Abstract
A study of group process in diabetic This study is an application of action research to improve diabetic outpatient service at Plapak Hospital, Nakhonpanom Province. The existing service was run through general outpatient service every Wednesday 8 -12 am. The regular services for diabetic patients included; weighing, blood pressure taking, fasting blood sugar testing, and seeing a physician for medication. While waiting for seeing physician, group health education was conducted by health personnel. In situation analysis, The first step of conducting action research, limitations of the existing service were defined. Firstly, it took times since patients had to do many stops, this might cause them hypoglycemia. Secondly, health education as such was not applicable for patients’ problems. The second stage, 17 insulin-independent diabetic patients were purposively selected to join as research participants. Group discussion technique was introduced to encourage patients’ participation to share their problems as well as ways to solve such problems. The following stage was evaluation. Results from research participants were the feedback of the new service system developed. The service system was rearranged as following: diebetic clinic was seperatety set up from general outpatient clinic; the service was run in every Wednesday and Friday morning; and patient-driven health education which based on self-help group concept was used. The scores of fasting blood sugar, body weight as well as self-care practice on dietary control, pesonal hygiene and foot care, exercise, medication and help-seeking behavior before and after new service system intervention were found statistical significant at 0.05 level by paired-T-test. Patients’ satisfaction in terms of having a say and being recognition were much higher. Consequently, patient were aware that it was their responsibility in living with diabetes. This enabled them to arrange their own self-help group at their villages. The outcome of this research also provided the lessons for health personnel. They changed their way of viewing patients, listened to them more and worked with them as equal partners.