Development of a Health Literacy Management Model to Delay Kidney Deterioration in Patients with Type 2 Diabetes with Complications of Chronic Kidney Disease stage 3 in the Wang Wiset District Network, Trang Province

Abstract

Background and Objectives Diabetes is a chronic disease caused by abnormalities in the production or response to the body's insulin hormone, leading to inefficient use of sugar and high blood sugar levels and resulting in chronic kidney complications. Health literacy is therefore a factor that can delay kidney deterioration in diabetic patients and reduce blood sugar levels. This research and development aimed to create a health literacy management model designed to delay kidney deterioration and evaluate the effectiveness of this model in patients with type 2 diabetes who have chronic kidney disease stage 3 complications within the Wang Wiset district network in Trang Province.

Methods The research was conducted using a research and development approach from March 2024 to May 2025 at the chronic diabetes and chronic kidney disease clinic, Wang Wiset Hospital, Trang Province. The sample consisted of 30 patients with type 2 diabetes with complications of chronic kidney disease stage 3. The research process included four phases: 1) Situational analysis and problem identification, 2) Development of a health literacy management model, 3) Implementation of the model for managing health literacy, and 4) Evaluation of the outcomes of using the health literacy management model. Research tools included in-depth interviews, feasibility questionnaires for the model, health literacy questionnaires for patients with diabetes, and satisfaction questionnaire for service providers using the health literacy management model. The research tools were validated by five experts. Data were analyzed using descriptive statistics, T-test, and content analysis.

Results Research results revealed that 1) the situational analysis identified the existing healthcare service model as reactive, lacking a complete interdisciplinary team. The sample group exhibited inappropriate behavioral outcomes, and their kidney filtration rates and blood sugar levels could not be controlled within the standard parameters. 2) The development of a health literacy management model to delay kidney deterioration utilized health literacy theory, and 3) the evaluation of the outcomes of using the health literacy management model to delay kidney deterioration showed that the average estimated glomerular filtration rate (eGFR) (M = 51.03, S.D. = 12.40) increased before using the health literacy management model (M = 44.95, S.D. = 7.91) and the average blood sugar level (HbA1c) (M = 7.15, S.D. = 0.93) decreased before using the health literacy management model  (M = 7.83, S.D. = 1.39) significantly (p<0.05).

Conclusion and Recommendation This research indicates that the developed health literacy management model to delay kidney deterioration in patients with type 2 diabetes can effectively enhance nursing quality and clinical outcomes.