Nurse-Led Psychoeducational Interventions for Glycemic and Psychosocial Outcomes in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Eva Susanti,1 Cecep Eli Kosasih,2 Ayu Prawesti Priambodo,2 Neti Juniarti,3 Muhammad Afiif Aziz,4 Reni Afriana4 1Doctoral Program in Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, Indonesia; 2Department of Critical Care and Emergency Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, Indonesia; 3Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, Indonesia; 4Master’s Program in Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, IndonesiaCorrespondence: Eva Susanti, Doctoral Program in Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, Indonesia, Tel +62 852-9218-1635, Email [email protected]: Conventional didactic education may be limited in addressing the psychosocial complexities of Type 2 Diabetes Mellitus (T2DM). Nurse-led multicomponent psychoeducational interventions provide a potential approach by integrating clinical and psychosocial support. This study aims to evaluate the glycemic and psychosocial outcomes of these interventions through a systematic review and meta-analysis.Methods: A systematic search was conducted across PubMed, Scopus, and EBSCOhost following PRISMA 2020 guidelines. Methodological quality was assessed using the Cochrane Risk of Bias tool. A meta-analysis using a random-effects model was performed for the primary outcome (HbA1c), while psychosocial outcomes were synthesized narratively in accordance with SWiM guidelines.Results: Fifteen primary studies involving diverse global cohorts were synthesized. Nine of the 15 trials showed statistically significant HbA1c reductions favoring the intervention group. Meta-analysis of 13 trials (n=3,568) revealed a pooled HbA1c reduction of − 0.69% (95% CI: − 1.00 to − 0.37; P < 0.0001). Sensitivity analysis, excluding two outliers, indicated a stable mean difference (MD) of − 0.51% (95% CI: − 0.69 to − 0.32; P < 0.00001) and substantially reduced heterogeneity in long-term subgroups (I-squared decreased from 96% to 23%). Beyond glycemic outcomes, the synthesis suggests that interventions combining emotional validation with structured behavioral action particularly those utilizing motivational interviewing and cognitive-behavioral techniques show potential in reducing diabetes distress and enhancing self-efficacy.Conclusion: Current meta-analytical evidence suggests that nurse-led multicomponent interventions may help bridge the gap between clinical requirements and humanistic needs, showing potential improvements in both HbA1c and psychosocial well-being. Based on these synthesized findings, this review presents the Education, Validation, and Action (EVA-Diabetes Care Model) framework as an exploratory conceptual model, positing that emotional validation may support sustained behavioral modification. Future well-powered, prospective, multicenter randomized controlled trials are required to empirically validate the clinical efficacy and long-term sustainability of the EVA-Diabetes Care Model protocol.Keywords: type 2 diabetes mellitus, nurse-led interventions, meta-analysis, HbA1c, diabetes distress, EVA-Diabetes Care Model