Effectiveness of a Self- and Family Management Support Program among Older People with Diabetic Retinopathy and Visual Impairment: A Randomized Controlled Trial

Abstract

Diabetic retinopathy is a microvascular complication of diabetes resulting in visual impairment. Controlling the progression of diabetic retinopathy and living with visual impairment are crucial tasks and skills for older people with diabetic retinopathy and visual impairment. This randomized controlled trial investigated the effects of a self- and family management support program on health outcomes of Thai older people with diabetic retinopathy and visual impairment who lived with family members in the community and on family satisfaction. Eighty-four participants were recruited at an eye-specialized hospital in a central province of Thailand and randomly assigned to either the experimental group (n = 42) or the comparison group (n = 42). The experimental group received the intervention program plus usual care, while the comparison group received only usual care. Instruments for data collection included a Demographic Data Form, the Perceived Security in Performance of Daily Life Activities Questionnaire, the Self-Management Behavior Questionnaire, the Sirindhorn National Medical Rehabilitation Center Functional Assessment, the Thai Visual Function Questionnaire 28, and the Family Satisfaction Questionnaire. Data analyses were performed using descriptive statistics, t-test, chi-square, two-way repeated measures ANOVA, and ANCOVA. Results showed that the experimental group had significantly more improved perceived security, self-management behavior, HbA1c, visual-related quality of life: performing activities dimension, and family satisfaction than the comparison group at Week 16. However, no significant differences in perceived security, self-management behavior, functional ability, and overall visual-related quality of life were found between the two groups at Week 8. This program be further tested before being implemented into practice. However, it has a potential for healthcare providers to create an intervention program encompassing disease control and skill training for older people with diabetic retinopathy and visual impairment and encourage their families to support them.