Family health nursing interventions for the digital empowerment of families of people with diabetes: scoping review
DOI:
https://doi.org/10.29352/mill0224e.45179Keywords:
diabetes mellitus; family nursing; family; health literacy; digital healthAbstract
Introduction: Diabetes mellitus is a chronic condition with significant individual and family impact, requiring role reorganization, the acquisition of competencies, and shared decision-making. The development of digital health technologies has created opportunities to support diabetes self-management, with the Family Health Nurse Specialist playing a mediating role in promoting the digital empowerment of families in community settings.
Objective: To map the scientific evidence on Family Health Nursing interventions that promote the digital empowerment of families of people with diabetes in community settings.
Methods: A scoping review was conducted according to the Joanna Briggs Institute methodology and the PRISMA-ScR guidelines. The search was performed in the PubMed and CINAHL databases without time restrictions and included studies published in Portuguese, English, and Spanish. Study selection and data extraction were carried out by independent reviewers, followed by narrative analysis and synthesis of the findings.
Results: Eight studies were included, from which three intervention axes emerged: family-centred care, health literacy, and teleassistance, including telemonitoring strategies, remote coaching, automated calls, and remote consultations. The interventions demonstrated improvements in self-management, treatment adherence, health literacy, and family involvement.
Conclusion: The evidence indicates that nursing interventions integrating family involvement, health literacy, and digital resources contribute to family empowerment and more effective diabetes management in community settings. However, gaps remain regarding the visibility of the role of the Family Health Nurse Specialist.
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Afonso, C., Spínola, A. C., Reis, A., Godinho, C., Saragoila, F., Rosa, M., & Melo, P. (2025). Young natives, migrants, stakeholders and health decisions at school: Scoping review protocol. Millenium - Journal of Education, Technologies, and Health, 2(17e), e39138. https://doi.org/10.29352/mill0217e.39138
Agency for Healthcare Research and Quality. (2021). Improving healthcare through AHRQ's digital healthcare research program: 2020 year in review. https://digital.ahrq.gov/2020-year-review
American Diabetes Association Professional Practice Committee. (2022). Facilitating behavior change and well-being to improve health outcomes: Standards of medical care in diabetes—2022. Diabetes Care, 45(Suppl. 1), S60–S82. https://doi.org/10.2337/dc22-S005
Arias López, M. del P., Ong, B. A., Borrat Frigola, X., Fernández, A. L., Hicklent, R. S., Obeles, A. J. T., Rocimo, A. M., & Celi, L. A. (2023). Digital literacy as a new determinant of health: A scoping review. PLOS Digital Health, 2(10), e0000279. https://doi.org/10.1371/journal.pdig.0000279
Azmiardi, A., Murti, B., Febrinasari, R. P., & Tamtomo, D. G. (2021). The effect of peer support in diabetes self-management education on glycemic control in patients with type 2 diabetes: A systematic review and meta-analysis. Epidemiology and Health, 43, e2021090. https://doi.org/10.4178/epih.e2021090
Busebaia, T. J. A., Thompson, J., Fairbrother, H., & Ali, P. (2023). The role of family in supporting adherence to diabetes self‐care management practices: An umbrella review. Journal of Advanced Nursing, 79(10), 3652–3677. https://doi.org/10.1111/jan.15689
De la Fuente Coria, M. C., Cruz-Cobo, C., & Santi-Cano, M. J. (2020). Effectiveness of a primary care nurse delivered educational intervention for patients with type 2 diabetes mellitus in promoting metabolic control and compliance with long-term therapeutic targets: Randomised controlled trial. International Journal of Nursing Studies, 101, 103417. https://doi.org/10.1016/j.ijnurstu.2019.103417
Figueiredo, M., Nené, M., & Sequeira, C. (2023). Enfermagem de Saúde Familiar (1.ª ed.). Lidel.
Gama, C. A. P. da, Bicalho, J. M. F., Dupin, T. O., Fonseca, P. da C., Dias, M. E. L., & Moreira, M. F. E. (2022). Estratégia de saúde da família e adesão ao tratamento do diabetes: Fatores facilitadores. Revista Baiana de Saúde Pública, 45(1), 11–35. https://doi.org/10.22278/2318-2660.2021.v45.n1.a3285
Greenwood, D. A., Gee, P. M., Fatkin, K. J., & Peeples, M. (2017). A systematic review of reviews evaluating technology-enabled diabetes self-management education and support. Journal of Diabetes Science and Technology, 11(5), 1015–1027. https://doi.org/10.1177/1932296817713506
Hebert, M. A., & Korabek, B. (2004). Stakeholder readiness for telehomecare: Implications for implementation. Telemedicine Journal and E-Health, 10(1), 85–92. https://doi.org/10.1089/153056204773644625
International Diabetes Federation. (2021). IDF Diabetes Atlas (10th ed.). International Diabetes Federation. https://diabetesatlas.org/atlas/tenth-edition/
Isidori, V., Diamanti, F., Gios, L., Malfatti, G., Perini, F., Nicolini, A., Longhini, J., Forti, S., Fraschini, F., Bizzarri, G., & Brancorsini, S. (2022). Digital technologies and the role of health care professionals: Scoping review exploring nurses' skills in the digital era and in the light of the COVID-19 pandemic. JMIR Nursing, 5(1), e37631. https://doi.org/10.2196/37631
Kenealy, T. W., Parsons, M. J. G., Rouse, A. P. B., Doughty, R. N., Sheridan, N. F., Hindmarsh, J. K. H., Masson, S. C., & Rea, H. H. (2015). Telecare for diabetes, CHF or COPD: Effect on quality of life, hospital use and costs. A randomised controlled trial and qualitative evaluation. PLOS ONE, 10(3), e0116188. https://doi.org/10.1371/journal.pone.0116188
Khalil, H., Bennett, M., Godfrey, C., McInerney, P., Munn, Z., & Peters, M. (2020). Evaluation of the JBI scoping reviews methodology by current users. International Journal of Evidence-Based Healthcare, 18(1), 95–100. https://doi.org/10.1097/XEB.0000000000000202
Macedo, M. M. L., Cortez, D. N., Santos, J. C. dos, Reis, I. A., & Torres, H. de C. (2017). Adesão e empoderamento de usuários com diabetes mellitus para práticas de autocuidado: Ensaio clínico randomizado. Revista da Escola de Enfermagem da USP, 51, e03278. https://doi.org/10.1590/s1980-220x2016050303278
Marcolino, M. S., Oliveira, J. A. Q., D’Agostino, M., Ribeiro, A. L., Alkmim, M. B. M., & Novillo-Ortiz, D. (2018). The impact of mHealth interventions: Systematic review of systematic reviews. JMIR mHealth and uHealth, 6(1), e23. https://doi.org/10.2196/mhealth.8873
Martins, M., Reis, A., & Afonso, C. (2026). Family health nursing interventions to promote breastfeeding in the context of parenthood: Scoping review. Millenium - Journal of Education, Technologies, and Health, 2(22e), e43616. https://doi.org/10.29352/mill0222e.43616
Matrook, K. A., Cowman, S., Pertl, M., & Whitford, D. (2024). Nurse-led family-based approach in primary health care for patients with type 2 diabetes mellitus: A qualitative study. International Journal of Qualitative Studies on Health and Well-Being, 19(1), 2323060. https://doi.org/10.1080/17482631.2024.2323060
Mayberry, L. S., & Osborn, C. Y. (2014). Family involvement is helpful and harmful to patients’ self-care and glycemic control. Patient Education and Counseling, 97(3), 418–425. https://doi.org/10.1016/j.pec.2014.09.011
Meleis, A. I., Sawyer, L. M., Im, E.-O., Hilfinger Messias, D. K., & Schumacher, K. (2000). Experiencing transitions: An emerging middle-range theory. Advances in Nursing Science, 23(1), 12–28. https://doi.org/10.1097/00012272-200009000-00006
Mihevc, M., Lukančič, M. M., Zavrnik, Č., Virtič Potočnik, T., Šter, M. P., Klemenc-Ketiš, Z., & Susič, A. P. (2024). Towards integrated care for the elderly: Exploring the acceptability of telemonitoring for hypertension and type 2 diabetes management. International Journal of Integrated Care, 24, 16. https://doi.org/10.5334/ijic.7621
Miranda, J. B. M. L., Afonso, C., & Spínola, A. C. (2025a). Empowerment of the school community for youth health literacy: Scoping review. Millenium - Journal of Education, Technologies, and Health, 2(27), e40142. https://doi.org/10.29352/mill0227.40142
Miranda, J. B. M. L., Afonso, C., & Spínola, A. C. (2025b). Empowerment of the school community to promote health literacy among young people: Scoping review protocol. Millenium - Journal of Education, Technologies, and Health, 2(17e), e39124. https://doi.org/10.29352/mill0217e.39124
Mogueo, A., & Defo, B. K. (2022). Patients’ and family caregivers’ experiences and perceptions about factors hampering or facilitating patient empowerment for self-management of hypertension and diabetes in Cameroon. BMC Health Services Research, 22(1), 1381. https://doi.org/10.1186/s12913-022-08750-4
Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18(1), 143. https://doi.org/10.1186/s12874-018-0611-x
Organização Mundial da Saúde. (2021). Estrategia mundial sobre salud digital 2020–2025. https://shre.ink/jZjW
Pamungkas, R., Chamroonsawasdi, K., & Vatanasomboon, P. (2017). A systematic review: Family support integrated with diabetes self-management among uncontrolled type II diabetes mellitus patients. Behavioral Sciences, 7(3), 62. https://doi.org/10.3390/bs7030062
Pérez-Cuevas, R., Reyes Morales, H., Doubova, S. V., Zepeda Arias, M., Díaz Rodríguez, G., Peña Valdovinos, A., & Muñoz Hernández, O. (2009). Atención integral de pacientes diabéticos e hipertensos con participación de enfermeras en medicina familiar. Revista Panamericana de Salud Pública, 26(6), 511–517. https://doi.org/10.1590/S1020-49892009001200006
Peters, M. D. J., Godfrey, C. M., Khalil, H., McInerney, P., Parker, D., & Soares, C. B. (2015). Guidance for conducting systematic scoping reviews. International Journal of Evidence-Based Healthcare, 13(3), 141–146. https://doi.org/10.1097/XEB.0000000000000050
Peters, M. D. J., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., McInerney, P., Godfrey, C. M., & Khalil, H. (2020). Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Synthesis, 18(10), 2119–2126. https://doi.org/10.11124/JBIES-20-00167
Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., Maryniuk, M. D., Siminerio, L., & Vivian, E. (2020). Diabetes self-management education and support in adults with type 2 diabetes: A consensus report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care, 43(7), 1636–1649. https://doi.org/10.2337/dci20-0023
Regulamento n.º 428/2018. (2018). Regulamento de competências específicas do enfermeiro especialista em enfermagem comunitária na área de enfermagem de saúde comunitária e de saúde pública e na área de enfermagem de saúde familiar. Diário da República, 2.ª série (135), 19354–19361. https://shre.ink/jZjU
Seng, J. J. B., Nyanavoli, H., Decruz, G. M., Kwan, Y. H., & Low, L. L. (2025). Health coaching and its impact in the remote management of patients with type 2 diabetes mellitus: Scoping review of the literature. Journal of Medical Internet Research, 27, e60703. https://doi.org/10.2196/60703
Silva, S. de O., Moreira, A. C. A., Centenaro, A. P. F. C., Girardon-Perlini, N. M. O., Weiller, T. H., & Schimith, M. D. (2025). Nursing consultation and diabetes: an educational and transformative process for primary health care. Revista Latino-Americana de Enfermagem, 33, e4464. https://doi.org/10.1590/1518-8345.7546.4464
Subrata, S. A. (2021). The nursing outlook of the self- and family management support programs among Indonesian with diabetes: An umbrella review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 15(1), 109–119. https://doi.org/10.1016/j.dsx.2020.12.018
Teles, M., Reis, A., & Afonso, C. (2026). The hospital-home transition of families in neonatal context: Family nursing contributions - scoping review. Millenium - Journal of Education, Technologies, and Health, 2(22e), e43471. https://doi.org/10.29352/mill0222e.43471
Thürlimann, E., Verweij, L., & Naef, R. (2022). The implementation of evidence-informed family nursing practices: A scoping review of strategies, contextual determinants, and outcomes. Journal of Family Nursing, 28(3), 258–276. https://doi.org/10.1177/10748407221099655
Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., … Straus, S. E. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850
Wright, L. M., & Leahey, M. (2013). Enfermeiras e famílias: guia para avaliação e intervenção na família (5.ª ed.). Roca.
Yuen, E. Y. K., Winter, N., Savira, F., Anderson, K., & Wong, C. K. H. (2024). Digital health literacy and its association with sociodemographic characteristics, health resource use, and health outcomes: Rapid review. Interactive Journal of Medical Research, 13, e46888. https://www.i-jmr.org/2024/1/e46888/
Zupa, M. F., Piette, J. D., Stoll, S. C., Obrosky, S. D., Kelly, M. B., Youk, A. O., Overholt, L., Trivedi, R., Rosland, A.-M., & Heisler, M. (2021). Patient and supporter factors affecting engagement with diabetes telehealth. The American Journal of Managed Care, 27(10), 409–414. https://doi.org/10.37765/ajmc.2021.88758
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