Effects of a Tele-Nursing–Based Self-Management Program on Self-Care Behaviors, Glycated Hemoglobin (HbA1c), and Blood Pressure among Patients with Type 2 Diabetes Mellitus and Hypertension

Abstract

This quasi-experimental study, using a two-group pretest–posttest design, aimed to examine the effects of a tele-nursing–based self-management program on self-care behaviors, glycated hemoglobin (HbA1c), and blood pressure among patients with type 2 diabetes mellitus and hypertension. The sample size was calculated using G*Power, with an estimated effect size of 0.98. A total of 68 participants were recruited and randomly allocated by simple random sampling without replacement to either an experimental group (n=34) or a control group (n=34). The experimental group participated in a 14-week self-management program developed based on the Nursing Division’s self-management framework derived from Creer’s concept and incorporating principles of lifestyle medicine. The program involved ongoing monitoring, support, and counseling provided by registered nurses via tele-nursing. The control group received usual care. Content validity of the program was confirmed (CVI=1.00). The self-care behavior questionnaire also demonstrated satisfactory validity and reliability (CVI=1.00; Cronbach’s α=0.81). Data were analyzed using descriptive statistics, independent t test, Mann–Whitney U test, paired-samples t test, Wilcoxon signed-rank test, chi-square test, and McNemar test.

Following the intervention, the experimental group showed significantly higher overall self-care behavior scores than at baseline and compared with the control group (p < 0.001). Mean HbA1c levels and blood pressure were also significantly reduced compared with both baseline and the control group (p<0.05). In addition, 58.82% of participants in the experimental group achieved improved self-management outcomes, representing a statistically significant increase (p<0.001). These findings indicate that integrating tele-nursing with self-management support and lifestyle medicine can improve both behavioral and clinical outcomes. The program may be applicable to primary care settings and could inform the development of sustainable digital health strategies for non-communicable diseases.