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The Effect of Implementing Orem’s Self-Care Model on Balance and Fatigue in Patients With Diabetic Neuropathy: A Clinical Trial

Nurs Open. 2026 Nov;13(11):e70985. doi: 10.1002/nop2.70985.

ABSTRACT

AIM: This study aims to determine the effect of applying Orem’s self-care model on balance and fatigue in patients with diabetic neuropathy.

DESIGN: Randomized clinical trial.

METHODS: Seventy diabetic neuropathy patients referred to Shahid Mofateh Clinic, affiliated with Yasuj University of Medical Sciences (YUMS), were chosen for this clinical trial study via convenience sampling and randomly assigned to an intervention group (n = 35) or a control group (n = 35). The intervention group received care based on Orem’s self-care model from a graduate nursing student over 2 months, followed by 1 month of self-care at home. The control group received no intervention. Both groups completed the research questionnaires (the Multidimensional Fatigue Inventory and the Berg Balance Test) at pretest and posttest. Data were analysed in SPSS version 27 using an ANCOVA test.

RESULTS: Before the intervention, there were no significant between-group differences (p > 0.05). After the intervention, fatigue was significantly lower in the intervention group, with an adjusted mean difference of -9.40 points (95% CI: -11.09 to -7.71; p < 0.001; partial η2 = 0.647). Balance scores were significantly higher in the intervention group across low, mean, and high baseline levels, with adjusted mean differences of 7.01, 5.77, and 4.52 points, respectively (all p < 0.001). The group × baseline balance interaction was significant (F(1,66) = 5.69, p = 0.020; partial η2 = 0.079).

IMPLICATIONS FOR NURSING: Nurses are recommended to apply Orem’s self-care model as an effective structured intervention to reduce fatigue and improve balance in patients with diabetic neuropathy.

PATIENT OR PUBLIC CONTRIBUTION: Patients with diabetic peripheral neuropathy (diagnosed by an internist using TCSS) who participated in this randomized clinical trial evaluating Orem’s self-care model effects on balance and fatigue.

PMID:42963341 | DOI:10.1002/nop2.70985