A Telenursing Program to Support Diabetes Self-Management

Feasibility outcomes, including participation rate, completion rate, and adherence level, were analyzed using descriptive statistics under the per-protocol (PP) approach, which included only participants who completed all study assessments.

HbA1c (%) will be measured using standard laboratory methods obtained from medical records at baseline and 12 weeks after enrollment to assess changes over time.

FBG (mg/dl) will be measured using standard laboratory methods obtained from medical records at baseline and 12 weeks after enrollment to assess changes over time.

Blood pressure will be obtained from health assessment record at baseline and 12 weeks after enrollment to assess changes over time.

Body mass index (kg/m²) will be calculated from measured weight and height obtained from health assessment record at baseline and 12 weeks after enrollment to assess changes over time.

Diabetes knowledge will be assessed using the Thai version of the Diabetes Knowledge Scale (DIAKS), consisting of 21 items with true, false, or don't know response options. Total scores will be calculated based on the number of correct responses. Assessments will be conducted at baseline, 6 weeks, and 12 weeks after enrollment to assess changes over time.

Self-care behavior will be assessed using the Thai Diabetes Self-Management Questionnaire-Revised (T-DSMQ-R). Total scores will be calculated according to standard scoring procedures, with higher scores indicating better diabetes self-management. Assessments will be conducted at baseline, 6 weeks, and 12 weeks after enrollment to assess changes over time.

Positive coping behavior will be assessed using the Short Thai Stress Test (ST-5), a five-item questionnaire rated on a 0-3 Likert scale. Total scores range from 0 to 15, with higher scores indicating greater stress severity. Assessments will be conducted at baseline, 6 weeks, and 12 weeks after enrollment to assess changes over time.

Quality of life will be assessed using the Thai version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL19). The average weighted impact (AWI) score will be calculated, with scores ranging from -9 to +3. Assessments will be conducted at baseline, 6 weeks, and 12 weeks after enrollment to assess changes over time.

Healthcare costs will be assessed through review of medical and financial records, including outpatient visits, inpatient admissions, medications, laboratory tests, and other diabetes-related expenses. Total healthcare costs per participant will be summarized for the 12-week follow-up period.

Frequency of acute care use will be assessed using hospital records, including emergency department visits and hospital admissions. The total number of acute care events per participant will be recorded during the follow-up period.

All-cause mortality will be assessed using hospital follow-up records. Mortality status will be recorded for each participant during the follow-up period.