Applying timing theory to nursing case management of type 2 diabetes mellitus: A clinical retrospective study

This study investigates the impact of a timing theory-based case management model on inpatient management efficiency, self-management capacity, and complication rates in patients with type 2 diabetes mellitus (T2DM). We retrospectively analyzed 120 inpatients with T2DM admitted between December 2023 and March 2024. Patients were divided into 2 groups based on the type of nursing care they received: an observation group (n = 60), which received a timing theory-based case management model, and a control group (n = 60), which received routine nursing care. The timing theory-based model structured nursing interventions into 5 progressive stages - diagnosis, stabilization, preparation, implementation, and adaptation - designed to align with patients' physical and psychological needs throughout the disease course. Primary outcomes included length of hospital stay, HbA1c target achievement rate, diabetes self-management questionnaire scores, psychological status (depression-anxiety-stress scale), and incidence of complications. Compared with the control group, the observation group had a shorter average hospital stay (8.56 ± 3.45 vs 10.34 ± 3.84 days, P < .001) and a 16.67% higher rate of achieving HbA1c goals (66.67% vs 50.00%, P = .041). Total diabetes self-management questionnaire scores (40.70 ± 3.50 vs 33.00 ± 3.80) and subscale scores - such as medication adherence and dietary control - were significantly better in the observation group (all P < .001). Post-intervention, scores for depression (10.46 ± 3.84 vs 15.51 ± 3.93) and anxiety (9.78 ± 3.73 vs 13.37 ± 3.96) were notably lower (both P < .001). The overall complication rate decreased by 26.66% (16.67% vs 43.33%, P = .007), while complete treatment adherence improved by 13.3% (50.0% vs 36.7%, P = .013). A timing theory-based case management model can significantly shorten hospital stays, enhance self-management and psychological well-being, and reduce the risk of complications in T2DM patients. These findings provide practical evidence for comprehensive diabetes care and offer new perspectives for long-term T2DM management.