Development of Nurse-led Self-Management Education Instruments for Type 2 Diabetes Mellitus Patients
Authors: Nursalam Nursalam , Septianingrum Yurike , Wijayanti Lono , Nurjanah Siti , Winoto Priyo Mukti Pribadi , Mufida Nurlela , Yahaya Nor Aziyan 
Published: March 2024

Purpose: The purpose of this study is to develop and outline the Nurse-Led Diabetes Mellitus Self-Management Education (Nu-DiMENTION) program, aimed at improving knowledge and behavior change among type 2 diabetes mellitus (DM) patients. Given the challenges faced by these patients in managing their disease effectively, including risks of complications such as diabetic foot ulcers, retinopathy, and ketoacidosis, there is a pressing need for tailored self-management education programs. The study seeks to address this need by creating a web-based nurse-led educational intervention that has demonstrated efficacy in increasing patient knowledge and promoting positive behavior change.

Methods: The research adopts a research and development (R&D) approach to outline the development process of Nu-DiMENTION. Drawing upon theory, existing research evidence, international guidelines, and qualitative data from target users, the study identifies determinants of self-management and defines the content to be included in the program. The development process involves multiple stages, including evaluating existing educational instruments, conducting focus groups with relevant stakeholders (e.g., healthcare professionals and type 2 DM patients), and assessing item validity through expert evaluation.

Results and discussion: The initial evaluation of 19 diabetes mellitus educational instruments revealed inadequacies in terms of goals, targets, content, methods, media, time, and evaluation. Subsequent focus groups involving healthcare professionals and type 2 DM patients provided valuable insights into strategic issues and innovation plans for the Nu-DiMENTION program. The assessment of item validity conducted by diabetes mellitus education experts confirmed the validity and reliability of the developed instruments, with a Cronbach's alpha value of 0.834 indicating good internal consistency.

Implications of the research: The development of Nu-DiMENTION holds significant implications for improving the self-management capabilities of type 2 DM patients and reducing the risk of diabetes-related complications. By providing accessible, web-based nurse-led education, the program has the potential to empower patients with the knowledge and skills necessary to effectively manage their condition. Moreover, the rigorous development process, including expert validation, ensures the quality and reliability of the program, enhancing its suitability for implementation in clinical settings.

Originality/value: This study contributes to the literature by outlining the development process and subject matter of Nu-DiMENTION, a novel web-based nurse-led self-management education program for type 2 DM patients. By synthesizing theory, existing evidence, and stakeholder insights, the program offers a comprehensive approach to addressing the educational needs of this patient population. Furthermore, the emphasis on item validity assessment ensures the program's reliability and effectiveness, adding to its value as a practical intervention for improving diabetes self-management. Overall, Nu-DiMENTION represents an innovative and valuable contribution to diabetes care and patient education.