabetes: A systematic review. J Clin Res Gov. 2014;3 (1): 9-15.
14. Gabbay, RA, Anel-Tiangco RM, Dellasega C, Mauger DT, Adelman A, Van Horn DH. Diabetes nurse case management and motivational interviewing for change (DYNAMIC): Results of a 2-year randomized controlled pragmatic trial. J Diabetes. 2013; 5(3):349-357.
15. Ishani A, Greer N, Taylor BC, Kubes L, Cole P, Atwood M, et al. Effect of nurse case management compared with usual care on controlling cardiovascular risk factors in patients with diabetes: A randomized controlled trial. Diabetes Care. 2011;34(8):1689-1694.
16. Taylor CB, Miller NH, Reilly KR, Greenwald G, Cunning D, Deeter A, et al. Evaluation of a nurse-care management system to improve outcomes in patients with complicated diabetes. Diabetes Care. 2003;26(4):1058-1063.
17. Angkatavanich J. Role-model Monks: Better nutrition promotes longer life[internet]. Thailand: Chulalongkorn University;2012 [cited2015 February 7]. Available from: https://www.research.chula.ac.th/web/cu_online/2555/ vol_25_01.html
18. Sila J, Kaewsribut N, Thipornpan K, Srilamai T, Romsri N. Self-care behaviors of monks with diabetes mellitus of Chum Phae Hospital in 2011. Khon Kean: Boromarajonani College of Nursing Khon Kaen; 2011.
19. Chatvarat P. Factors related to health behavior of monks living in Maung Phayao District, Phayao Province. Phayao: Boromarajonani College of Nursing Phayao; 2010.
20. Apiwanno P. Self-care behaviors of monks in Phrae Province [master’s thesis]. [Phrae]: Mahachulalongkorn rajavidyalaya University, Phrae Campus; 2011.
21. Suthiwatjano S. Health behaviors of monks in Pung Khon District, Sakonnakorn Province [master’s thesis]. [Bangkok]: Mahachulalongkornrajavidyalaya University; 2013.
22. Srimanee S, Matwangkul C, Poomrittikul P, Chancharoen K, Hongkrilert N, Somnukul N. Factors related to dietary behaviors of monks and food offering behaviors people in Phasicharoen District, Bangkok. Bangkok; 2013.
23. Pongnoomkul A, Saneha J, Phanitrat R, Kusuma N Ayuthaya K, Sangkapong T. Eating behaviors of monks in Bangkoknoi District, Bangkok. Bangkok: Mahidol University; 2011.
24. Himathongkham T. Diabetes Mellitus. Bangkok: Wittayapat; 2007.
25. Lohitthai S. Effects of health promotion program on health belief perception and preventive behaviors in first degree relatives of persons with type 2 diabetes mellitus[master’s thesis]. [Bangkok]. Faculty of Medicine, Ramathibodi Hospital, Mahidol University; 2010.
26. Akephalakorn V, Porapakkam Y, Thanipanitchakul S, Pakchareon H, Satiannophakao W, Thaikla K. Thailand health survey. Nontaburi: The Graphico System;2009.
27. Ganz ML, Wintfeld N, Li Q, Alas V, Langer J, Hammer M. The association of body mass index with the risk of type 2 diabetes: a case-control study nested in an electronic health records system in the United States. Diabetology & metabolic syndrome. 2014;6(1):1-8.
28. Diabetic Association of Thailand. Clinical practice guideline for diabetes 2014. Bangkok: Srimaungkan; 2014.
29. Kuramasuwan B, Howteerakul N, Suwannapong N, Rawdaree P. Diabetes, impaired fasting glucose, daily life activities, food and beverage consumption among Buddhist monks in Chanthaburi Province, Thailand. International Journal Of Diabetes In Developing Countries. 2013: 33(1);23-28.
30. Fukfon K, Pragodpol P. Outcomes of nursing case management for patients with hypertension and diabetes mellitus. Nontaburi: Yuththarin Press; 2014.
31. Sutherland D, Hayter M. Structured review: evaluating the effectiveness of nurse case managers in improving health outcomes in three major chronic diseases.J of Clin Nursing.2009;18(21):2978-2992.
32. Welch G, Garb J, Zagarins S, Lendel I, & Gabbay RA. Nurse diabetescase management interventions and blood glucose control: Results of a meta-analysis. Diabetes Research in Clinical Practice. 2010;88(1):1-6.
33. PartiprajakS, Hanucharurnkul S, Piaseu N, Brooten D, & Nityasuddhi D. Outcomes of an advanced practice nurse-led type-2 diabetes support group. Pacific Rim International Journal of Nursing Research. 2011; 15(4): 288-304.
34. Ishani A, Greer N, Taylor BC, Kubes L, Cole P, Atwood M, Clothier B, Ercan-Fang N. Effect of nurse case management compared with usual care on controlling cardiovascular risk factors in patients with diabetes: A randomized controlled trial. Diabetes Care. 2011; 34(8):1689-1694.
35. Angkatavanich J. Media of Thai monks stay clear from diseases: Nutritional integration to Thai monks’ life styles. Bangkok: Department of Nutrition and Dietetics, Faculty of Allied Health Science, Chulalongkorn University; 2016.
36. Taylor C. The impact of nursing case management on women with diabetes in pregnancy. JOGNN. 2012; 41(Suppl 1):S131–S132.
37. Shojania KG, Ranji SR, McDonald KM, Jeremy M, Grimshaw CHChB, Sundaram V, et al. Effects of quality improvement strategies for type 2 diabetes on glycemic control: A meta-regression analysis. The Journal of the American Medical Association.2006;296(4):427- 440.
38. Sujitwanich N, Bausri J, Tantiveas M, Leelayuwatanakul S,Kocthanan A, Jintaridth P. The effectiveness of diabetic mellitus diet-counseling to monks with type 2 diabetes mellitus in Priest Hospital. Thammasat Medical Journal. 2011;11(3): 409-419.
39. Zenga Z, Shuaia T, Yia LJ, Wangb Y, Songc GM. Effect of case management on patients with type 2 diabetes mellitus: a meta-analysis. Chinese Nursing Research. 2016;3(2):71-76.
40. Ma J, Berra K, Haskell WL, Klieman L, Hyde S, Smith MW, et al. Case management to reduce cardiovascular risk in a county healthcare system. Archive Internal Medicine. 2009;169(21):1988–1995.
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2017-08-07
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Chaimai A, Piaseu N, Mekwiwatanawong C. Effects of Nursing Case Management of Buddhist Monks at Risk for Type 2 Diabetes: A Randomized Controlled Trial. PRIJNR [Internet]. 2017 Aug. 7 [cited 2024 Apr. 20];21(4):305-16. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/71958
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