Application of a theoretical framework to foster a cardiac-diabetes self-management programme


  • C.-J. (Jo) Wu RN, DrHlthSc, FACN,

    Senior Research Fellow, Corresponding author
    1. School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Australia
    • Correspondence address: Dr Chiung-Jung (Jo) Wu, School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences Australian Catholic University, 1100 Nudgee Road, Banyo, Qld 4014, Australia; Tel: +61 7 3623 7889; Fax: +61 7 3623 7105; E-mail:;

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  • A.M. Chang RN, PhD, FRCNA

    1. School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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  • Conflict of interest: The authors declare that they have no competing conflict of interest.



This paper analyses and illustrates the application of Bandura's self-efficacy construct to an innovative self-management programme for patients with both type 2 diabetes and coronary heart disease.


Using theory as a framework for any health intervention provides a solid and valid foundation for aspects of planning and delivering such an intervention; however, it is reported that many health behaviour intervention programmes are not based upon theory and are consequently limited in their applicability to different populations. The cardiac-diabetes self-management programme has been specifically developed for patients with dual conditions with the strategies for delivering the programme based upon Bandura's self-efficacy theory. This patient group is at greater risk of negative health outcomes than that with a single chronic condition and therefore requires appropriate intervention programmes with solid theoretical foundations that can address the complexity of care required.

Sources of Evidence

The cardiac-diabetes self-management programme has been developed incorporating theory, evidence and practical strategies.


This paper provides explicit knowledge of the theoretical basis and components of a cardiac-diabetes self-management programme. Such detail enhances the ability to replicate or adopt the intervention in similar or differing populations and/or cultural contexts as it provides in-depth understanding of each element within the intervention.


Knowledge of the concepts alone is not sufficient to deliver a successful health programme. Supporting patients to master skills of self-care is essential in order for patients to successfully manage two complex, chronic illnesses.

Implications for Nursing Practice or Health Policy

Valuable information has been provided to close the theory-practice gap for more consistent health outcomes, engaging with patients for promoting holistic care within organizational and cultural contexts.