Diabetes: Promoting self-management through virtual nursing interventions

Individuals with diabetes, a common chronic metabolic disease, face a higher risk of premature mortality, disability, micro- and macrovascular complications associated with diabetes, and deterioration of their health status. These increased risks pose significant challenges to individuals and their families and place a substantial economic burden on the healthcare system. Education and support for self-management - a often underused care resource - can assist individuals with diabetes in making informed decisions to better cope with treatment requirements and life challenges associated with the condition. There is strong evidence that the health outcomes of patients improve when they are encouraged to adopt self-management behaviour; however, the use of virtual nursing care remains relatively unexplored.

Objectives

The objectives of the study are to develop a virtual nursing intervention with active participation from nurses and patients, to test its feasibility (acceptance, ease of implementation, recruitment, completion), and to estimate its effectiveness in relation to metabolic and psychosocial outcomes. Study setting: diabetes clinic, including inpatient and outpatient settings.

Methodology

The study will follow the first two phases of the UK Medical Research Council (MRC) Framework for the development and evaluation of complex interventions; for this project this involves using a qualitative approach for the development phase and a randomized controlled feasibility study (with a waiting list design) for the evaluation phase. In the first phase of the study, 20 participants (10 patients and 10 nurses) will be recruited to actively collaborate in designing a virtual self-management intervention that can be used in diabetes clinics with inpatients or outpatients. For the second phase, 60 patients will be randomly allocated to either the intervention group immediately receiving the virtual nursing intervention or a control group placed on a waiting list and receiving the same intervention after a waiting time of 6 months. The outcomes of both groups will be evaluated at 6 and 12 months.

The study will produce an intervention designed jointly by patients with diabetes and nurses. This intervention aims to encourage individuals with diabetes to engage more constructively in self-management of their condition and to adopt behaviours that improve their health status. The study will provide a deeper understanding of how to implement a virtual nursing intervention in expanded healthcare practice. Broadening the use of virtual nursing interventions could mitigate the negative effects of diabetes on patients' health, their families, and society overall.