Data collection
Data were gathered through standard questionnaire, anthropometry measurements(weight, height, blood pressure, and waist circumference),and blood test(HbA1c,FPG). Patients provided information about their demographics, personal
and family medical histories, health behavior, and physical activity. The internal consistency( Cribbage's ¤coefficient) of health behavior was 0.78 and QOL was 0.67. Depression was assessed by the Thai version of the Patient Health Questionnaire(PHQ-9),Cronbach's ¤was 0.79,sensitivity was 0.53,and specificity was 0.98 (Lotrakul et al.,2008).
Health behavior included 13 items concerning diet, eight items concerning food care ,and 10 items concerning general self-care.Diabetes QOL was assessed by the 15 items of brief clinical inventory category(Burroughs et al.,2004).Each item of the PHQ-9 ranges from 0(not at all) to3 (nearly every day).The QOL ranges from 1(very dissatisfied/all the time) to 5 (vary satisfied/never) .Patients' satisfaction ranges from 1 (vary dissatisfied) to 5 (vary satisfied). Health behavior score ranges from 1 (never) to 5 (everyday).Five milliliters(mL) venous blood sample was collected from each patient after 8-h overnight fast.All blood tests were performed in the same laboratory at the BMA Health Department. The laboratory quality control was assessed by the Thai Medical Science Center. All data were collected at baseline,three- and six month follow-up in both groups.After finishing the program session,we invited 10 nurse supporters to participate in the focus group on April 2012. The aim was to assess the DSMS program. The moderator facilitated the discussion while the assistant moderator kept detailed notes and audio recorders.