Self-management of Diabetes for Empty Nest Older Adults: A Randomized Controlled Trial

Abstract

Background: Despite much evidence showing the effectiveness of structured self-management education for diabetes, poor glycemic control remains a challenge among empty nest older adults. Objective: We explored the effect of a health education intervention based on the PRECEDE-PROCEED model on the self-management of empty nest older adults with type 2 diabetes in Lanzhou, China. Methods: We conducted a 2-armed, randomized controlled trial using a multistage sampling method. A total of 100 patients were randomly assigned to receive either community nurse–led diabetes education based on the PRECEDE-PROCEED model or general community diabetes education. Self-management scores and blood glucose were compared at baseline and at 3 and 6 months after the intervention. Results: Analyses were conducted on the 98 patients completing follow-up. In the experimental group, diabetes self-management knowledge ( t = 7.578, P < .001), self-management attitude ( t = 9.155, P < .001), self-management behavior ( t = 7.809, P < .001), and overall self-management scores ( t = 7.626, P < .001) improved, with hemoglobin A1c ( t = −2.825, P = .006), fasting plasma glucose ( t = −3.100, P = .003), 2-hour postprandial blood glucose ( t = −3.812, P < .001), and diastolic blood pressure ( t = −2.104, P = .038) decreasing compared with the control group at 6 months postintervention. Conclusions: This study demonstrated that education based on the PRECEDE-PROCEED model was more effective than general health education in improving diabetes self-management and glycemic control among empty nest older adults.