A Family Empowerment Model Based on Family-Centered Care (FCC) in Managing Type 2 Diabetes Mellitus in Rural Communities

Authors

  • Anih Kurnia Diploma of Nursing Program, Faculty of Health Sciences, Universitas Bakti Tunas Husada, Tasikmalaya, Indonesia
  • Miftahul Falah Department of Nursing, Faculty of Health Science, Universitas Muhammadiyah Tasikmalaya, Tasikmalaya, Indonesia
  • Teti Agustin Diploma of Nursing Program, Faculty of Health Sciences, Universitas Bakti Tunas Husada, Tasikmalaya, Indonesia
  • Ida Rosidawati Department of Nursing, Faculty of Health Sciences, Universitas Muhammadiyah Tasikmalaya, Tasikmalaya, Indonesia

DOI:

https://doi.org/10.35568/healthcare.v7i2.6675

Keywords:

Family empowerment, family-centered care, type 2 diabetes, rural health, qualitative research

Abstract

Background: Type 2 diabetes mellitus (T2DM) poses a significant burden among older adults in rural communities due to limited health literacy, inadequate access to services, and deeply rooted cultural practices. Family involvement is often essential yet unsupported by structured interventions.

Purpose: This study aimed to develop a culturally contextual Family Empowerment Model based on Family-Centered Care (FCC) to strengthen diabetes self-management among older adults with T2DM in rural settings.

Methods: A descriptive qualitative design was employed, involving 21 participants (older adults, family caregivers, and health workers) from Sukamaju Village, Tasikmalaya, Indonesia. Data were collected through in-depth interviews and focus group discussions, and analyzed using Braun and Clarke’s thematic analysis framework.

Results: Four main themes were identified: (1) Family as the first line of care, (2) Cultural and spiritual values in caregiving, (3) Need for empowerment and health literacy, and (4) Community health workers as bridging agents. These findings informed a structured empowerment model encompassing family roles, cultural alignment, health education, and community engagement.

Conclusion: The FCC-based Family Empowerment Model offers a comprehensive, culturally appropriate approach to improve T2DM care in rural areas. It has the potential to enhance self-care capacity, reduce caregiver burden, and strengthen community-based health systems.

 

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References

Abu, S., & Llahana, S. (2025). Factors influencing the uptake of culturally tailored diabetes self-management education and support programmes among ethnic minority patients with type 2 diabetes: A systematic review. Primary Care Diabetes, 19(2), 103–110. https://doi.org/https://doi.org/10.1016/j.pcd.2025.01.010

Boswell, E., Probst, J., Hung, P., Herbert, L., & Crouch, E. (2024). Rural-Urban Differences in Self-Reported Participation in Diabetes Self-Management Education. Journal of Public Health Management and Practice, 30(6). https://journals.lww.com/jphmp/fulltext/2024/11000/rural_urban_differences_in_self_reported.5.aspx

Braun, V., & and Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Bui, D., Huyen, T., Thi, A. N., Vu, D., Kim, T., Minh, H. Le, Gammeltoft, T., & Vestergaard, A. R. (2023). Mobilizing morality : how caregivers in Vietnam handle the challenges of daily diabetes care. BMC Public Health, 1–9. https://doi.org/10.1186/s12889-023-16691-8

Care, D., & Suppl, S. S. (2024). 11 . Chronic Kidney Disease and Risk Management : Standards of Care in Diabetes — 2024. Diabetes Care, 47(January), 219–230.

Chaimongkon, S., Sakulwattana, W., Ong-artborirak, P., Liyanage, E., & Seangpraw, K. (2025). Health Literacy and Behaviors of Patients and Caregivers Related to Glycemic Control Among Individuals With Type 2 Diabetes in Chiang Mai Health Literacy and Behaviors of Patients and Caregivers Related to Glycemic Control Among Individuals With Type 2 Di. Patient Preference and Adherence ISSN:, 19, 753–765. https://doi.org/10.2147/PPA.S501095

Curtis, L. M., Davis, T. C., Arnold, C. L., Gan, J. M., Jean, C., Hur, S., Kwasny, M. J., Wolf, M. S., Hadden, K., Curtis, L. M., Davis, T. C., Arnold, C. L., Gan, J. M., Jean, C., Hur, S., Kwasny, M. J., Wolf, M. S., & Effectiveness, K. H. (2024). Effectiveness of a health literacy intervention to improve diabetes outcomes in rural family medicine clinics : a randomized pragmatic trial. Health Literacy and Communication Open, 2(1). https://doi.org/10.1080/28355245.2024.2382133

Desse, T. A., Namara, K. M., & Manias, E. (2024). Patient-Perceived Challenges to Type 2 Diabetes Self-Management in Sub-Saharan Africa: A Qualitative Exploratory Study. Science of Diabetes Self-Management and Care. https://doi.org/10.1177/26350106241279809

Gudlavalleti, A. G., Babu, G. R., & Kamalakannan, S. (2024). Training of Community Health Workers in Diabetes Lead to Improved Outcomes for Diabetes Screening and Management in Low- and Middle-Income Countries : Protocol for a Systematic Review Corresponding Author : JMIR Research Protocols, 13, 1–8. https://doi.org/10.2196/57313

Huyen, D., Bui, T., Nguyen, B. X., Jens, S., Id, T. M. G., Bygbjerg, I. C., Nielsen, J., & Meyrowitsch, D. W. (2024). Informal caregiving among people supporting a person with type 2 diabetes in rural communities of Northern Vietnam : A cross-sectional study of caregiver burdens. PLoS ONE, 1–13. https://doi.org/10.1371/journal.pone.0304821

Kuo, D. Z., Houtrow, A. J., Arango, P., Neff, J. M., Family-centered, K. F. Á., & Patient-centered, Á. (2012). Family-Centered Care : Current Applications and Future Directions in Pediatric Health Care American Academy of Pediatrics. Matern Child Health, 16, 297–305. https://doi.org/10.1007/s10995-011-0751-7

Makmuriana, L., Glorino, M., Pandin, R., & Sukartini, T. (2024). Philosophy of Family-Centered Nursing in Patient Diabetes Type 2 : A Systematic Literature Review and Meta-Analysis Philosophy of Family-Centered Nursing in Patient Diabetes Type 2 : A Systematic Literature Review and. 0–13. https://doi.org/10.20944/preprints202412.0313.v1

Meiliana, S. W., Kristianingrum, N. D., & Kartika, A. W. (2024). The Burden of Family Caregivers in the Care of Type 2 Diabetes Mellitus Patients: A Literature Review. Journal of Rural Community Nursing Practice (JRCNP), 2(1), 40–47.

Molla, I. B., Hagger, V., Rothmann, M. J., & Rasmussen, B. (2025). The Role of Community Organisation, Religion, Spirituality and Cultural Beliefs on Diabetes Social Support and Self-Management in Sub-Saharan Africa: Integrative Literature Review. In Journal of Religion and Health (Issue 0123456789). Springer US. https://doi.org/10.1007/s10943-024-02233-y

Moody, J. G. (2025). Spiritual Self-Care Practices, Diabetes Knowledge, and Diabetes Self-Care Practices for African Americans. Journal of Holistic Nursing, 43(1), 38–48.

Munir, M. (2025). Correlation of Self-empowerment and Family Support with the Quality of Life of Diabetes Mellitus Patients. Malaysian Journal Nursing, 16(April), 77–86. https://doi.org/10.31674/mjn.2025.v16i04.008

Parasuraman, G., Jeemon, P., Thankappan, K. R., Ali, M. K., Mahal, A., Mcpake, B., Chambers, J., Absetz, P., Thirunavukkarasu, S., Nabil, A. M., Valsa, S., Kripa, S., Akshay, P. K., Ayyasamy, L., & Nambirajan, M. K. (2024). Community Control of Hypertension and Diabetes ( CoCo-HD ) program in the Indian states of Kerala and Tamil Nadu : a study protocol for a type 3 hybrid trial. BMC Public Health, 24(2275), 1–12.

Ragavan, M. I., Hewitt, B., Mickievicz, E., Laubacher, C., Harrison, C., Ray, K. N., Carpenter, A., Williams, L., Geer, B. W., & Garg, A. (2025). Health-Related Social Needs Intervention for Adolescents and Young Adults With Type 2 Diabetes and Their Caregivers: An Exploratory Study Using Human-Centered Design. Community Health Equity Research & Policy, 2752535X251316990.

Rondhianto, R., Kushariyadi, K., & Rahmatullah, M. N. (2024). The Effect of Family Caregiver Empowerment Model Intervention on Fear of Hypoglycemia in People with Type-2 Diabetes Mellitus. Nurse Media Journal of Nursing, 14(2), 267–278.

Sari, R. Y., Septianingrum, Y., Faizah, I., Rohmawati, R., & Muhith, A. (2024). Spiritual Diabetes Self-Management Health Coaching Against Psychological Well-Being and Self-Management Compliance in Diabetes Mellitus Patients. South Eastern European Journal of Public Health, 183–192. https://doi.org/10.70135/seejph.vi.836

Tang, R., Luo, D., Li, B., Wang, J., & Li, M. (2023). The role of family support in diabetes self‐management among rural adult patients. Journal of Clinical Nursing, 32(19–20), 7238–7246.

Tu, J., & Liao, J. (2021). Primary care providers ’ perceptions and experiences of family-centered care for older adults : a qualitative study of community-based diabetes management in. BMC Geriatrics, 21(438), 1–10.

Virtič Potočnik, T., Ružić Gorenjec, N., Mihevc, M., Zavrnik, Č., Mori Lukančič, M., Poplas Susič, A., & Klemenc-Ketiš, Z. (2024). Person-centred diabetes care: examining patient empowerment and diabetes-specific quality of life in Slovenian adults with type 2 diabetes. Healthcare, 12(9), 899.

Zan, H., Meng, Z., Li, J., Zhang, X., & Liu, T. (2024). Factors associated with quality of life among elderly patients with type 2 diabetes mellitus: the role of family caregivers. BMC Public Health, 24(1), 1–9. https://doi.org/10.1186/s12889-024-17917-z

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Published

2025-07-31