The effectiveness of nurse-led diabetes self-management education among adults with uncontrolled type 2 diabetes mellitus

Abstract

Ample evidence has supported the efficacy of diabetes self-management education (DSME) in diabetes care. However, specific evidence that supports the effects of nurse-led DSME on glycemic control and prevention of diabetes complications remains limited. The purpose of this quantitative, quasi-experimental project was to determine if any, and to what extent a relationship existed between a nurse-led DSME intervention and the lowering of FBS levels to 100mg/dl or below, and the reports of improved self-efficacy among patients with poorly controlled T2DM at a primary care clinic located in an underserved community in Northwest, Texas. Theoretical support for the project was drawn from Ajzen’s theory of planned behavior (TPB) and Orem’s theories of self-care and self-care deficit. The target population was T2DM patients at the primary care clinic and the sample size was 10. Pre-intervention FBS levels: (M = 196.7, SD = 52.3) and after nurse-led DSME (M = 176.40, SD = 55.1) at the .05 level of significance (t = 13.5, df = 9, n = 10, p < .05, 95% CI for mean difference (16.893 to 23.707). Although, none of the participants reached the target FBS level of 100mg/dl, they all achieved significant reductions in their FBS levels of at least 20.3 points. Reported self-efficacy pre-DSME (M = 42.5, SD = 14.3). After nurse-led DSME (M = 70.7, SD = 5.5) at the .05 level of significance (t = - 9.0, df = 9, n = 10, p < .000, 95% CI for mean difference (−35.2 to −21.1). Patients are more aware of the role of self-care in managing their condition and the clinic administrator is open to accepting nurse-led DSME and is considering hiring a diabetes-nurse educator. More work is needed to establish a definitive relationship between nurse-led DSME and glycemic control and diabetes self-efficacy.