Evaluation and Comparison of the Effectiveness of Empowerment Program for Nurses and Health Care Providers in Education and Control of Type 2 Diabetes: A Randomized Controlled Trial Nested in an Action Research

The study aimed to compare the effectiveness of empowerment program for nurses and health care providers on glycosylated hemoglobin in middle-aged people with type 2 diabetes.

A double-blind randomized controlled trial was performed on 480 patients covered by health centers in Isfahan during an action research using nested evaluation design in 2018. Patients were divided into 4 equal groups of 120 cases in 4 groups of intervention and control in two divided groups of nurses and health-care providers. Intervention groups of nurses and health care provider participated in 7 sessions of empowerment workshop, then they thought their patients in 4 sessions about self-care issues based on their needs assessment. Patients' data and glycosylated hemoglobin (HbA1c)at first and 3 months after intervention were collected by accurate and reliable methods. Data were analyzed in SPSS software version 20 with Kolmogorov-Smirnov, ANOVA, chi-square, independent t-test and paired t-test at a significant level of 0.05.

Four groups of patients in the intervention and control subgroups of nurses and health care providers did not differ significantly in demographic variables and before the intervention(p=0.409). Three months after the intervention, mean difference of  the patients'  HbA1c level between the two groups of empowerment (nurses and health care providers) were significant (p=0.003) compared with their control groups. Best effectiveness was seen in the nurses' intervention group (p=0.003).

The effectiveness of the empowerment program on patients' glycemic control was confirmed in both groups with higher effect of nurses' education for A1c control in diabetic patients. Therefore, the implementation of this empowerment programs for health personnel and the use of trained nursing staff is recommended due to their important role in health system mission to improve diabetic control.