Effect of Telephone Follow‑up by Nurses on Self‑care in Children with Diabetes

Zahra Samimi, Sedigeh Talakoub, Zohreh Ghazavi


Background: Diabetes is a serious chronic disease during childhood. Because of the chronic nature of the disease, self‑care is necessary. Education alone is not effective in providing care. Misunderstanding by the patients regarding diabetes during the training programs render telephone follow‑up after training essential.

 Materials and Methods: This quasi‑experimental study with two groups (experimental and control) was conducted in two phases in 2014. The study population consisted of 70 children of 10–18 years of age with type I diabetes (35 patients in the experimental group and 35 in the control group). The participants were randomly selected from the patients referring to the Sedigheh Tahereh Diabetic Research and Treatment Center in Isfahan, Iran. Data were collected using a researcher‑made  questionnaire on self‑care and a glycosylated hemoglobin recording form. The experimental group received 12 weeks of telephone follow‑up training by the center, whereas the control group received no follow‑up.

Results: The results showed that, after intervention, the total mean score of self‑care in all aspects of diabetes care for children was significantly higher in the experimental group (p < 0.001). In addition, a statistically significant difference was observed between the experimental and control groups in terms of mean glycosylated hemoglobin after the intervention (p = 0.030).

Conclusions: It can be concluded that telephone follow‑up by a nurse can improve total self‑care and glycosylated hemoglobin in patients with type I diabetes.


Children, glycosylated hemoglobin, Iran, nurses, self‑care, telephone follow‑up, type 1 diabetes mellitus

Full Text:



Meerabeau L, Wright K. Long‑term conditions nursing care and management. 1st ed. Blackwell Publishing Ltd; 2011. p.119‑120,247, 271.

Lehmkuhl HD, Storch EA, Cammarata C, Meyer K, Rahman O,Silverstein J, et al. Telehealth behavior therapy for the management of type 1 diabetes in adolescents. J Diabetes Sci Technol 2010;4:199‑208.

World Health Organization and International Diabetes Federation.Diabetes action now: An initiative of World Health Organization International Diabetes Federation. Available from: http://www.who.int/entity/diabetes/actionnow/en/consultation. [Last accessed on 2012 May 02].

Maria P, Gerry R, Nicola S, Elizabeth M, Anne R, Anne K, et al.Self-management support interventions to reduce health care utilisation without compromising outcomes: A systematic review and meta-analysis. BMC Health Services Research 2014;14:356.

Kawaguchi T, Azuma M, Ohta K. Development of a telenursing system for patients with chronic conditions. J Telemed Telecare 2004;10:239‑44.

Pena V, Watson AJ, Kvedar JC, Grant RW. Mobile phone technology for children with type 1 and type 2 diabetes: A parent survey. J Diabetes Sci Technol 2009;3:1481‑9.

Aliha JM, Asgari M, Khayeri F, Ramazani M, Farajzadegan Z,Javaheri J. Group education and nurse‑telephone follow‑up effects on blood glucose control and adherence to treatment in type 2 diabetes patients. Int J Prev Med 2013;4:797‑802.

Zolfaghari M, Mousavifar A, Pedram S, Haghani H. The impact of nurse short message services and telephone follow‑ups on diabetic adherence: Which one is more effective? J Clin Nurs 2011;21:1922‑31.

Wong FK, Mok MP, Chan T, Tsang MW. Nurse follow-up of patients with diabetes: Randomized controlled trial. J Adv Nurs 2005;50:391‑402.

Wu L, Forbes A, Griffiths P, Milligan P, While A. Telephone follow-up to improve glycaemic control in patients with Type 2 diabetes: Systematic review and meta-analysis of controlled trials. Diabetic Med 2010;27:1217‑25.

Parizad N, Hemmati Maslakpak M, Khalkhali HR. Promoting Self‑Care in Patients with Type 2 Diabetes: Tele‑Education.Hakim Res J 2013;16:220‑7.

Lorig K, Ritter PL, Villa F, Piette JD. Spanish Diabetes Self‑Management With and Without Automated Telephone Reinforcement Two randomized trials. Diabetes Care 2008;31:408‑14.

Peimani M, Rambod C, Omidvar M, Larijani B, Ghodssi-Ghassemabadi R, Tootee A, et al. Effectiveness of short message service-based intervention (SMS) on self-care in type 2 diabetes:A feasibility study. Prim Care Diabetes 2016;10:251-8.

Tavşanlı NG, Karadakovan A, Saygili F, The use of videophone technology (telenursing) in the glycaemic control of diabetic patients: A randomized controlled trial. J Diabetes Res Clin Metab 2013;2:1‑7.

Bell AM, Fonda SJ, Walker MS, Schmidt V, Vigersky RA.Mobile phone‑based video messages for diabetes self‑care support. J Diabetes Sci Tech 2012;6:310‑9.

Karimy M, Araban M, Zareban I, Taher M, Abedi A.Determinants of adherence to self-care behavior among women with type 2 diabetes: An explanation based on health belief model. Med J Islam Repub Iran 2016;30:368.

Piette JD, Weinberger M, Kraemer FB, McPhee SJ. Impact of automated calls with nurse follow‑up on diabetes treatment outcomes in a Department of Veterans Affairs Health Care System:A Randomized Controlled Trial. Diabetes Care 2001;24:202‑8.


  • There are currently no refbacks.