Summary: In a small nursing trial, home-based diabetes self-management education built on Orem’s self-care model improved glucose, HbA1c, lipids, blood pressure, and self-care agency over six weeks compared with usual care.
PICO Summary
| Element | Detail |
|---|---|
| Population | 65 patients with diabetes (35 experimental, 30 control); randomised controlled trial, Turkey. |
| Intervention | Home-based diabetes self-management education and support structured on Orem’s self-care model, with four weekly home visits. |
| Comparison | Routine diabetes care without the structured home-based programme. |
| Outcome | Six weeks after the intervention, the experimental group had lower blood glucose, HbA1c, lipids, and blood pressure, and a higher self-care agency score, with significant differences from controls (p<0.05). |
Expert Commentary
This is a sensible, theory-driven nursing trial addressing a real implementation gap, since structured diabetes self-management education is standard of care yet many patients cannot access clinic-based services, and delivering it at home, where self-care actually happens, is intuitively appealing. Orem’s self-care model provides a coherent framework for matching support to each patient’s deficits, and the results are encouraging across glycaemic, lipid, blood-pressure, and self-care measures. I would read the magnitude cautiously, however. With 65 patients at a single centre and only a six-week post-intervention window, this is a small short study, the HbA1c reduction was not quantified in the abstract so its clinical size is unclear, and a six-week interval is too brief to confirm durability. The design also cannot separate the contribution of the Orem framework from the simple benefit of intensive home contact. Can I use this with my patients? Yes, in principle and direction. It supports offering home-based or, increasingly, telehealth-delivered self-management education to patients facing barriers to clinic attendance, while I would temper expectations about effect size and durability and would value longer, larger confirmation before treating the specific model as essential.
References
Güngörmüş Z, Kaplan Ö. Home-based diabetes self-management education and support through Orem’s self-care model: a randomized controlled trial. Health Educ Res. 2025;40(4):cyaf063. doi:10.1093/her/cyaf063