Table 1.
Components of Self-Care Promoting Program (SCPP)
| Components of Theory | Strategies | Description of Intervention |
|---|---|---|
| Self-Care of Chronic Illness Theory | ||
| Self-care maintenance | Health education Skills training | Individual health education regarding self-care, including diet, physical activities and exercise, medication and treatment adherence, and stress management (based on ADCES guidelines) |
| Self-care monitoring | Skills training Diary log record |
Monitoring DM control, observing and recording blurred vision symptoms (based on ADCES guidelines) of DR related to poorly controlled DM |
| Self-care management | Health education |
The nurse taught the patient how to manage symptoms autonomously or through consultation when the symptoms occur (based on ADCES guidelines) |
| Self-Efficacy (Self-Care Confidence) | ||
| Mastery experience | Patient-nurse interaction | Discussion regarding success at self-care skills for glycemic control |
| Self-monitoring | Teaching patients to observe and record in a diary their performance and identify problems performing self-care | |
| Goal setting | The researchers discussed the patient’s goal for self-care behaviors and clinical outcomes (HbA1c, VA, VRQoL, Severity of DR) | |
| Vicarious experience |
Observation with Successful Model | The successful model was presented to demonstrate how to perform self-care actions to control DM and its complications |
| The patients observed and discussed the successful model regarding techniques to control DM and overcoming barriers to achieving their goals | ||
| Verbal persuasion |
Education and discussion | The researcher encouraged patients that they had the capability to undertake more activities than they had performed and supported them as they began making a lifestyle change |
| Physiological and emotional states | Education, discussion, and training | The researcher discussed physical and emotional barriers impacting patients’ confidence and performance and re-interpreted their symptoms and emotions, such as fatigue, blurred vision, fear of falling, or blindness, and suggested ways to overcome these barriers |
| ADCES Guidelines for DSME/T Implementation Process | ||
| Applying and integrating the five steps of the ADCES Guidelines with the theory of Self-Care of Chronic Illness, Self-Efficacy, and related literature reviews to be the major strategies of the Self-Care Promoting Program (SCPP) | ||
| Assessment | Assessing patients’ needs, barriers, and strengths | The researcher performed an individual face-to-face discussion aimed at assessing the patient's needs and symptoms (e.g., eye pain, blurred vision, hypo/hyperglycemia) using specific instruments such as the near card Snellen VA, Amsler grid, or self-monitoring blood glucose instrument |
| Goal setting and planning | Setting the goal and formulating the plan | The desired behavioral goal and specific strategic planning were set in mutual agreement with each participant. These goals and strategic plans were based on the patient's problems, needs, and strengths. The plan was developed to increase the patient’s knowledge and skills required for self-management and the confidence to perform appropriate self-care and eye-care behaviors |
| Implementation | Self-care skills practice and implementation |
The researcher educated and trained the patients regarding self-care maintenance, monitoring, and management |
| Education, discussion and training |
The participants were encouraged to maintain and continuously perform self-care skills and monitor symptoms for controlling illness from the hospital to their home | |
| Evaluation/Monitoring | Evaluating and monitoring performance | The researcher evaluated the participants’ self-care and eye-care behaviors, gave feedback, and empowered them to sustain their performance of new self-care and eye-care behaviors to prevent the complications of DR The results of participants’ health outcomes were evaluated to ensure that the goals were met as expected |