Effectiveness of the 5A Self-Management Nursing Intervention on Psychosocial Adaptation Among Patients With Diabetes: A Randomized Controlled Trial
AI Summary
5A self-management programme significantly improved psychosocial adaptation among hospitalised patients with type 2 diabetes compared with routine care.
Randomised controlled trial of 80 patients showed lower PAIS scores in the intervention group (58.6 ± 7.9) versus control (72.4 ± 8.3), p < 0.001.
Recommendation to implement the 5A programme in healthcare settings to enhance psychosocial adaptation among patients with type 2 diabetes.
Nurs Res Pract. 2026 May 18;2026:2814645. doi: 10.1155/nrp/2814645. eCollection 2026.
ABSTRACT
BACKGROUND: Diabetes management requires not only biomedical control but also psychosocial adaptation, which is often overlooked in routine care. The 5A model (Assess, Advise, Agree, Assist, and Arrange) has shown promise in chronic disease management, yet its impact on psychosocial outcomes in diabetes remains underexplored.
AIM: This study aimed to determine the effect of the 5A self-management program on psychosocial adaptation among hospitalized patients with type 2 diabetes in selected teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences.
METHODS: In this randomized controlled trial (RCT), 80 patients with type 2 diabetes who met the inclusion criteria were selected through convenience sampling and randomly assigned to either the intervention group (n = 40) or the control group (n = 40). The intervention group received the 5A self-management program, while the control group received routine care. Data were collected using demographic questionnaires, the Diabetes Knowledge Questionnaire, the Diabetes Self-Management Questionnaire, and the Derogatis Psychosocial Adjustment Questionnaire. Data analysis was performed using SPSS Version 20 with descriptive and inferential statistical tests.
RESULTS: The findings showed no significant differences between the two groups in demographic characteristics (p > 0.05). After the intervention, the mean score of psychosocial adaptation in the intervention group (58.6 ± 7.9) was significantly lower than that in the control group (72.4 ± 8.3) (p < 0.001). Within-group comparison revealed a significant decrease in PAIS scores (indicating improvement) in the intervention group.
CONCLUSION: The 5A self-management program can be considered an effective intervention for improving psychosocial adaptation among patients with type 2 diabetes. It is recommended that this program be utilized in the healthcare system to enhance psychosocial adaptation in these patients.
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