당뇨병 환자의 사례관리 실시 전후 혈당 및 자가관리 이행수준 변화 (Changes in Blood Sugar Value and Performance Level of Self-Management Following the Case Management Programs for Diabetic Patients)

서지정보

· 발행기관 : 고신대학교(의대) 고신대학교 의과대학 학술지
· 수록지 정보 : 고신대학교 의과대학 학술지 / 22권 / 2호 / 1 ~ 7페이지
· 저자명 : 최용우, 이용환, 유병철, 전만중

초록

Background : Diabetes mellitus is one of the common chronic disease in Korea. As most chronic diseases need continuous cares and behavioral controls, one of the effective managements for diabetes is maintenance healthy life style which is based on correct medical knowledge. So, we conducted this study to assess change of blood sugar levels and self-management behavior of diabetic patients following the case-management program enforced by National Health Insurance Corporation (NHIC).
Methods : We conducted this study during the period from January 2006 to December 2006, 29 case managers performed the case management program for 672 diabetic patients in the districts of Busan, Woolsan, and Gyeongnam. We evaluated the effectiveness of the case management program based on the changes of blood sugar level, knowledge for diabetes and self-management behavior of diabetic patients. Data analysis was performed with t-test, paired t-test, McNemar X2-test and correlation analysis using SPSS program(ver 12.0).
Results : After the case management program, smoking rate was reduced from 22.3% to 21.4% and exercise rate was increased from 65.0% to 80.2%(p<0.05). The knowledge standard of diabetics on 10-point scale revealed considerable increase from 6.05 before the management to 8.69 after the case management(p<0.05). All of diabetic self-management behaviors including nutrition management, self-test on blood sugar level, foot care, oral care and diabetic medication showed considerable improvement; the overall behavioral change, on a 5-point scale, improved from 3.25 to 3.75(p<0.05). The FBS level was improved from 138.4mg/dl to 131.5mg/dl and the blood sugar level 2 hours after a meal was improved from 203.7mg/dl to 183.5mg/dl(p<0.05).
Conclusion : From the above results, we concluded that the case management program enforced by the NHIC showed positive behavioral changes on smoking and exercise, increased knowledge about diabetes as well as the level of nutrition management and also demonstrated decline of blood sugar levels. So, we need research of customized information for every patients rather than generally summarized information on diabetes and a self-dependent group formations for sustaining improved self-management after case management as well as development of education and training programs for case managers.

영어초록

Background : Diabetes mellitus is one of the common chronic disease in Korea. As most chronic diseases need continuous cares and behavioral controls, one of the effective managements for diabetes is maintenance healthy life style which is based on correct medical knowledge. So, we conducted this study to assess change of blood sugar levels and self-management behavior of diabetic patients following the case-management program enforced by National Health Insurance Corporation (NHIC).
Methods : We conducted this study during the period from January 2006 to December 2006, 29 case managers performed the case management program for 672 diabetic patients in the districts of Busan, Woolsan, and Gyeongnam. We evaluated the effectiveness of the case management program based on the changes of blood sugar level, knowledge for diabetes and self-management behavior of diabetic patients. Data analysis was performed with t-test, paired t-test, McNemar X2-test and correlation analysis using SPSS program(ver 12.0).
Results : After the case management program, smoking rate was reduced from 22.3% to 21.4% and exercise rate was increased from 65.0% to 80.2%(p<0.05). The knowledge standard of diabetics on 10-point scale revealed considerable increase from 6.05 before the management to 8.69 after the case management(p<0.05). All of diabetic self-management behaviors including nutrition management, self-test on blood sugar level, foot care, oral care and diabetic medication showed considerable improvement; the overall behavioral change, on a 5-point scale, improved from 3.25 to 3.75(p<0.05). The FBS level was improved from 138.4mg/dl to 131.5mg/dl and the blood sugar level 2 hours after a meal was improved from 203.7mg/dl to 183.5mg/dl(p<0.05).
Conclusion : From the above results, we concluded that the case management program enforced by the NHIC showed positive behavioral changes on smoking and exercise, increased knowledge about diabetes as well as the level of nutrition management and also demonstrated decline of blood sugar levels. So, we need research of customized information for every patients rather than generally summarized information on diabetes and a self-dependent group formations for sustaining improved self-management after case management as well as development of education and training programs for case managers.

참고자료

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