Outcome of a Nurse-led Diabetes Education Program on Coping Strategies and Health-related Quality of Life among Adults with Type 2 Diabetes Mellitus in Kaduna State, Nigeria: A Single-group Pre-post Study

Abstract

Type 2 diabetes mellitus (T2DM) poses a significant public health challenge in Nigeria, exacerbated by the psychosocial burden of the disease. While nurse-led education is a promising intervention, evidence regarding its impact on coping strategies and health-related quality of life (HRQoL) in Nigerian adults remains limited. A quasi-experimental pre-post study was conducted with 332 adults with T2DM across three secondary healthcare facilities in Kaduna State. Participants received a six-week structured nurse-led diabetes education program covering self-management and coping skills. Outcomes were assessed using the Brief COPE inventory and WHOQOL-BREF instrument. Data were analyzed using paired t-tests and multiple linear regression. Post-intervention, significant improvements were observed in diabetes knowledge, total coping strategies, and HRQoL (p < 0.001 for all). While adaptive coping increased, a small increase in maladaptive coping was also noted. Regression analysis indicated that post-intervention coping scores significantly predicted HRQoL (β = 0.184, p < 0.001), whereas knowledge scores did not. Tertiary education was also identified as an independent predictor of better HRQoL. In Conclusion The nurse-led education program significantly improved knowledge, coping strategies, and HRQoL. The finding that coping skills, rather than knowledge alone, predicted HRQoL suggests that educational interventions should prioritize psychological coping development. These findings support the integration of structured, coping-focused nurse-led education into routine diabetes care in low-resource settings.