Summary: In 60 adults with type 2 diabetes, a family-centered empowerment program (FCEP) added to usual care produced significantly higher self-reported illness acceptance and self-management scores than usual care alone, immediately after the intervention and at six weeks (illness acceptance 6-week: 47.1 vs 34.7, p<0.001; self-management 6-week: 36.4 vs 23.3, p<0.001). The findings rest on short-term, subjective questionnaire endpoints in a single-blind trial.
PICO Summary
| Element | Detail |
|---|---|
| Population | 60 adults with type 2 diabetes; single-centre, single-blind randomised controlled trial (block randomisation, sealed opaque envelopes); Iran. |
| Intervention | Family-centred empowerment program (FCEP): structured education and support directed at both the patient and their family, added to routine care (n=30). |
| Comparison | Usual/routine care without the family-involved program (n=30). |
| Outcome | Self-reported questionnaire scores (intervention vs control). Illness acceptance (DAS): baseline 32.2 vs 34.5, p=0.396 (NS); immediately after 41.8 vs 34.9, p=0.008; 6 weeks 47.1 vs 34.7, p<0.001. Self-management (DSMQ): baseline 21.7 vs 23.0, p=0.305 (NS); immediately after 30.9 vs 23.6, p<0.001; 6 weeks 36.4 vs 23.3, p<0.001. No 95% CI, ARR or NNT were reported (continuous between-group comparisons); adverse events, HbA1c and other clinical endpoints were not reported. |
Family-centred empowerment in type 2 diabetes
RCT · type 2 diabetes · 6 weeks
Adding a family-centred empowerment program raised self-reported self-management and illness acceptance at six weeks. Both endpoints are subjective questionnaires in an unblindable trial with no glycaemic outcome.
Expert Commentary
The verdict is that a real but soft signal has been demonstrated: a family-centred empowerment program was associated with markedly higher self-reported illness acceptance and self-management at six weeks, with baseline scores balanced and between-group differences that reached statistical significance. These are encouraging results for a low-cost, nurse-led behavioural intervention. The principal limitation is that both primary endpoints are subjective questionnaires (the Diabetes Acceptance Scale and the Diabetes Self-Management Questionnaire) measured in a trial where participants could not be blinded to an educational program; the implausibly large divergence, with intervention self-management scores climbing from 21.7 to 36.4 while the control arm stayed essentially flat, is the pattern expected when expectancy and social-desirability bias inflate self-report. No objective glycaemic outcome such as HbA1c was reported, follow-up was only six weeks, and the sample was 60 patients at a single Iranian centre, which limits durability and generalisability. Can I use this with my patients? Not yet as proof of clinical benefit, though the approach is reasonable to trial pragmatically in a motivated patient with engaged family support, framed as a way to improve engagement rather than a guaranteed route to better control. Future work should blind outcome assessment where feasible, extend follow-up, and anchor claims to objective metabolic endpoints.
References
Amani N, Nazari AM, Sanaie N, Abbasi A, Borhani F. Effects of family-centered empowerment program on illness acceptance and self-management of patients with type 2 diabetes: a randomized controlled trial. Sci Rep. 2025;15(1):21615. doi:10.1038/s41598-025-05833-0