Effects of Nurse-Led Telehealth-Based DSMES on Health Literacy, Self-Management, and Glycemic Control in Patients with Poorly Controlled T2DM: A Quasi-Experimental Study

Supranee Yossala; Krittapat Fukfon; Rada Techakunviroj

doi:10.33192/smj.v78i8.281295

Authors

Supranee Yossala Department of Non-Communicable Diseases, Chun Hospital, Phayao Province 56150, Thailand.
Krittapat Fukfon Boromarajonani College of Nursing Phayao, Faculty of Nursing, Praboromarajchanok Institute, Phayao Province 56000, Thailand https://orcid.org/0000-0002-9116-1840
Rada Techakunviroj Department of Family Medicine, Chun Hospital, Phayao Province 56150, Thailand.

DOI:

https://doi.org/10.33192/smj.v78i8.281295

Keywords:

nurse-led telehealth DSMES, health literacy, self-management, fasting blood glucose, HbA1c, type 2 diabetes mellitus

Abstract

Objective: This study aimed to determine the effects of a nurse-led telehealth-based Diabetes Self-management Education and Support (DSMES) program on health literacy (HL), self-management (SM), and glycemic control (GC) in individuals with poorly controlled type 2 diabetes mellitus (T2DM).

Materials and Methods: A 24-week quasi-experimental study with a non-equivalent control group design was conducted. Sixty adults (HbA1c ≥ 7.0%) were sequentially allocated to experimental (n = 30) or control (n = 30) groups. Both groups received standard DSMES at baseline. The experimental group additionally received structured, nurse-led telehealth sessions at Weeks 4, 6, 8, 16, and 20 via digital platforms. HL and SM were measured using validated Thai scales. Fasting blood glucose (FBG) and HbA1c were retrieved from medical records at baseline, 12, and 24 weeks. Data were analyzed using repeated measures ANOVA.

Results: Significant between-subject effects favored the experimental group for HL (F(1,58) = 9.70, p = .003) and SM (F(1,58) = 6.21, p = .016). A significant Time × Group interaction was found for FBG (p = .037), showing a more pronounced reduction trajectory in the experimental group. Although both groups achieved significant HbA1c reduction over time (p < .001), the experimental group demonstrated a clinically superior mean reduction of 1.97% (from 9.29% to 7.32%), compared to 1.22% in the control group.

Conclusion: Integrating nurse-led telehealth services with routine DSMES is effective for improving HL, SM, and FBG control in T2DM patients with poor GC. This intervention supports telehealth as a potent nursing strategy for enhancing patient empowerment and achieving superior behavioral and clinical results.

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