Effect of Orem's Self-Care Model on self-efficacy, self-management, quality of life, and HbA1c among children with type 1 diabetes mellitus in Palestine.

BACKGROUND

Type 1 diabetes mellitus (T1DM) is a growing global and national health concern, particularly among Palestinian children who face significant psychosocial, educational, and structural barriers to optimal disease management. Effective self-care requires developmentally appropriate education that enhances self-efficacy, supports family involvement, and promotes independent diabetes self-management. Orem’s Self-Care Model provides a theoretical framework for identifying self-care deficits and guiding supportive–educative interventions. AIM: To evaluate the effect of applying Orem’s Self-Care Model on self-efficacy, diabetes self-management, quality of life (QoL), and HbA1c among children with T1DM in Hebron, Palestine.

METHODS

A quasi-experimental pretest–posttest-controlled design was conducted among 48 children aged 8–12 years attending governmental and private pediatric diabetes clinics. Participants were allocated into intervention (n = 24) and control (n = 24) groups based on clinic grouping. The intervention comprised four structured, two-hour supportive–educative sessions grounded in Orem’s model. Standard routine care was provided to the control group. Outcomes were measured using validated Arabic versions of the Children’s Self-Efficacy Scale, PedsQL 3.0 Diabetes Module, the Diabetes Self-Management Questionnaire (DSMQ), and laboratory-recorded HbA1c. Data were analyzed using paired and independent t-tests.

RESULTS

Significant improvements were observed in the intervention group for self-efficacy, self-management, QoL, and HbA1c. HbA1c decreased from 14.0% to 10.7% (p = .001), compared with a nonsignificant change in the control group (13.4% to 12.5%, p = .306). Posttest comparisons confirmed superior outcomes in the intervention group (p < .05 across variables).

CONCLUSION

Orem’s Self-Care Model significantly enhanced glycemic control and psychosocial self-care capacities among Palestinian children with T1DM. Theory-based, family-centered educational interventions represent a feasible and effective strategy for improving pediatric diabetes outcomes in resource-limited settings.