Self-Care Management Clinical Protocol for Patients with Type II Diabetes Mellitus: A Delphi Design Study

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a chronic illness that is characterized by raised levels of blood glucose resulting from insulin resistance and deficiency. It is a complex public health concern that has significant health, social, economic, and familial burdens. Studies suggested that effective self-care management for type 2 diabetic patients has shown the best health outcomes and reduced disease burdens. A significant obstacle for nurses and doctors in health settings is the lack of self-care management clinical guidelines and protocols.
Method: Using a Delphi method, a judgmental panel of experts (N=16) who were academic staff with experience in clinical protocol development and primary healthcare. In addition, primary health care nurses (N=8) and physicians (N=22) who were actively engaged in T2DM management in primary health care (PHC). provided their perspectives regarding the designed clinical protocol. A Delphi checklist on a 5-Likert scale was used to obtain the consensus of participants regarding the module ratings. Directed content analyses were used to analyze qualitative data, and quantitative data were summarized by using the descriptive statistics.
Results: Participants' views on content, required resources, policies, competences, facilities, benefits, type 2 diabetic patients' challenges, and common questions beside their recommendations were noted as key considerations. There was a strong consensus between participants regarding the clinical protocol's content and media, with an excellent agreement exceeding 0.9.
Conclusion and Recommendation: This study underscores the importance of involving experts and primary health care nurses and physicians in the design process of clinical protocol, which provides evidence to support the clinical protocol using it as effective and interactive guidance for clinical protocol users and type 2 diabetic patients toward diabetes self-care management. External validity and applicability testing are recommended to prove its impact on primary health care nurses and physicians ' practice