ABSTRACT
@#Family members play a vital role in both helping and undermining diabetes mellitus self-management practices. This qualitative study aimed to explore the potentially unmet needs of family function to support diabetes self-management (DSM) practices. In-depth interviews and focus group discussions (FGDs) were conducted among different key informants, including uncontrolled T2DM patients, caretakers and healthcare providers (HCPs) at community health centres. An open-ended approach was applied to elicit responses from the key informants. A total of 22 participants were involved in this study. All interview and FGD processes were audio-recorded and transcribed verbatim. The results found that all key informants addressed six core themes, with sub-themes to describe the unmet needs of family function to support DSM practice. The critical unmet needs of family function include: 1) Lack of problem-solving skills to deal with poor diabetes management; 2) Ineffective communication and refusal to share the burden of diabetes management; 3) Lack of affective responsiveness to encourage patients’ compliance; 4) Lack of affective involvement in DSM; 5) Insufficient family roles in supporting patients; 6) Poor behaviour control of T2DM. Our findings provide insights into how family function may influence the adoption and maintenance of healthy behaviours among diabetic patients. Since health providers seek new approaches to improve DSM practices, this valuable finding was essential to understand how family function can improve and empower patients in DSM practice.
ABSTRACT
This study is aimed at evaluating a research and development project on integrated network for health and quality of life development among Thachene-Maklong Basins communities, focused on an area-based study of Samut Sakhon Province during 2003-2006. Input, process and outcome evaluation was conducted by using secondary sources of data and focused group discussion with community stakeholders. Input evaluation indicated that Mahidol University had an effective research strategy on an area-based study. The research network consisted of a researcher team from Mahidol University, community leaders, local authorities and local organizations. The goal, objectives and plan were set up under the vision of “Healthy Amphang”. Community people are involved in problem identification and given suggestions through public hearing approach, but are found only among a limited group. Process evaluation revealed that clear objectives were given for community preparation. Community strengthening and capacity building was conducted by training, seminar and study visit to help the area-based research networks to apply their knowledge and experiences for community development. Village broadcasting was used to disseminate information to community people to realize and to participate in the program. Weaknesses of the project implementation included low community involvement and a limited number of personnel with high workload. Strengths of the program were willingness of community people to work for the others, more consensus agreement, and development of a network to share and exchange knowledge and ideas between community and the research team. Supervision, monitoring and evaluation of the program were conducted by local authorities using a Tambol Administrative Organization (TAO) as a focal point. Outcome evaluation showed application of knowledge and experiences of the local network from training, seminar and study visit was performed by a group facilitator and healthy community development. The local communities were capable to conduct a health promoting program themselves by establishing regular public hearing and by setting up a plan together. Community people changed their health behaviors and improved through this better environment. The research team gained more experiences which they will apply in future work based on the plan and will aim for sustainability development of a healthy community.