The Effect of Self-Care Management Intervention on Hardiness in Type 2 Diabetes Mellitus Patients
DOI:
10.29303/jossed.v7i1.14268Published:
2026-04-30Downloads
Abstract
Type 2 diabetes mellitus (T2DM) requires continuous self-care management and has the potential to impact psychological outcomes such as hardiness. This study aims to analyze the effect of self-care management interventions on hardiness in T2DM patients. The design used was a quasi-experimental pretest–posttest with a non-randomized control group at 3 community health centers in Bima City (August–October 2025). A purposive sample of 100 T2DM patients was divided into treatment (n=50) and control (n=50) groups. The intervention was a structured self-care management education program (diet, physical activity, medication adherence, glucose monitoring, foot care, stress management, and problem-solving). Hardiness was measured before and after the intervention and analyzed using the Wilcoxon test. Descriptively, the proportion of “good” hardiness in the treatment group increased from 6% to 80%, while in the control group decreased from 28% to 24%. The Wilcoxon test showed a significant increase in hardiness in the treatment group (Z=−6.083; p<0.001) and no significant increase in the control group (Z=−0.632; p=0.527). These findings support the effectiveness of self-care management interventions in improving hardiness in T2DM patients, with the potential for confounding by differences in baseline characteristics between groups (age and duration of DM).
Keywords:
DMT2 Hardiness Quasi-Experiment Self-Care Management WilcoxonReferences
Ahn, J.-S., & Kim, H. (2022). Mutations in Acute Myeloid Leukemia: A Review Focusing on Clinically Applicable Drugs. Blood Research, 57(S1), 32– 36. https://doi.org/10.5045/br.2022.2022017
Akbari-Nassaji, N., Aston, M., Hughes, J., Cassidy, C., & Benoit, B. (2023). Women’s Experiences Regarding Physical Activity during the Postpartum Period: A Feminist Poststructuralist Study. Nursing Reports, 13(1), 445–455. https://doi.org/10.3390/nursrep13010041
AlHaqwi, A. I., Amin, M. M., Tulaihi, B. A., & Abolfotouh, M. A. (2023). Impact of Patient-Centered and Self-Care Education on Diabetes Control in a Family Practice Setting in Saudi Arabia. International Journal of Environmental Research and Public Health, 20(2), 1109. https://doi.org/10.3390/ijerph20021109
Almotairy, K. A., Sabbagh, T. T., Talkab, M. A., Hawsawi, R. A., & Baroom, N. A. (2024). The Impact of Health Education on Hemoglobin A1C in Diabetic Patients at the Family Medicine Department of King Fahad Armed Forces Hospital in Jeddah. In Cureus. https://doi.org/10.7759/cureus.75627
Asmat, K., Dhamani, K., Gul, R., & Froelicher, E. S. (2022). The Effectiveness of Patient-Centered Care vs. Usual Care in Type 2 Diabetes Self-Management: A Systematic Review and Meta-Analysis. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.994766
Babazadeh, T., Lotfi, Y., & Ranjbaran, S. (2023). Predictors of Self-Care Behaviors and Glycemic Control Among Patients With Type 2 Diabetes Mellitus. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.1031655
Çelik, S., Yılmaz, F. T., Gündoğdu, S., & Türkoğlu, M. (2024). The Effect of Nursing Counseling on Treatment Compliance: Acute Coronary Syndrome and Diabetes Mellitus. Journal of Nursing Research, 32(4), 339. https://doi.org/10.1097/jnr.0000000000000621
Esferjani, S. V, Naghizadeh, E., Albokordi, M., Zakerkish, M., & Araban, M. (2022). Effectiveness of a Mobile-Based Educational Intervention on Self-Care Activities and Glycemic Control Among the Elderly With Type 2 Diabetes in Southwest of Iran in 2020. Archives of Public Health, 80(1). https://doi.org/10.1186/s13690-022-00957-5
Fadli, F., Nursalam, N., Sjattar, E. L., Sumbara, S., Pangesti, D. N., & Pelawi, A. M. P. (2024). The Self-Management-Based Care Interventions on Quality of Life in Type 2 Diabetes Mellitus Patients. An Integrative Review. Multidisciplinary Reviews, 7(6), 2023086. https://doi.org/10.31893/multirev.2024086
Fereidooni, G. J., Ghofranipour, F., & Zarei, F. (2024). Interplay of Self-Care, Self-Efficacy, and Health Deviation Self-Care Requisites: A Study on Type 2 Diabetes Patients Through the Lens of Orem’s Self-Care Theory. BMC Primary Care, 25(1). https://doi.org/10.1186/s12875-024-02276-w
Feriadianto, F., Natashia, D., Gayatri, D., Jumaiyah, W., & Yuniarsih, W. (2025). Effectiveness of Digital Application-Based Foot Care Education and Training Programmes in Improving Self-Efficacy and Foot Care Behaviour in Patients With Type 2 Diabetes Mellitus. Jurnal Ners, 9(4), 5985–5992. https://doi.org/10.31004/jn.v9i4.49962
Golboni, F., Ahmadzadeh, H., Nadrian, H., Babazadeh, T., Najafi, S., Ghahremaninasab, P., & Mahmoodi, H. (2024). Effects of a Short-Time Health Literacy Promotion Program (HeLPP) on Biochemical Factors, Self-Care and Quality of Life Among Rural Patients With Type-2 Diabetes: A Field Trial With Solomon Four-Group Design. Health Promotion Perspectives, 14(2), 175–184. https://doi.org/10.34172/hpp.42787
Gosak, L., Pajnkihar, M., & Štiglic, G. (2022). The Impact of Mobile Health Use on the Self-Care of Patients With Type 2 Diabetes: Protocol for a Randomized Controlled Trial. Jmir Research Protocols, 11(6), 31652. https://doi.org/10.2196/31652
Hapsari, A. R. (2025). The Effect of Android-Based Self Care Management on Self Efficacy and Control of Fasting Blood Sugar Levels of People With Type 2 Diabetes Mellitus in the Working Area of the Tempel Sleman Health Center. Eduvest - Journal of Universal Studies, 5(4), 4008–4026. https://doi.org/10.59188/eduvest.v5i4.49974
Kaveh, M. H., Montazer, M., Karimi, M., & Hassanzadeh, J. (2022). Effects of a Theory-Based Training Program With Follow-Up Home Visits on Self-Management Behavior, Glycemic Index, and Quality of Life Among Iranian Patients With Type 2 Diabetes Mellitus. BMC Public Health, 22(1). https://doi.org/10.1186/s12889-022-13959-3
Khavere, S., Hadjiconstantinou, M., Miksza, J., Hagan, J., Salisu-Olatunji, S. O., Naderpour, S., & Gillies, C. (2025). Effectiveness of Self‐management Interventions on Type 2 Diabetes Among Young Adults (18–45 years): A Systematic Review and Meta‐analysis. Diabetic Medicine, 42(10). https://doi.org/10.1111/dme.70127
Pao, J.-B., Wu, S., Guo, Y.-W., & Huang, W. (2025). Evaluating Pharmacist-Driven Interventions in Multidisciplinary Diabetes Care: A Quasi-Experimental Study. The Science of Diabetes Self-Management and Care, 51(5), 462–475. https://doi.org/10.1177/26350106251361368
Pettersson, S. (2024). Supporting Self-Care in Migrants with Type 2 Diabetes [Doctoral dissertation: Linköping University Electronic Press]. Retrieved from https://www.diva-portal.org/smash/record.jsf?pid=diva2:1839161
Quynh, A. L. H. T., Nguyễn, V. Q. H., Tam, N. M., Wens, J., Derese, A., Peersman, W., & Pype, P. (2024). Exploring the Relationships Between Self-Efficacy, Self-Care, and Glycaemic Control in Primary Care Diabetes Management. Sage Open Medicine, 12. https://doi.org/10.1177/20503121241310016
Rahbar, S., Zarifsanaiey, N., & Mehrabi, M. (2024). The Effectiveness of Social Media-Based Microlearning in Improving Knowledge, Self-Efficacy, and Self-Care Behaviors Among Adult Patients With Type 2 Diabetes: An Educational Intervention. BMC Endocrine Disorders, 24(1). https://doi.org/10.1186/s12902-024-01626-0
Ranjbaran, S., Shojaeizadeh, D., Dehdari, T., Yaseri, M., & Shakibazadeh, E. (2022). The Effectiveness of an Intervention Designed Based on Health Action Process Approach on Diet and Medication Adherence Among Patients With Type 2 Diabetes: A Randomized Controlled Trial. Diabetology & Metabolic Syndrome, 14(1). https://doi.org/10.1186/s13098-021-00773-x
Rondhianto, R., Hakam, M., & Alawi, R. I. A. (2025). Effect of the Family Caregiver Empowerment Model Intervention on the Self-Efficacy of People With Type 2 Diabetes Mellitus. Jurnal Keperawatan Soedirman, 20(1), 7. https://doi.org/10.20884/1.jks.2025.20.1.9388
Tanamas, N. S., Jusuf, H., & Liputo, G. P. (2025). DSME to Improve Self-Care and Self-Efficacy in Type 2 Diabetes: A Quasi-Experimental Study. Journal Syifa Sciences and Clinical Research, 7(2), 188–196. https://doi.org/10.37311/jsscr.v7i2.31122
TERKEŞ, N., Bektaş, H., & Balcı, M. K. (2024). Effect of Web‐based Education Intervention on Blood Glucose Control, Self‐care and Quality of Life in Patients With Type 2 Diabetes: A Single‐blinded Randomized Controlled Trial. International Journal of Nursing Practice, 30(6). https://doi.org/10.1111/ijn.13298
Tisna, V. K., Kamelia, E., & Aryanti, D. (2025). Improving Self-Care and Self-Efficacy in Type 2 Diabetes Mellitus Patients by Online DSME Educational Videos. Jurnal Info Kesehatan, 23(1), 114–123. https://doi.org/10.31965/infokes.vol23.iss1.1346
Tolasa, A. G., & Akyol, A. D. (2024). Effectiveness of a Theory-Based Foot Care Education Program on Self-Efficacy and Adaptation in Patients With Diabetes in Turkey: A Randomized Controlled Trial. Wound Management & Prevention, 70(1). https://doi.org/10.25270/wmp.23007
Wang, H., Ge, L., Kwok, J. Y. Y., Zhang, Z., Wiley, J., & Guo, J. (2024). A Blended Mindfulness-Based Stress Reduction Program to Improve Diabetes Self-Management Among People With Type 2 Diabetes Mellitus: A Mediation Effect Analysis. Annals of Behavioral Medicine, 59(1). https://doi.org/10.1093/abm/kaae075
Yaagoob, E., Lee, R., Stubbs, M., Shuaib, F., Johar, R., & Chan, S. W. (2024). WhatsApp‐based Intervention for People With Type 2 Diabetes: A Randomized Controlled Trial. Nursing and Health Sciences, 26(2). https://doi.org/10.1111/nhs.13117
Yehualashet, F. A., Kessler, D., Bizuneh, S., & Donnelly, C. (2024). The Feasibility of the Diabetes Self-Management Coaching Program in Primary Care: A Mixed-Methods Randomized Controlled Feasibility Trial. International Journal of Environmental Research and Public Health, 21(8), 1032. https://doi.org/10.3390/ijerph21081032
Zaini, N., Idris, I. B., Ahmad, N., Hashim, S. M., Abdullah, N. N., & Shamsusah, N. A. (2025). Enhancing Self-Care Management Among Women With Type 2 Diabetes Mellitus. Scientific Reports, 15(1). https://doi.org/10.1038/s41598-025-96308-9
License
Copyright (c) 2026 Kurniadi Kurniadi, Sukmawati, Syarief Suwardhin, Supriadin
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with Journal of Science and Science Education, agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Attribution 4.0 International (CC BY 4.0). This license allows authors to use all articles, data sets, graphics and appendices in data mining applications, search engines, web sites, blogs, and other platforms by providing an appropriate reference. The journal allows the author(s) to hold the copyright without restrictions and will retain publishing rights without restrictions.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Journal of Science and Science Education.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
