Trisna Vitaliati, Irwina Angelia Silvanasari, Nurul Maurida, Ahmad Ali Basri

Family-Centred Nursing Theory and the Functional Consequences Model Improve Diabetes Self-Management in Elderly Diabetics

Introduction

Family-centred nursing theory and the functional consequences model improve diabetes self-management in elderly diabetics. Improve diabetes self-management in elderly patients using Family-Centred Nursing Theory and the Functional Consequences Model. Enhance self-efficacy & family support for better care.

Abstract

Background: The self-care management of older diabetics is inconsistent and exhibits low adherence. This incident may be influenced by the elderly's disease management capabilities and familial involvement, which may not be conducive to their health and care. This study aimed to develop a management plan for elderly diabetes mellitus that emphasizes self-efficacy and family involvement. Methods: This research employed an explanatory survey design with a cross-sectional methodology. The probability sampling method, particularly simple random sampling, was employed to choose respondents for this study from a cohort of 100 individuals with diabetes mellitus and their families. We created a thorough assessment questionnaire for diabetes mellitus management in the elderly, utilizing the functional consequence model and family-centred nursing theory as the research framework. The statistical method employed was SEM-PLS. Results: The outer model analysis revealed that all indicators of each construct were valid, with a factor loading value of > 0.7. The inner model analysis revealed that the variables family structure, family function, family stressors, elderly risk factors, age-related changes, and elderly consequence functions had a significant effect with a t-value of >1.96 and p-value <0.05. Conclusion: The diabetic mellitus management model, which is based on self-efficacy and familial support, improves self-care management among the elderly. Nurses should adopt the diabetic mellitus management model to increase patient autonomy and educate families on how to support their loved ones, thereby improving the self-care practices of elderly adults with diabetes.

Review

This study addresses a critical and highly relevant issue concerning the inconsistent self-care management and low adherence among older adults with diabetes, emphasizing the pivotal roles of self-efficacy and family involvement. The authors propose a management plan integrating Family-Centred Nursing Theory and the Functional Consequences Model to enhance diabetes self-management. The theoretical grounding of the study is robust, drawing on established frameworks that acknowledge the complex interplay of individual capabilities, age-related changes, and familial support in chronic disease management, making its aim to develop an evidence-based approach timely and important for geriatric nursing and diabetes care. However, the methodology presents some significant limitations in light of the ambitious claims made. While the use of an explanatory survey design with a cross-sectional methodology is suitable for exploring relationships between variables, it inherently limits the ability to infer causality or demonstrate "improvement" as suggested by the title and conclusion. The reported results, indicating significant effects between constructs such as family structure, family function, and elderly consequence functions, establish associations consistent with the theoretical framework. Yet, the abstract does not explicitly detail how these findings directly translate to or *test the efficacy* of a *developed management plan* or how it specifically *improves* self-management within the scope of this cross-sectional study. The sample size of 100 for an SEM-PLS analysis, especially given the complexity of the model with multiple latent variables, could also be considered relatively modest, potentially impacting the generalizability of the findings. Consequently, while the study's premise and theoretical underpinnings are commendable, the conclusion that the "diabetic mellitus management model...improves self-care management" appears to overstate what can be definitively concluded from a cross-sectional design. The findings more accurately describe the existing relationships among the theoretical constructs rather than demonstrating the impact or effectiveness of a specific intervention or developed management plan. While the proposed model holds promise, future research utilizing longitudinal or interventional study designs would be necessary to truly validate its efficacy in improving self-care practices among elderly adults with diabetes and to fully justify the strong recommendations for nurses to adopt this model in practice.

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