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Chatwin H, Broadley M, de Galan B, Bazelmans E, Speight J, Pouwer F, Nefs G. Effectiveness of educational and behavioural interventions for reducing fear of hypoglycaemia among adults with type 1 diabetes: Systematic review and meta-analyses. Diabet Med 2023; 40:e15071. [PMID: 36807935 DOI: 10.1111/dme.15071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 02/02/2023] [Accepted: 02/16/2023] [Indexed: 02/20/2023]
Abstract
AIMS To summarize and critically appraise evidence regarding the effectiveness of educational and/or behavioural interventions in reducing fear of hypoglycaemia among adults with type 1 diabetes. METHODS Systematic searches of medical and psychology databases were conducted. Risk-of-bias was assessed using the Joanna Briggs Institute Critical Appraisal Tools. Data were synthesized using random-effects meta-analyses for randomized controlled trials (RCTs) and narrative synthesis for observational studies. RESULTS Five RCTs (N = 682) and seven observational studies (N = 1519) met the inclusion criteria, reporting on behavioural, structured education and cognitive-behavioural therapy (CBT) interventions. Most studies assessed fear of hypoglycaemia using the Hypoglycaemia Fear Survey Worry (HFS-W) and Behaviour (HFS-B) subscales. Mean fear of hypoglycaemia at baseline was relatively low across studies. Meta-analyses showed a significant effect of interventions on HFS-W (SMD = -0.17, p = 0.032) but not on HFS-B scores (SMD = -0.34, p = 0.113). Across RCTs, Blood Glucose Awareness Training (BGAT) had the largest effect on HFS-W and HFS-B scores, and one CBT-based program was as effective as BGAT in reducing HFS-B scores. Observational studies showed that Dose Adjustment for Normal Eating (DAFNE) was associated with significant fear of hypoglycaemia reductions. CONCLUSIONS Current evidence suggests that educational and behavioural interventions can reduce fear of hypoglycaemia. However, no study to date has examined these interventions among people with high fear of hypoglycaemia.
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Affiliation(s)
- Hannah Chatwin
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Melanie Broadley
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Bastiaan de Galan
- Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, Netherlands
- CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, Netherlands
| | - Ellen Bazelmans
- Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Jane Speight
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense, Denmark
- Department of Medical Psychology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Giesje Nefs
- Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg, Netherlands
- Diabeter, Center for Type 1 Diabetes Care and Research, Rotterdam, Netherlands
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2
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Pérez‐Fernández A, Fernández‐Berrocal P, Gutiérrez‐Cobo MJ. The relationship between well-being and HbA1c in adults with type 1 diabetes: A systematic review. J Diabetes 2023; 15:152-164. [PMID: 36796311 PMCID: PMC9934956 DOI: 10.1111/1753-0407.13357] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Diabetes has been associated with psychological problems, which in turn have been related to poorer glycemic control (glycosylated hemoglobin [HbA1c]). On the contrary, psychological well-being constructs have been associated with superior medical outcomes, including better HbA1c. AIM The main objective of this study was to systematically review the existing literature about the relationships between subjective well-being (SWB) and HbA1c in adults with type 1 diabetes (T1D). METHODS Comprehensive searches were conducted in PubMed, Scopus, and Medline, time restricted to 2021, for studies examining the link between HbA1c and the cognitive (CWB) and affective (AWB) components of SWB. A total of 16 eligible studies were selected according to the inclusion criteria, of which 15 measured CWB and 1 AWB. RESULTS Of the 15 studies included, 11 showed a relationship between CWB and HbA1c, with a higher level of HbA1c being related to poorer CWB. The other four studies did not find any significant association. Finally, the only study examining the relationship between AWB and HbA1c found a marginally association between these variables in the expected direction. CONCLUSION The overall data suggest that CWB is negatively related to HbA1c in this population, but these results are inconclusive. This systematic review offers clinical implications, such as the possible evaluation, prevention, and treatment of the problems associated with diabetes through the study and training of the psychosocial variables that may directly influence SWB. Limitations and future lines of investigation are discussed.
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Affiliation(s)
- Aida Pérez‐Fernández
- Department of Basic Psychology, Faculty of PsychologyUniversity of MálagaMálagaSpain
| | | | - María José Gutiérrez‐Cobo
- Department of Developmental and Educational Psychology, Faculty of PsychologyUniversity of MálagaMálagaSpain
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3
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Determinants of blood glucose control among people with Type 2 diabetes in a regional hospital in Ghana. PLoS One 2021; 16:e0261455. [PMID: 34936668 PMCID: PMC8694475 DOI: 10.1371/journal.pone.0261455] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 12/02/2021] [Indexed: 11/19/2022] Open
Abstract
Aims To assess the determinants of glycaemic control among patients with Type 2 diabetes mellitus (T2DM) presenting at the Greater Accra Regional Hospital, Ghana. Methods The study employed semi-structured questionnaires and review of clinical records of patients 16 years and above with Type 2 Diabetes. Results The mean age of participants was 56.6 ± 13.8 years, with majority (71.6%) being females. A total of 161 (59.4%) of patients had poor glycaemic control (HbA1c ≥8.1%; 95% CI: 53.6 to 65.3%). Poor glycaemic control was significantly associated with high body mass index of the patient (AOR 13.22; 95% CI: 1.95 to 89.80), having only elementary education (AOR 5.22, 95% CI 2.12–12.86, p<0.0001) and being on insulin therapy (AOR 2.88; 95% CI: 1.05 to 7.88). On the other hand, seldom coffee intake (AOR: 0.27; 95% CI: 0.11 to 0.64), high physical activity (AOR 1.57, 95% CI 1.06–2.35, p = 0.025) and having a cardiovascular disease (AOR: 0.15; 95% CI: 0.05 to 0.46) appeared to positively influence glycaemic control. Self-monitoring of blood glucose and diet interventions did not appear to influence glycaemic control. Conclusions The study results showing that a high proportion of patients attending the Diabetes Clinic with uncontrolled diabetes has serious implications for the management of T2DM diabetes as it suggests that current hospital-based treatment measures are less effective. Comprehensive management of T2DM targeting all the key factors identified in this study and incorporating a multispectral collaborative effort based on holistic approach, combined with non-pharmacological components are strongly warranted.
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Stanton-Fay SH, Hamilton K, Chadwick PM, Lorencatto F, Gianfrancesco C, de Zoysa N, Coates E, Cooke D, McBain H, Heller SR, Michie S. The DAFNEplus programme for sustained type 1 diabetes self management: Intervention development using the Behaviour Change Wheel. Diabet Med 2021; 38:e14548. [PMID: 33617669 DOI: 10.1111/dme.14548] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 01/06/2021] [Accepted: 02/02/2021] [Indexed: 11/29/2022]
Abstract
AIMS Self-management programmes for type 1 diabetes, such as the UK's Dose Adjustment for Normal Eating (DAFNE), improve short-term clinical outcomes but difficulties maintaining behavioural changes attenuate long-term impact. This study used the Behaviour Change Wheel (BCW) framework to revise the DAFNE intervention to support sustained behaviour change. METHODS A four-step method was based on the BCW intervention development approach: (1) Identifying self-management behaviours and barriers/enablers to maintain them via stakeholder consultation and evidence synthesis, and mapping barriers/enablers to the Capability, Opportunity, Motivation-Behaviour (COM-B) model. (2) Specifying behaviour change techniques (BCTs) in the existing DAFNE intervention using the Behaviour Change Techniques Taxonomy (BCTTv1). (3) Identifying additional BCTs to target the barriers/enablers using the BCW and BCTTv1. (4) Parallel stakeholder consultation to generate recommendations for intervention revision. Revised materials were co-designed by stakeholders (diabetologists, psychologists, specialist nurses and dieticians). RESULTS In all, 34 barriers and 5 enablers to sustaining self-management post-DAFNE were identified. The existing DAFNE intervention contained 24 BCTs, which partially addressed the enablers. In all, 27 BCTs were added, including 'Habit formation', 'Credible source' and 'Conserving mental resources'. In total, 15 stakeholder-agreed recommendations for content and delivery were incorporated into the final DAFNEplus intervention, comprising three co-designed components: (1) face-to-face group learning course, (2) individual structured follow-up sessions and (3) technological support, including blood glucose data management. CONCLUSIONS This method provided a systematic approach to specifying and revising a behaviour change intervention incorporating stakeholder input. The revised DAFNEplus intervention aims to support the maintenance of behavioural changes by targeting barriers and enablers to sustaining self-management behaviours.
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Affiliation(s)
- Stephanie H Stanton-Fay
- Clinical, Health and Educational Psychology/Centre for Behaviour Change, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Kathryn Hamilton
- Clinical, Health and Educational Psychology/Centre for Behaviour Change, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Paul M Chadwick
- Clinical, Health and Educational Psychology/Centre for Behaviour Change, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Fabiana Lorencatto
- Clinical, Health and Educational Psychology/Centre for Behaviour Change, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Carla Gianfrancesco
- Sheffield Diabetes and Endocrine Centre, Sheffield Teaching Hospitals NHSF Trust, Sheffield, United Kingdom of Great Britain and Northern Ireland
| | - Nicole de Zoysa
- Diabetes Centre, King's College Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Elizabeth Coates
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom of Great Britain and Northern Ireland
| | - Debbie Cooke
- School of Health Sciences, University of Surrey, London, United Kingdom of Great Britain and Northern Ireland
| | - Hayley McBain
- Health Services Research Centre, City, University of London, London, United Kingdom of Great Britain and Northern Ireland
| | - Simon R Heller
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom of Great Britain and Northern Ireland
| | - Susan Michie
- Clinical, Health and Educational Psychology/Centre for Behaviour Change, University College London, London, United Kingdom of Great Britain and Northern Ireland
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5
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Coates E, Amiel S, Baird W, Benaissa M, Brennan A, Campbell MJ, Chadwick P, Chater T, Choudhary P, Cooke D, Cooper C, Cross E, De Zoysa N, Eissa M, Elliott J, Gianfrancesco C, Good T, Hopkins D, Hui Z, Lawton J, Lorencatto F, Michie S, Pollard DJ, Rankin D, Schutter J, Scott E, Speight J, Stanton-Fay S, Taylor C, Thompson G, Totton N, Yardley L, Zaitcev A, Heller S. Protocol for a cluster randomised controlled trial of the DAFNE plus (Dose Adjustment For Normal Eating) intervention compared with 5x1 DAFNE: a lifelong approach to promote effective self-management in adults with type 1 diabetes. BMJ Open 2021; 11:e040438. [PMID: 33462097 PMCID: PMC7813353 DOI: 10.1136/bmjopen-2020-040438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/23/2020] [Accepted: 12/15/2020] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The successful treatment of type 1 diabetes (T1D) requires those affected to employ insulin therapy to maintain their blood glucose levels as close to normal to avoid complications in the long-term. The Dose Adjustment For Normal Eating (DAFNE) intervention is a group education course designed to help adults with T1D develop and sustain the complex self-management skills needed to adjust insulin in everyday life. It leads to improved glucose levels in the short term (manifest by falls in glycated haemoglobin, HbA1c), reduced rates of hypoglycaemia and sustained improvements in quality of life but overall glucose levels remain well above national targets. The DAFNEplus intervention is a development of DAFNE designed to incorporate behavioural change techniques, technology and longer-term structured support from healthcare professionals (HCPs). METHODS AND ANALYSIS A pragmatic cluster randomised controlled trial in adults with T1D, delivered in diabetes centres in National Health Service secondary care hospitals in the UK. Centres will be randomised on a 1:1 basis to standard DAFNE or DAFNEplus. Primary clinical outcome is the change in HbA1c and the primary endpoint is HbA1c at 12 months, in those entering the trial with HbA1c >7.5% (58 mmol/mol), and HbA1c at 6 months is the secondary endpoint. Sample size is 662 participants (approximately 47 per centre); 92% power to detect a 0.5% difference in the primary outcome of HbA1c between treatment groups. The trial also measures rates of hypoglycaemia, psychological outcomes, an economic evaluation and process evaluation. ETHICS AND DISSEMINATION Ethics approval was granted by South West-Exeter Research Ethics Committee (REC ref: 18/SW/0100) on 14 May 2018. The results of the trial will be published in a National Institute for Health Research monograph and relevant high-impact journals. TRIAL REGISTRATION NUMBER ISRCTN42908016.
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Affiliation(s)
- Elizabeth Coates
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Stephanie Amiel
- Department of Diabetes, King's College London Faculty of Life Sciences and Medicine, London, UK
| | - Wendy Baird
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Mohammed Benaissa
- Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | | | | | - Tim Chater
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Pratik Choudhary
- Department of Diabetes, King's College London Faculty of Life Sciences and Medicine, London, UK
| | - Debbie Cooke
- Department of Diabetes, King's College London Faculty of Life Sciences and Medicine, London, UK
| | - Cindy Cooper
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Elizabeth Cross
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | | | - Mohammad Eissa
- Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield, UK
| | - Jackie Elliott
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
| | - Carla Gianfrancesco
- Diabetes Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Tim Good
- Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield, UK
| | - David Hopkins
- General and Emergency Medicine, King's College London, London, UK
| | - Zheng Hui
- Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield, UK
| | - Julia Lawton
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | | | - Daniel John Pollard
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - David Rankin
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Elaine Scott
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Jane Speight
- The Australian Centre for Behavioural Research in Diabetes, Melbourne, Victoria, Australia
| | | | - Carolin Taylor
- Diabetes Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - Nikki Totton
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Lucy Yardley
- Academic Unit of Psychology, University of Southampton, Southampton, UK
| | - Aleksandr Zaitcev
- Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield, UK
| | - Simon Heller
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
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Brzoza Z, Nabrdalik K, Moos L, Kwiendacz H, Badura-Brzoza K, Jarolim H, Kapeluszna K, Gumprecht J. Chronic Spontaneous Urticaria and Type 1 Diabetes Mellitus-Does Quality of Life Impairment Always Reflect Health Danger? J Clin Med 2020; 9:jcm9082505. [PMID: 32759745 PMCID: PMC7465008 DOI: 10.3390/jcm9082505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/16/2020] [Accepted: 07/30/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND AIMS Chronic spontaneous urticaria (CSU) and diabetes mellitus type 1 (T1DM) may compromise the quality of life (QoL). We decided to compare the QoL of T1DM patients to those suffering from CSU. MATERIALS AND METHODS Sixty-six patients with well-controlled T1DM (male 52%) in the mean age of (SD) 36.3 (11.09) years and 51 patients with CSU (male 33%) in the mean age of (SD) 35.8 (8.53) years were enrolled in this observational study. All the participants completed a Short-Form 36 (SF-36) QoL. RESULTS The QoL related to social functioning was significantly worse among CSU patients. There were differences related to gender found in the group of patients with T1DM-where men tended to declare a better quality of life than women (p = 0.015)-especially in the area of energy/fatigue and pain. It appeared that due to physical and emotional problems occurring in married patients, the QoL is lower in T1DM group in comparison to the CSU one. CONCLUSIONS The patients with CSU presented significantly worse social functioning compared to the ones with T1DM. This fact proves the QoL impairment level is not always related to the level of health danger. The differences in the QoL related to gender and marital status found among T1DM patients point to the necessity for further exploration in a larger group of patients. Due to the fact that optimal disease management should ensure patient's good emotional well-being, there is a need for additional psychological and social care for patients from those two groups.
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Affiliation(s)
- Zenon Brzoza
- Department of Internal Medicine with Division of Allergology, Institute of Medical Sciences, University of Opole, 45-401 Opole, Poland; (L.M.); (K.K.)
- Correspondence:
| | - Katarzyna Nabrdalik
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesiain Katowice, 40-055 Katowice, Poland; (K.N.); (H.K.); (H.J.); (J.G.)
| | - Lukasz Moos
- Department of Internal Medicine with Division of Allergology, Institute of Medical Sciences, University of Opole, 45-401 Opole, Poland; (L.M.); (K.K.)
| | - Hanna Kwiendacz
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesiain Katowice, 40-055 Katowice, Poland; (K.N.); (H.K.); (H.J.); (J.G.)
| | - Karina Badura-Brzoza
- Department of Psychiatry in Tarnowskie Góry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Hanna Jarolim
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesiain Katowice, 40-055 Katowice, Poland; (K.N.); (H.K.); (H.J.); (J.G.)
| | - Katarzyna Kapeluszna
- Department of Internal Medicine with Division of Allergology, Institute of Medical Sciences, University of Opole, 45-401 Opole, Poland; (L.M.); (K.K.)
| | - Janusz Gumprecht
- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesiain Katowice, 40-055 Katowice, Poland; (K.N.); (H.K.); (H.J.); (J.G.)
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7
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Speight J, Holmes-Truscott E, Hendrieckx C, Skovlund S, Cooke D. Assessing the impact of diabetes on quality of life: what have the past 25 years taught us? Diabet Med 2020; 37:483-492. [PMID: 31797443 DOI: 10.1111/dme.14196] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2019] [Indexed: 01/06/2023]
Abstract
Over the past 25 years, there has been significant acknowledgement of the importance of assessing the impact of diabetes on quality of life. Yet, despite the development of several diabetes-specific quality of life measures, the challenges we faced in 1995 remain. There is little consensus on the definition of quality of life because of the complexity and subjectivity of the concept. General quality of life comprises several domains of life, and these are highly individualized. Assessing the impact of diabetes on these life domains adds to the complexity. While comprehensive diabetes-specific quality-of-life measures typically increase respondent burden, brief questionnaires may not capture all relevant/important domains. Today, the lack of resolution of these challenges may explain why the impact of diabetes on quality of life is not systematically assessed in research or clinical care. Few researchers report detailed rationales for assessment, there is often a mismatch between the concept of interest and the measure selected, and data are misinterpreted as assessing the impact of diabetes on quality of life when, in reality, related but distinct constructs have been assessed, such as diabetes distress, treatment satisfaction or health status. While significant efforts are being made to increase routine monitoring of psychological well-being and understand the lived experience, no guidelines currently recommend routine clinical assessment of diabetes-specific quality of life, and there is no consensus on which questionnaire(s) to use. The gaps identified in this review need urgent attention, starting with recognition that assessment of diabetes-specific quality of life is as important as biomedical markers, if we are to improve the lives of people with diabetes.
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Affiliation(s)
- J Speight
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - E Holmes-Truscott
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - C Hendrieckx
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - S Skovlund
- Steno Diabetes Centre Northern Denmark, Aalborg University Hospital, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - D Cooke
- School of Health Sciences, University of Surrey, Guildford, UK
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8
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Lucherini M. Spontaneity and serendipity: Space and time in the lives of people with diabetes. Soc Sci Med 2019; 245:112723. [PMID: 31838333 DOI: 10.1016/j.socscimed.2019.112723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/06/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
Abstract
This article considers the relevance of non-representational theory to understanding the lived experience of diabetes. While non-representational theory has gained traction in the social sciences, especially Human Geography, its usefulness in extending our understanding of experiences of health and illness is often restricted to an idea of wellbeing that assumes an able and healthy body. This article draws on qualitative research on the everyday experiences of living with diabetes, to consider how non-representational theory can be applied to understanding the everyday experience of ill bodies. The analysis moves through ideas of mobility, routine, anticipation and adjustment to highlight the challenges of spontaneity and serendipity in the everyday lives of people with diabetes. The article concludes by considering some of the advantages of a non-representational approach for healthcare practice.
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Affiliation(s)
- Mark Lucherini
- School of Geography, Geology and the Environment, Keele University, Keele, ST5 5BG, United Kingdom.
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9
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McCay D, Hill A, Coates V, O'Kane M, McGuigan K. Structured diabetes education outcomes: looking beyond HbA
1c
. A systematic review. PRACTICAL DIABETES 2019. [DOI: 10.1002/pdi.2221] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Deirdre McCay
- School of Biomedical Sciences (NICHE)Ulster University Coleraine UK
| | - Alyson Hill
- School of Biomedical Sciences (NICHE)Ulster University Coleraine UK
| | - Vivien Coates
- School of NursingUlster University Coleraine UK
- Western Health & Social Care TrustLondonderry UK
| | | | - Karen McGuigan
- School of Nursing and MidwiferyQueen's University Belfast UK
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Downie GA, Mullan BA, Boyes ME, McEvoy PM. The effect of psychological distress on self-care intention and behaviour in young adults with type 1 diabetes. J Health Psychol 2019; 26:543-555. [PMID: 30666886 DOI: 10.1177/1359105318824795] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
An extended theory of planned behaviour including psychological distress was used to predict blood glucose monitoring in young adults with type 1 diabetes. Participants completed two surveys, a week apart (n = 167). Attitudes and perceived behavioural control were significantly associated with intention but subjective norm was not. Intention predicted blood glucose monitoring at T2. Higher scores in psychological distress significantly predicted poorer blood glucose monitoring at T2 but did not moderate the intention-behaviour relationship. Findings demonstrate some concerns with the theory of planned behaviour to predict self-care behaviour, yet highlight the importance of addressing psychological distress in diabetes self-management.
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11
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Alvarado-Martel D, Ruiz Fernández MA, Cuadrado Vigaray M, Carrillo A, Boronat M, Expósito Montesdeoca A, Nattero Chávez L, Pozuelo Sánchez M, López Quevedo P, Santana Suárez AD, Hillman N, Subias D, Martin Vaquero P, Sáez de Ibarra L, Mauricio D, de Pablos-Velasco P, Nóvoa FJ, Wägner AM. ViDa1: The Development and Validation of a New Questionnaire for Measuring Health-Related Quality of Life in Patients with Type 1 Diabetes. Front Psychol 2017; 8:904. [PMID: 28620331 PMCID: PMC5450776 DOI: 10.3389/fpsyg.2017.00904] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/16/2017] [Indexed: 01/07/2023] Open
Abstract
This study describes the development of a new questionnaire to measure health-related quality of life (HRQoL) in patients with type 1 diabetes (the ViDa1 questionnaire) and provides information on its psychometric properties. For its development, open interviews with patients took place and topics relevant to patients' HRQoL were identified and items were generated. Qualitative analysis of items, expert review, and refinement of the questionnaire followed. A pilot study (N = 150) was conducted to explore the underlying structure of the 40-item ViDa1 questionnaire. A Principal Component Analysis (PCA) was performed and six of the items that did not load on any of the factors were eliminated. The results supported a four-dimensional structure for ViDa1, the dimensions being Interference of diabetes in everyday life, Self-care, Well-being, and Worry about the disease. Subsequently, the PCA was repeated in a larger sample (N = 578) with the reduced 34-item version of the questionnaire, and a Confirmatory Factor Analysis (CFA) was performed (N = 428). Overall fit indices obtained presented adequate values which supported the four-factor model initially proposed [([Formula: see text] 2601.93) (p < 0.001); Root Mean Square Error of Approximation = 0.060 (CI = 0.056 -0.064)]. As regards reliability, the four dimensions of the ViDa1 demonstrated good internal consistency, with Cronbach's alphas ranging between 0.71 and 0.86. Evidence of convergent-discriminant validity in the form of high correlations with another specific HRQoL questionnaire for diabetes and low correlations with other constructs such as self-efficacy, anxiety, and depression were presented. The ViDa1 also discriminated between different aspects of clinical interest such as type of insulin treatment, presence of chronic complications, and glycemic control, temporal stability, and sensitivity to change after an intervention. In conclusion, the ViDa1 questionnaire presents adequate psychometric properties and may represent a good alternative for the evaluation of HRQoL in type 1 diabetes.
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Affiliation(s)
- Dácil Alvarado-Martel
- Department of Endocrinology and Nutrition, Complejo Hospitalario Univesitario Insular Materno-Infantil de Gran CanariaLas Palmas de Gran Canaria, Spain
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran CanariaLas Palmas de Gran Canaria, Spain
| | | | - Maribel Cuadrado Vigaray
- Department of Endocrinology and Nutrition, CIBER of Diabetes and Associated Metabolic Diseases, Hospital Universitario Germans Trias i PujolBadalona, Spain
| | - Armando Carrillo
- Department of Endocrinology and Nutrition, Complejo Hospitalario Univesitario Insular Materno-Infantil de Gran CanariaLas Palmas de Gran Canaria, Spain
| | - Mauro Boronat
- Department of Endocrinology and Nutrition, Complejo Hospitalario Univesitario Insular Materno-Infantil de Gran CanariaLas Palmas de Gran Canaria, Spain
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran CanariaLas Palmas de Gran Canaria, Spain
| | - Ana Expósito Montesdeoca
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran CanariaLas Palmas de Gran Canaria, Spain
| | - Lía Nattero Chávez
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y CajalMadrid, Spain
| | - Maite Pozuelo Sánchez
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y CajalMadrid, Spain
| | - Pino López Quevedo
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor NegrínLas Palmas de Gran Canaria, Spain
| | - Ana D. Santana Suárez
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor NegrínLas Palmas de Gran Canaria, Spain
| | - Natalia Hillman
- Unit of Diabetes, Hospital Universitario La PazMadrid, Spain
| | - David Subias
- Department of Endocrinology and Nutrition, Hospital Universitario Parc TaulíSabadell, Spain
| | | | | | - Didac Mauricio
- Department of Endocrinology and Nutrition, CIBER of Diabetes and Associated Metabolic Diseases, Hospital Universitario Germans Trias i PujolBadalona, Spain
| | - Pedro de Pablos-Velasco
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran CanariaLas Palmas de Gran Canaria, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor NegrínLas Palmas de Gran Canaria, Spain
| | - Francisco J. Nóvoa
- Department of Endocrinology and Nutrition, Complejo Hospitalario Univesitario Insular Materno-Infantil de Gran CanariaLas Palmas de Gran Canaria, Spain
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran CanariaLas Palmas de Gran Canaria, Spain
| | - Ana M. Wägner
- Department of Endocrinology and Nutrition, Complejo Hospitalario Univesitario Insular Materno-Infantil de Gran CanariaLas Palmas de Gran Canaria, Spain
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran CanariaLas Palmas de Gran Canaria, Spain
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Umeh K. Are Ethnic Disparities in HbA1c Levels Explained by Mental Wellbeing? Analysis of Population-Based Data from the Health Survey for England. J Racial Ethn Health Disparities 2017; 5:86-95. [PMID: 28281176 PMCID: PMC5816119 DOI: 10.1007/s40615-017-0346-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/06/2017] [Accepted: 01/29/2017] [Indexed: 12/20/2022]
Abstract
Aims It is unclear how ethnic differences in HbA1c levels are affected by individual variations in mental wellbeing. Thus, the aim of this study was to assess the extent to which HbA1c disparities between Caucasian and South Asian adults are mediated by various aspects of positive psychological functioning. Methods Data from the 2014 Health Survey for England was analysed using bootstrapping methods. A total of 3894 UK residents with HbA1c data were eligible to participate. Mental wellbeing was assessed using the Warwick-Edinburgh Mental Well-being Scale. To reduce bias BMI, blood pressure, diabetes status, and other factors were treated as covariates. Results Ethnicity directly predicted blood sugar control (unadjusted coefficient −2.15; 95% CI −3.64, −0.67), with Caucasians generating lower average HbA1c levels (37.68 mmol/mol (5.6%)) compared to South Asians (39.87 mmol/mol (5.8%)). This association was mediated by positive mental wellbeing, specifically concerning perceived vigour (unadjusted effect 0.30; 95% CI 0.13, 0.58): South Asians felt more energetic than Caucasians (unadjusted coefficient −0.32; 95% CI −0.49, −0.16), and greater perceived energy predicted lower HbA1c levels (unadjusted coefficient −0.92; 95% CI −1.29, −0.55). This mediator effect accounted for just over 14% of the HbA1c variance and was negated after adjusting for BMI. Conclusions Caucasian experience better HbA1c levels compared with their South Asian counterparts. However, this association is partly confounded by individual differences in perceived energy levels, which is implicated in better glycaemic control, and appears to serve a protective function in South Asians.
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Affiliation(s)
- Kanayo Umeh
- School of Natural Sciences & Psychology, Liverpool John Moores University, Liverpool, L3 3AF, UK.
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