Effects of Integrated Health Coaching, Mindfulness, and Family Participation on Self-Efficacy and HbA1c among People with Type 2 Diabetes with Neuropathy: A Quasi-Experimental Study

Abstract

Type 2 diabetes mellitus with diabetic peripheral neuropathy often leads to impaired self-management and poor glycemic control. Psychological stress, limited family support, and insufficient behavioral guidance may weaken motivation to maintain effective diabetes care. An integrated intervention was developed by combining Bandura’s self-efficacy construct and Orem’s self-care theory to strengthen diabetes self-management. The quasi-experimental study took place at community health centers in Kendari City, Indonesia. People with type 2 diabetes and diabetic peripheral neuropathy were recruited using consecutive sampling and randomly allocated to an intervention group (n = 45) or a control group (n = 47). The 12-week intervention consisted of six structured sessions that integrated diabetes coaching, mindfulness practices, family participation, and scheduled home visits. Primary outcomes were diabetes self-efficacy, measured at baseline, 3 months, and 6 months, and HbA1c, measured at baseline and 6 months after the intervention. Data were collected using a demographic questionnaire, the Holistic Diabetes Self-Efficacy Scale, and HbA1c testing. Analyses included descriptive statistics, paired t-tests, independent t-tests, and generalized estimating equations. Post-intervention analysis demonstrated that the intervention group had significantly higher total and domain-specific self-efficacy scores than the control group at both 3 and 6 months, and also showed greater improvement in HbA1c over time. Self-efficacy and glycemic control were improved through this integrated intervention among people with type 2 diabetes mellitus and diabetic peripheral neuropathy. Nurses can apply this intervention to practice. However, further multi-site randomized controlled trials are needed before wider implementation.