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Development of a Nurse-led Family-based Intervention for Adults with T2DM in Primary Healthcare of Bahrain

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posted on 21.03.2022, 15:03 by Khadija HasanKhadija Hasan
As the burden of diabetes continues to rise across the world, the role of nurses becomes increasingly important in diabetes management. The findings suggest that families can play an essential role in supporting patients. Nurse-led Family-based (NLFB) intervention is an important area to study in Bahrain due to the established nursing workforce and family connectedness and limited relevant research. In addressing the research question (i.e. what are the effective components of a NLFB intervention for adults with T2DM?), the PhD utilized 4 research elements (i.e. Cochrane systematic review, a qualitative study, intervention protocol development (IPD), and a Delphi study) guided by the Behavior Change Wheel (BCW) theory within the overarching Medical Research Council (MRC) framework.The Cochrane systematic review and the qualitative element establishes the literature foundation for developing a NLFB intervention. The intervention development element utilizes the BCW theory. The Delphi element obtains priority tasks of the NLFB intervention.The PhD study ultimately led to the development of a novel NLFB intervention that is evidence-based, theoretically informed, and culturally sensitive.The PhD results found a significant mean difference of HbA1c (P0.003) in the family-based intervention compared to usual care. The findings of both the qualitative, and IPD elements confirmed knowledge and training importance for the NLFB intervention and diabetes. The outcomes.The intervention development designed an intervention protocol including 15 tasks. Over 90% of nurses prioritized 15 tasks of the NLFB protocol in three rounds of iteration. The PhD study indicates that the nurse-led care was not fully understood and that nurses tended to favor the multidisciplinary team over the nurse-led approach. The study found that nurse-led approach is not mutually exclusive to the multidisciplinary team. Instead, nurse-led care was found inclusive within the multidisciplinary team. The compiled findings indicated favoring the family-based intervention, with uncertainty around the nurse-led roles in diabetes care. Such findings suggest the need for enhanced nursing capacity building that could have a positive impact on nurses’ role, thus improve diabetes care.


Dilmun PhD Grant


First Supervisor

Prof Seamus Cowman

Second Supervisor

Prof David Whitford


A thesis submitted for the degree of Doctor of Philosophy from the Royal College of Surgeons in Ireland in 2021

Published Citation

Hasan, K., Development of a Nurse-led Family-based Intervention for Adults with T2DM in Primary Healthcare of Bahrain [PhD Thesis]. Dublin: Royal College of Surgeons in Ireland 2021

Degree Name

Doctor of Philosophy (PhD)

Date of award



  • Doctor of Philosophy (PhD)

Research Area

  • Nursing and Midwifery
  • Population Health and Health Services