Background: Tuberculosis and diabetes mellitus (TBDM) comorbidity poses a major public health challenge, particularly in rural Indonesia, where fragmented services and limited healthcare access worsen patient outcomes. Despite global recognition of nurse-led care models, there is limited evidence on their application in rural, community-based TBDM management within Indonesia. This study introduces NaCo-Care (Nurse-Led and Collaborative Community Care), an integrated model designed to strengthen nursing leadership and interdisciplinary collaboration at the primary healthcare level.
Methods: The study comprises four stages: (1) initial epidemiological mapping of TBDM in Jember (descriptive spatial study); (2) iterative development of the NaCo-Care model based on patient and provider input (mixed-methods exploratory); (3) validation of the model through expert panel discussions (Delphi method) and usability testing; and (4) a quasi-experimental pretest-posttest with a control group design to assess the model's effectiveness. Key outcome measures include changes in HbA1c levels, systemic inflammatory and immunological responses (via MRT, AFB, and ELISA), treatment adherence (MMAS-8), and patient quality of life (WHOQOL-BREF). Data will be analyzed using descriptive statistics, thematic analysis, CVI, and ANCOVA.
Expected Results: The NaCo-Care intervention group is expected to show significant improvement in glycemic control, biomarker profiles, medication adherence, and quality of life compared to controls, sustained over a six-month follow-up.
Conclusion: This study is anticipated to provide empirical evidence for the effectiveness of a nurse-led, community-based intervention for TBDM in rural Indonesia, addressing a key gap in integrated chronic disease management.
Type of Study:
Study Protocol |
Subject:
● Service Quality Received: 2025/09/13 | Accepted: 2026/01/27 | Published: 2026/08/23