Development and Validation of a Framework for Type 2 Diabetes Patient Self-Management Education Program

Abstract

Background and Objective: Patient self-management education has been a major factor in the intervention and management of chronic diseases as it engages and empowers patients to control and/or prevent complications of chronic diseases. The objective of this study was to develop and validate a framework standard for diabetic patient's self-management education. Methods: A quantified qualitative research method was applied to design and validate a patient self-management framework. Previously published 26 international diabetes management standards and guidelines were reviewed, analyzed, tabulated, and coded into three categories; systems, constructs, and themes. The resulting matrix with coding criteria was validated by a 3-session focus group for consensus, verification, and re-verification of the model. Co-researchers reviewed and reclassified the focus group re-verification data with >90% reliability. Results: The framework consisted of main three domains: the health system with four constructs and 96 items; the delivery system with five constructs and 139 items; and the system of decision, support, supervision, monitoring, and evaluation with 6 constructs and 32 items. Results are reported for the 3 focus group sessions and the co-researchers' review. It resulted in a modification of <30% of the original framework (N of items = 277 − 203 = 74 [26.7%]). Conclusion: A focus group methodology was effectively used to design and validate an appropriate patient self-management education framework. A valid framework of standards and guidelines for type 2 diabetes mellitus self-management was developed and validated to reflect the diabetic patients' needs. An outcome measurement tool would be developed based on the framework to assess the effectiveness of patient self-management outcomes in Saudi Arabian society.