Effect of narrative nursing on treatment adherence and self-management in elderly patients with diabetes: a randomized controlled trial

叙事护理对老年糖尿病患者治疗依从性和自我管理的影响:一项随机对照试验

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Abstract

OBJECTIVE: To explore the influence of the narrative nursing model on medication and dietary compliance in elderly patients with diabetes mellitus (DM). METHODS: A total of 84 elderly patients with DM admitted to the hospital between January 2022 and January 2023 were randomly assigned to either the control group or observation group, with 42 patients in each group. The control group received standard nursing care for elderly patients with DM, while patients in the observation group received care based on the narrative nursing model. Outcomes compared between the two groups included medication compliance (assessed by the Adherence to Refills and Medications Scale [ARMS] and the Self-Efficacy for Appropriate Medication Use Scale [SEAMS]), dietary behavior compliance, self-management behavior (measured by the Diabetes Self-Management Behavior for Older Adults Scale [DSMB-FOK]), fear of disease progression (assessed by the Fear of Progression Questionnaire-Short Form [FOP-Q-SF]), and the incidence of nursing-related adverse events. RESULTS: Patients in the observation group had significantly higher scores following treatment in SEAMS, dietary compliance, and DSMB-FOK compared to those in the control group. Conversely, ARMS and FOP-Q-SF scores, as well as the incidence of nursing-related adverse events (2.38%), were significantly lower in the observation group than in the control group (21.43%) (P < 0.05). CONCLUSION: The narrative nursing model significantly improves medication and dietary compliance, enhances self-management behavior, reduces fear of disease progression, and lowers the occurrence of nursing-related risk events in elderly patients with DM. RELEVANCE FOR CLINICAL PRACTICE: This study provided evidence supporting the effectiveness of the narrative nursing model in enhancing rational medication use and dietary adherence among elderly diabetic patients. It also presented a basis for incorporating narrative nursing into clinical practice to reduce the incidence of adverse events and strengthen comprehensive diabetes management in elderly populations. CLINICAL TRIAL NUMBER: Not applicable.

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