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Background <p>Type 2 diabetes is a major and growing public health challenge, both for patients and healthcare systems worldwide. Its management and control largely depend on patients’ self-care behaviors. This study aimed to investigate the effect of a digital educational intervention based on Orem’s Self-Care Theory on improving self-care behaviors, self-efficacy, and HbA1c levels in patients with type 2 diabetes in Rasht, Iran.</p> Methods <p>This quasi-experimental study was conducted in 2024 on 96 patients with type 2 diabetes in Rasht. A multi-stage cluster random sampling method was used to allocate patients into two groups: the intervention group (receiving the digital educational program) and the control group, with 48 participants in each. Data collection tools included the Summary of Diabetes Self-Care Activities Measure (SDSCA), Orem’s Self-Care Needs Assessment Questionnaire, and the Self-Efficacy Questionnaire/Scale. HbA1c levels were assessed via blood samples. The digital educational program followed a “Microlearning approach” delivered over 8 sessions across 4 weeks (two sessions per week) in short digital modules. Data were collected at three time points: before the intervention, immediately after, and two months post-intervention. Statistical analysis was performed using chi-square, ANOVA, Friedman, independent t-test, and Mann-Whitney U tests through SPSS version 23.</p> Results <p>The mean age of patients in the intervention group was 52.54 <i>±</i> 7.07 years, while in the control group it was 54.45 ± 6.94 years, with no significant demographic differences between groups. Prior to the intervention, there were no significant differences between the groups in terms of self-care needs, self-efficacy, self-care behaviors, or HbA1c levels (<i>p</i> &gt; 0.05). However, after the intervention, the intervention group showed significant improvements in self-care behaviors, self-efficacy, and self-care requisites, as well as a significant reduction in HbA1c levels compared to the control group (all <i>p</i> &lt; 0.001). These improvements were sustained at the two-month follow-up.</p> Conclusion <p>The findings suggest that the combined application of Orem’s Self-Care Model and self-efficacy theory in digital self-care education programs, particularly through mobile-based digital platforms, can enhance self-care behaviors and reduce HbA1c levels in patients with type 2 diabetes. Therefore, it is recommended that healthcare professionals incorporate this educational method into routine diabetes care, especially for patients who face barriers to attending in-person sessions due to physical limitations, distance, cost, or other factors.</p> Trial registration <p>IRCT20240529061941N2 Avaiable at: <a href="https://en.irct.ir/trial/89349">https://en.irct.ir/trial/89349</a></p>

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Effect of a digital educational intervention based on orem’s self-care theory on improving self-care behaviors, self-efficacy, and reducing HbA1c in type 2 diabetes patients: a quasi-experimental study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月17日

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  • Ghorbanali Jennat-Fereidooni,
  • Fatemeh Zarei,
  • Fazlollah Ghofranipour

摘要

Background

Type 2 diabetes is a major and growing public health challenge, both for patients and healthcare systems worldwide. Its management and control largely depend on patients’ self-care behaviors. This study aimed to investigate the effect of a digital educational intervention based on Orem’s Self-Care Theory on improving self-care behaviors, self-efficacy, and HbA1c levels in patients with type 2 diabetes in Rasht, Iran.

Methods

This quasi-experimental study was conducted in 2024 on 96 patients with type 2 diabetes in Rasht. A multi-stage cluster random sampling method was used to allocate patients into two groups: the intervention group (receiving the digital educational program) and the control group, with 48 participants in each. Data collection tools included the Summary of Diabetes Self-Care Activities Measure (SDSCA), Orem’s Self-Care Needs Assessment Questionnaire, and the Self-Efficacy Questionnaire/Scale. HbA1c levels were assessed via blood samples. The digital educational program followed a “Microlearning approach” delivered over 8 sessions across 4 weeks (two sessions per week) in short digital modules. Data were collected at three time points: before the intervention, immediately after, and two months post-intervention. Statistical analysis was performed using chi-square, ANOVA, Friedman, independent t-test, and Mann-Whitney U tests through SPSS version 23.

Results

The mean age of patients in the intervention group was 52.54 ± 7.07 years, while in the control group it was 54.45 ± 6.94 years, with no significant demographic differences between groups. Prior to the intervention, there were no significant differences between the groups in terms of self-care needs, self-efficacy, self-care behaviors, or HbA1c levels (p > 0.05). However, after the intervention, the intervention group showed significant improvements in self-care behaviors, self-efficacy, and self-care requisites, as well as a significant reduction in HbA1c levels compared to the control group (all p < 0.001). These improvements were sustained at the two-month follow-up.

Conclusion

The findings suggest that the combined application of Orem’s Self-Care Model and self-efficacy theory in digital self-care education programs, particularly through mobile-based digital platforms, can enhance self-care behaviors and reduce HbA1c levels in patients with type 2 diabetes. Therefore, it is recommended that healthcare professionals incorporate this educational method into routine diabetes care, especially for patients who face barriers to attending in-person sessions due to physical limitations, distance, cost, or other factors.

Trial registration

IRCT20240529061941N2 Avaiable at: https://en.irct.ir/trial/89349