Factors Affecting Self-Reported Diabetes Management Competency in Elementary School Nurses: A Study Based on an Ecological Approach

This study aimed to analyze factors influencing school nurses’ diabetes management competency using an ecological model encompassing individual, interpersonal, and organizational factors. Data were collected from 122 elementary school nurses through an online survey conducted from June 3 to 18, 2024. Diabetes management competency was measured using a self-report instrument assessing perceived competence. Analyses included descriptive statistics, one-way ANOVA, Pearson correlation, and hierarchical multiple regression. Results showed that competence was positively associated with experience in managing students with diabetes, participation in diabetes training, nurse–student interaction, and availability of school supplies. In the final model, nurse–student interaction (β = .33, p < .001), number of supplies (β = .31, p < .001), and participation in training (β = .18, p = .024) explained 37.8% of the variance. Given advances in diabetes care—including insulin delivery, glucose monitoring, and lifestyle-based management—school nurses must have access to up-to-date training to support students with diabetes effectively.