Authors (including presenting author) :
Li CY(1), Lam TF(1), Pau CL(1), Yip NM(1),So MY(1), Leung MLG(1), Lam YF(1) and Ng ML(1)
Affiliation :
(1) Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Keyword 2: :
enhance self-management of DM
Introduction :
Effective diabetes self-management is essential for older adults with type 2 diabetes admitted for suboptimal glycaemic control; deficits in glucose monitoring, dietary management, physical activity and follow-up increase complication risk. In the medical ward of Pamela Youde Nethersole Eastern Hospital, limited knowledge, low self-efficacy and fragmented caregiver support were commonly observed. The validated Diabetes Self-Management Questionnaire (DSMQ) was used to identify priority domains and develop a nurse-led initiative.
Objectives :
To determine the mean DSMQ Sum Scale score and common hindering domains among elderly inpatients with type 2 diabetes, and to evaluate the impact of a nurse-led multidisciplinary intervention using pre and post-intervention DSMQ scores.
Methodology :
A pre–post study was conducted from January to October 2025. Patients aged ≥65 years, living in the community with caregiver support and admitted for suboptimal diabetes control were included; exclusions were long-term systemic steroid therapy, severe frailty or cognitive impairment. Baseline Chinese DSMQ assessment was followed by one-week interventions: education for patients/caregivers, dietitian referral, physiotherapist advice on simple home exercise, and diabetes nurse monitoring support. DSMQ was repeated post-intervention; caregiver confidence was surveyed before discharge.
Result & Outcome :
Results: Twenty patients were included (mean age 75.0 ± 5.7 years). Mean DSMQ Sum Score increased from 5.49 ± 0.26 to 6.04 ± 0.33 (mean +0.56). Physical Activity remained the lowest domain (baseline 4.01 ± 0.62). Fifteen caregivers reported confidence in supporting patients’ diabetes self-management. Conclusions: The average DSMQ Sum Scale score of 5.49 at baseline reflected only moderate diabetes self-management among elderly inpatients with type 2 diabetes in this medical ward, with Physical Activity identified as the weakest domain. After implementing a nurse-led multidisciplinary intervention incorporating structured education, goal setting and caregiver engagement, patients’ overall DSMQ Sum Scale and all subscale scores improved, with a statistically significant increase in the total score to 6.04. These findings suggest that a nurse-led initiative using the DSMQ to guide assessment and tailored education can effectively enhance diabetes self-management among elderly inpatients. Integrating DSMQ-based assessment and nurse-led education into routine ward practice may help identify patients at risk of poor self-management and provide timely, individualised support. As a further action, this nurse-led DSMQ-based programme could be extended and adapted to other geriatric female wards to standardise diabetes self-management support across similar patient populations. Further studies with larger samples, control groups and longer follow-up are recommended to confirm the sustainability of these improvements and to explore targeted strategies for strengthening physical activity behaviours.
