What Works in a Nurse Led Self-Management Program for Patients with Serious Mental Illness (SMI) and Diabetes (DM).
Carol Blixen, Stephanie W Kanuch, Adam T Perzynski and 3 others
PMID 29413063WHAT IT FOUND
Patients with serious mental illness and diabetes described a nurse-led group program as building confidence and knowledge through peer support.
They learned to view their two conditions as connected and adopted practical self-management skills like reading labels and scheduling medications.
Key findings
01Participants identified positive group experience, increased health knowledge, and increased self-confidence as the mechanisms that led to improved self-management of their comorbid conditions.
02The intervention helped patients understand the relationship between their mental illness and diabetes, leading them to manage both conditions with equal priority rather than focusing solely on psychiatric symptoms.
03Peer educators sharing their own struggles with the conditions facilitated discussion and group cohesiveness, while nurse educators provided the core self-management curriculum.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample size was small (10 participants) and drawn from a single urban health system, limiting the transferability of the findings. The participants were all from the intervention arm of the parent RCT, so the study cannot compare their experiences to those who received usual care. The study relied on self-report at the 13-week mark, which may not capture long-term changes or social desirability bias. The population studied had severe mental illness and diabetes in a safety-net setting, so results may not apply to patients with milder illness or different healthcare access.
Declared interests
Dr. Sajatovic has received research grants from multiple pharmaceutical companies and foundations, serves as a consultant to several drug manufacturers, and receives royalties from various publishers. All other authors declared no conflicts of interest.
The easy way to misread this
Do not interpret these qualitative themes as proof that the nurse-led intervention caused the health improvements seen in the parent RCT. This study only describes the perceptions of 10 participants who received the treatment; it does not measure clinical outcomes or compare them to a control group.