Effect of Nurse-led Education on Health-related Quality of Life among Diabetes Mellitus Patients at Secondary Healthcare Facilities in Kaduna State, Nigeria

Abstract

Background: This study evaluated the impact of nurse-led education on health-related quality of life (HRQoL) among patients with type 2 diabetes mellitus (T2DM) attending secondary healthcare facilities in Kaduna State, Nigeria. Objective: The aim was to determine changes in HRQoL across physical, psychological, social, and environmental domains following a structured nurse-led educational intervention. Methods: A quasi-experimental pre–post design was used, involving 332 adults with T2DM recruited from secondary healthcare facilities in Kaduna South and Chikun Local Government Areas. Participants attended three weekly nurse-led education sessions covering self-management, coping strategies, lifestyle modification, and medication adherence. HRQoL was assessed at baseline and four weeks post-intervention using the WHOQOL-BREF. Paired t-tests compared mean scores, with effect sizes calculated using Cohen’s d. Results: Significant improvements were observed in all HRQoL domains. Physical health scores increased from 54.2 to 61.0 (d=0.68, p<0.001) and psychological well-being from 51.5 to 57.4 (d=0.61, p<0.001). Social relationships (56.3 to 59.5; d=0.29, p<0.001) and environmental factors (58.9 to 61.0; d=0.23, p<0.001) also improved, though with smaller effect sizes. Subdomain analysis showed gains in daily activities, energy, mobility, positive feelings, and self-esteem. Conclusion: Nurse-led education produced meaningful improvements in physical and psychological health, with additional benefits in social and environmental well-being. Integrating structured nurse-led education into routine diabetes care could enhance self-management and overall quality of life for T2DM patients in similar resource-constrained settings.