Effect of Empowerment Program with and without Telenursing on Self-efficacy and Glycosylated Hemoglobin Index of Patients with Type-2 Diabetes: A Randomized Clinical Trial

Abstract

Abstract
Introduction:Developing new training methods for improving the health of diabetic patients
has always been a concern for nurses. The present study aims to investigate the effects of
empowerment-based interventions with or without telenursing on self-efficacy and HbA1c
level in diabetic patients.
Methods:In this randomized clinical trial, 156 patients with type-2 diabetes were randomly
assigned into two intervention groups (empowerment with/without telenursing) and one control
group. All subjects in the intervention groups participated in two sessions of the empowerment
program. However, only the group of empowerment with telenursing received telephone
counseling for 12 weeks. The patients in the control group did not receive any intervention
programs. Self-efficacy was measured by diabetes-specific self-efficacy scale. The HbA1c level
was measured using Bionic kit. Data were analyzed using SPSS Statistics for Windows, version
13.0 (SPSS Inc., Chicago, Ill., USA).
Results:After 14 weeks, while the changes in self-efficacy scores of the control group were not
statistically significant, they were significant in the two intervention groups. Comparison of the
two intervention groups showed that self-efficacy was higher in the group of empowerment
with telenursing. It was only in the empowerment with telenursing group that the reduction of
HbA1
c was significant.
Conclusion:Training based on empowerment models and emphasis on the strengths of clients
in solving their own problems can play a major role in increasing self-efficacy and reduction of
HbA1c level. In addition, a continuous training program, along with telephone follow-ups can
result in higher self-efficacy and lower HbA1c level.

Keywords: Diabetes mellitus, Empowerment, Telenursing, Glycated hemoglobin A, Selfefficacy