Limitations of the study
There were some limitations to this study. The participants were followed for only a short period of time (6 months).The
length of the study was not sufficient to examine the lasting effects of the SEEIP. Longer follow-up studies are needed to
determine whether or not the benefits can be sustained over the life course of the disease. The effects of the SEEIP in this
study might have been influenced by a Hawthorne effect due to the increased amount of attention that was paid to the
participants in the intervention group by the group facilitator; however, a standard research procedure for the intervention
was provided in order to minimize the limitation. The tool that was designed to collect the healthcare use data at
the beginning of this study considered the number of hospitalizations and the number of visits to emergency rooms to be continuous variables. Unfortunately, the participants disclosed that they found it difficult to recall exact numbers and were able only to answer “yes” or “no” to the questions. Therefore, the continuous variables were changed to categorical variables. This change might have influenced the results of this study. Moreover, other significant outcomes
(HbA1c, Body Mass Index, blood pressure, and body weight) were not measured in this study.