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Gutiérrez-Domingo T, Farhane-Medina NZ, Villaécija J, Vivas S, Tabernero C, Castillo-Mayén R, Luque B. Effectiveness of Mindfulness-Based Interventions with Respect to Psychological and Biomedical Outcomes in Young People with Type 1 Diabetes: A Systematic Review. Healthcare (Basel) 2024; 12:1876. [PMID: 39337217 PMCID: PMC11430895 DOI: 10.3390/healthcare12181876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/28/2024] [Accepted: 09/01/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Type 1 diabetes is a chronic disease especially affecting young people. Mindfulness-based psychological interventions might reduce emotional symptoms post-diagnosis, but the evidence is limited. OBJECTIVES This systematic review aimed to evaluate the effectiveness of mindfulness interventions on psychological well-being and biomedical variables in young people with type 1 diabetes. METHODS A systematic review of trials was conducted that involved a bibliographic search in electronic databases (Web of Science, MEDLINE, SciELO, Scopus, PsycINFO, and Cochrane Library) considering studies published between 2013 and 2024. RESULTS A total of 434 records were identified, of which 252 underwent selection according to title and abstract, leaving 32 that were evaluated for eligibility and 7 included in this review. From Google Scholar, six more studies were identified and evaluated, and two were selected. Finally, nine studies were subjected to full reading and a detailed analysis of the inclusion criteria. A total of 66.6% of the studies were evaluated as having a methodological quality of moderate or optimal, but the samples analysed tended to be small, and only two articles carried out short-term follow-up evaluations. CONCLUSIONS Mindfulness-based interventions, upon reviewing the preliminary results, may be posited as a viable strategy to enhance psychological (anxiety, diabetes distress, perceived stress, depression, self-efficacy, psychological well-being, and quality of life) and biomedical outcomes (glycaemic control, blood glucose levels, and diastolic blood pressure) for type 1 diabetes in young people. Although promising, further research is required to improve the quality, methodology, and design of studies.
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Affiliation(s)
- Tamara Gutiérrez-Domingo
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain; (N.Z.F.-M.); (J.V.); (S.V.); (C.T.); (R.C.-M.); (B.L.)
- Department of Psychology, University of Cordoba, 14071 Córdoba, Spain
- Reina Sofia University Hospital, 14071 Córdoba, Spain
| | - Naima Z. Farhane-Medina
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain; (N.Z.F.-M.); (J.V.); (S.V.); (C.T.); (R.C.-M.); (B.L.)
- Department of Psychology, University of Cordoba, 14071 Córdoba, Spain
- Reina Sofia University Hospital, 14071 Córdoba, Spain
| | - Joaquín Villaécija
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain; (N.Z.F.-M.); (J.V.); (S.V.); (C.T.); (R.C.-M.); (B.L.)
- Department of Psychology, University of Cordoba, 14071 Córdoba, Spain
- Reina Sofia University Hospital, 14071 Córdoba, Spain
| | - Sebastián Vivas
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain; (N.Z.F.-M.); (J.V.); (S.V.); (C.T.); (R.C.-M.); (B.L.)
- Department of Psychology, University of Cordoba, 14071 Córdoba, Spain
- Reina Sofia University Hospital, 14071 Córdoba, Spain
| | - Carmen Tabernero
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain; (N.Z.F.-M.); (J.V.); (S.V.); (C.T.); (R.C.-M.); (B.L.)
- Reina Sofia University Hospital, 14071 Córdoba, Spain
- Department of Psychology, University of Salamanca, 37007 Salamanca, Spain
- Institute of Neurosciences of Castilla y León (INCYL), University of Salamanca, 37007 Salamanca, Spain
| | - Rosario Castillo-Mayén
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain; (N.Z.F.-M.); (J.V.); (S.V.); (C.T.); (R.C.-M.); (B.L.)
- Department of Psychology, University of Cordoba, 14071 Córdoba, Spain
- Reina Sofia University Hospital, 14071 Córdoba, Spain
| | - Bárbara Luque
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14071 Córdoba, Spain; (N.Z.F.-M.); (J.V.); (S.V.); (C.T.); (R.C.-M.); (B.L.)
- Department of Psychology, University of Cordoba, 14071 Córdoba, Spain
- Reina Sofia University Hospital, 14071 Córdoba, Spain
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Uneno Y, Kotera Y, Kikuchi K, Yamada M, Sugitani M, Terado S, Maehara H, Sakamoto Y, Sugao S, Tani H, Shimizu A, Kubo Y, Fujisawa D, Muto M. Self-compassion-based online group psychotherapy for bereavement-related grief: The COMPACT feasibility trial. Gen Hosp Psychiatry 2024; 90:116-123. [PMID: 39173331 DOI: 10.1016/j.genhosppsych.2024.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 08/11/2024] [Accepted: 08/16/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVE This study aimed to examine the feasibility and effectiveness of online group psychotherapy focused on self-compassion for individuals experiencing bereavement-related grief. METHOD This single-arm feasibility trial involved participants aged 18 years or older who had experienced bereavement at least 6 months prior the five-week intervention. Outcomes were measured at baseline, immediately post-intervention, and 4 and 12 weeks later. The primary endpoint was the percentage of participants who completed four out of five sessions; the pre-defined feasibility criterion was 70%. Secondary endpoints included measures of grief, depression, anxiety, self-compassion, and resilience. RESULTS The program was conducted in three courses with 18, 26, and 16 participants, respectively. The primary endpoint was met for 83.1% of participants (54/65). Cohen's d effect sizes ([95% CI] 12 weeks vs. baseline) for grief, depression, anxiety, self-compassion, and resilience were - 0.25 [-0.52, 0.03], -0.64 [-0.94, -0.34], -0.48 [-0.77, -0.19], 0.50 [0.21, 0.79], and - 0.07 [-0.34, 0.21], respectively. CONCLUSIONS Online group psychotherapy focused on self-compassion for individuals with bereavement-related grief is feasible and effective for addressing grief and psychological distress. Randomized controlled trials are warranted to confirm the intervention's efficacy. TRIAL REGISTRATION NUMBER UMIN000048554, registered 2 August 2022.
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Affiliation(s)
- Yu Uneno
- Department of Palliative Medicine, Kyoto University Hospital, Kyoto, Japan.
| | - Yasuhiro Kotera
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Kyoko Kikuchi
- Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Osaka, Japan
| | - Misako Yamada
- Department of Drug Dependence Research, National Institute of Mental Health, Tokyo, Japan
| | | | - Saori Terado
- Department of Palliative Medicine, Shimada Hospital, Fukuoka, Japan
| | - Hiroko Maehara
- Graduate School of Human Science, Ritsumeikan University, Osaka, Japan
| | | | - Shoko Sugao
- Graduate School of Human Science, Osaka University, Osaka, Japan
| | - Haruka Tani
- Graduate School of Human Science, Osaka University, Osaka, Japan
| | - Akiko Shimizu
- Faculty of Clinical Psychology, Kyoto Bunkyo University, Kyoto, Japan
| | - Yoko Kubo
- Graduate School of Clinical Psychology, Kagoshima University, Kagoshima, Japan
| | - Daisuke Fujisawa
- Department of Neuropsychiatry and Palliative Care Center, Keio University School of Medicine, Tokyo, Japan
| | - Manabu Muto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Humiston T, Cummings C, Suss S, Cohen LB, Hazlett-Stevens H, Hughes Lansing A. Acceptability of a Self-Led Mindfulness-Based Intervention for Teens with Type 1 Diabetes: Pilot Randomized Controlled Trial. JMIR Form Res 2024; 8:e45659. [PMID: 38289663 PMCID: PMC10865210 DOI: 10.2196/45659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Diabetes distress among adolescents with type 1 diabetes has been associated with suboptimal diabetes outcomes, including lower quality of life, increased diabetes self-management challenges, and suboptimal glycemic outcomes. OBJECTIVE This study examined the feasibility and acceptability of a scalable self-led mindfulness-based intervention to reduce diabetes distress in adolescents with type 1 diabetes. METHODS Adolescents (N=25) aged between 14 and 18 years diagnosed with type 1 diabetes completed a baseline assessment. Participants were randomized to receive a 10-week self-guided mindfulness-based stress reduction workbook program (e-book or paper option) immediately (n=15) or after a 10-week wait (n=10). During the intervention period, participants completed weekly assignments and feedback surveys. At 10 weeks and 20 weeks, follow-up assessments were completed. RESULTS Findings indicated that participants did not find the original intervention feasible or acceptable. Adolescents reported barriers to completing the weekly material, such as that they forgot or that the material was not sufficiently related to their diabetes management. Adolescents also reported that a digital format rather than a workbook or e-book may be more acceptable. Results from weekly surveys provided the foundation for recommendations for future iterations of the mindfulness-based intervention for adolescents with type 1 diabetes. CONCLUSIONS Participant feedback informed recommendations for self-led mindfulness programs for youth with type 1 diabetes. Adolescents indicated that a shorter, digital mindfulness-based intervention focused on diabetes-specific behaviors may be more helpful. TRIAL REGISTRATION ClinicalTrials.gov NCT05115175; https://clinicaltrials.gov/study/NCT05115175.
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Affiliation(s)
- Tori Humiston
- Department of Psychological Sciences, University of Vermont, Burlington, VT, United States
| | - Caroline Cummings
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, United States
| | - Stephen Suss
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Laura B Cohen
- Department of Psychological Sciences, University of Vermont, Burlington, VT, United States
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Fisher V, Li WW, Malabu U. The effectiveness of mindfulness-based stress reduction (MBSR) on the mental health, HbA1C, and mindfulness of diabetes patients: A systematic review and meta-analysis of randomised controlled trials. Appl Psychol Health Well Being 2023; 15:1733-1749. [PMID: 36855248 DOI: 10.1111/aphw.12441] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 02/16/2023] [Indexed: 03/02/2023]
Abstract
The clinically standardised mindfulness-based stress reduction (MBSR) has been utilised as an intervention for improving mental health among diabetes patients The present study aimed to assess the effectiveness of mindfulness-based stress reduction (MBSR) on the mental health, haemoglobin A1c (HbA1C), and mindfulness of diabetes patients. A systematic review and meta-analysis approach was employed to review randomised controlled trials published in the English language between the inception of eight databases to July 2022. Eleven articles from 10 studies, with a combined sample size of 718 participants, were included in the systematic review, and nine studies were included in the meta-analysis. In the meta-analysis, outcomes at post-intervention and follow-up were compared between the MBSR intervention and control groups with an adjustment of the baseline values. The results showed that MBSR demonstrated effects at post-intervention and follow-up (in a period between one to 12 months with a mean length of 4.3 months) in reducing anxiety and depressive symptoms, and enhancing mindfulness, with large effect sizes. However, the effect of MBSR on reducing stress was observed at follow-up, but not at post-intervention. Effects of MBSR on HbA1C were not detected at post-intervention and follow-up. The findings suggest that MBSR appears to be an effective treatment for improving mental health conditions and mindfulness in people with diabetes. The measurement of cortisol is recommended to be used as a biological measure to evaluate the effectiveness of MBSR in diabetes patients in future research.
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Affiliation(s)
| | | | - Usman Malabu
- James Cook University, Townsville, Australia
- Townsville University Hospital, Townsville, Australia
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Uneno Y, Kotera Y, Fujisawa D, Kataoka Y, Kosugi K, Murata N, Kessoku T, Ozaki A, Miyatake H, Muto M. Development of a novel COMPAssion focused online psyChoTherapy for bereaved informal caregivers: the COMPACT feasibility trial protocol. BMJ Open 2022; 12:e067187. [PMID: 36549732 PMCID: PMC9772635 DOI: 10.1136/bmjopen-2022-067187] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION An easy-to-access and effective psychotherapy for bereaved informal caregivers has not been established. People with higher self-compassion status tend to have lower bereavement related grief, psychotherapy focused on self-compassion can be promising for this population. This study aimed to examine the feasibility of online self-compassion focused psychotherapy for bereaved informal caregivers. METHOD AND ANALYSIS A total of 60 study participants will undergo an intervention programme comprising online sessions of 2 hours per week for five consecutive weeks and undertake postsession work. The intervention personnel will comprise psychologists who have received more than 10 hours of structured training. The primary endpoint will be assessed on the intervention completion rate, with secondary endpoints consisting of the Complicated Grief Questionnaire, Patient Health Questionnaire-9, Generalised Anxiety Disorder-7, Brief Resilience Scale and Self-Compassion Scale. Evaluations will be conducted preintervention, immediately after intervention, and 4 and 12 weeks after intervention. ETHICS AND DISSEMINATION This study has been reviewed and approved by the Ethics Committee of the Kyoto University Graduate School and Faculty of Medicine, Kyoto University Hospital, Japan (Approved ID: C1565). The results of this study will be disseminated through publication in a peer-reviewed journal and conference presentations. TRIAL REGISTRATION NUMBER UMIN000048554.
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Affiliation(s)
- Yu Uneno
- Department of Therapeutic Oncology, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Yasuhiro Kotera
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Daisuke Fujisawa
- Department of Neuropsychiatry and Palliative Care Center, Keio University School of Medicine, Tokyo, Japan
| | - Yuki Kataoka
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Kyoto, Japan
- Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
| | - Kazuhiro Kosugi
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Nanami Murata
- Medical School, Wakayama Medical University, Wakayama, Japan
| | - Takaomi Kessoku
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Japan
- Department of Palliative Medicine, Yokohama City University Hospital, Yokohama, Japan
| | - Akihiko Ozaki
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | | | - Manabu Muto
- Department of Therapeutic Oncology, Kyoto University, Graduate School of Medicine, Kyoto, Japan
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de Wit M, Gajewska KA, Goethals ER, McDarby V, Zhao X, Hapunda G, Delamater AM, DiMeglio LA. ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes. Pediatr Diabetes 2022; 23:1373-1389. [PMID: 36464988 PMCID: PMC10107478 DOI: 10.1111/pedi.13428] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Maartje de Wit
- Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Public Health, Amsterdam, Netherlands
| | - Katarzyna A Gajewska
- Diabetes Ireland, Dublin, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | | | | | - Xiaolei Zhao
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Given Hapunda
- Department of Psychology, University of Zambia, Lusaka, Zambia
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Linda A DiMeglio
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA.,Department of Pediatrics, Division of Pediatric Endocrinology and Diabetology, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA
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Koerner R, Rechenberg K. Mindfulness in adolescents and young adults with diabetes: An integrative review. Complement Ther Clin Pract 2022; 49:101659. [PMID: 35986987 DOI: 10.1016/j.ctcp.2022.101659] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 07/25/2022] [Accepted: 08/09/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND PURPOSE Type 1 diabetes (T1D), type 2 diabetes, and prediabetes are increasing in incidence. Adolescents and young adults with diabetes experience psychosocial comorbidities at an increased incidence. As such, exploring interventions that can improve psychosocial and glycemic outcomes are needed. The purpose of this integrative review is to examine and synthesize the literature on mindfulness in adolescents and young adults with type 1 or type 2 diabetes or prediabetes. METHODS Four databases were searched during May 2021. Included studies were published between 2000 and 2021, evaluated adolescents and young adults, diagnosed with type 1 or type 2 diabetes or prediabetes. Studies were excluded if they were not in English; not original research; evaluated complementary/alternative therapies as a group. To assess for risk of bias, the National Institutes of Health quality assessment tools and the Cochrane Collaboration's tool were utilized. Whittemore and Knafl's (2005) method for conducting an integrative review was utilized to synthesize results. RESULTS We identified 137 articles in our initial search and 74 articles remained after removing for duplicates. Ten articles were included in the review, with 5 including adolescents and young adults with T1D and 5 including adolescents and young adults with prediabetes. No studies evaluated mindfulness in adolescents and young adults with type 2 diabetes. CONCLUSION Mindfulness is an acceptable intervention in adolescents and young adults with T1D and prediabetes, resulting in positive psychosocial and glycemic outcomes. There were issues with feasibility of the intervention and mobile health technology delivery methods should be evaluated.
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Affiliation(s)
- Rebecca Koerner
- University of South Florida, College of Nursing, 12901 Bruce B. Downs Blvd, MDC Box 22, Tampa, FL, 33612, USA.
| | - Kaitlyn Rechenberg
- University of South Florida, College of Nursing, 12901 Bruce B. Downs Blvd, MDC Box 22, Tampa, FL, 33612, USA.
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Gentile C, Starnino L, Dupuis G, D'Antono B. Mindfulness-Based Stress Reduction in Older Adults at Risk for Coronary Artery Disease: A Pilot Randomized Trial. Clin Gerontol 2022; 45:272-286. [PMID: 33719899 DOI: 10.1080/07317115.2021.1887421] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Stress influences metabolic activity and increases risk for cardiovascular disease (CVD). We sought to a) examine feasibility and acceptability of mindfulness-based stress reduction (MBSR) in older adults at risk for CVD, and b) obtain preliminary data on its metabolic impact. METHODS A pilot RCT was conducted using a pre-post, 2-month follow-up design. Eighty-one individuals with metabolic syndrome and non-normative responses to stress in a previous investigation were invited. Participants were randomized (by sex and stress response) to a 9-week MBSR or a wait-list control group. Feasibility and acceptability were assessed and blood assayed. Between-subjects (MBSR vs waitlist control) ANOVAs on metabolic parameter change scores, and one-way repeated measures ANOVAs (pre-, post-, follow-up) were performed. RESULTS Thirty-three individuals (41%) responded to invitations, 26 were interested, of whom 19 were randomized (Mage = 67 years, SD = 7.70). Completion rate of MBSR was 72% and overall attendance was 96%. Reported benefits included increased relaxation, greater interpersonal connection, and increased body awareness. MBSR led to a decrease of 15% in LDL cholesterol and 10% in total cholesterol versus 4.5% and 1%, respectively, in the waitlist. Within group analyses showed notable decreases in LDL, triglycerides, and waist circumference post-MBSR and 2 months later. CONCLUSIONS A RCT was largely feasible and MBSR acceptable to participants. MBSR may lead to sustained decreases in cholesterol levels, warranting development of large-scale research on this topic. CLINICAL IMPLICATIONS Given the role of stress in CVD, addition of stress management interventions may serve as a useful complement to risk management among older individuals.
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Affiliation(s)
| | - Louisia Starnino
- Research Centre, Montreal Heart Institute, Montreal, Quebec, Canada.,Psychology Department, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Gilles Dupuis
- Psychology Department, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Bianca D'Antono
- Research Centre, Montreal Heart Institute, Montreal, Quebec, Canada.,Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
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Xia T, Lopes S, Chen L, Roth R, Zinzow H, Jones K, Zhang L, Shi L, Jindal M. A Feasibility Study on Low-dose Mindfulness-based Stress Reduction Intervention Among Prediabetes and Diabetes Patients. Complement Ther Med 2022; 65:102810. [DOI: 10.1016/j.ctim.2022.102810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/30/2021] [Accepted: 01/25/2022] [Indexed: 11/03/2022] Open
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Abujaradeh H, Viswanathan P, Galla BM, Sereika SM, DiNardo M, Feeley CA, Cohen SM, Charron-Prochownik D. Trait Mindfulness and Mindfulness Practices in Adolescents with Type 1 Diabetes: Descriptive and Comparative Study. J Pediatr Health Care 2021; 35:592-600. [PMID: 34493407 DOI: 10.1016/j.pedhc.2021.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/13/2021] [Accepted: 07/24/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Study describes mindfulness (trait and practices) and compares levels of trait mindfulness (low/high) and practices (yes/no) on demographic, clinical characteristics, and diabetes-related outcomes among adolescents with type 1 diabetes (T1D). METHODS Adolescents completed a survey on demographics, clinical data, trait mindfulness/practices, diabetes-specific stress, and diabetes self-management (DSM). Glycemic control (A1c) obtained from medical records. T and χ2 tests were applied for comparative analyses. RESULTS 129 adolescents (12-18 years) reported moderately high levels of mindfulness (31 ± 8; range, 10-40). One-third (30%) reported having experience with mindfulness practices (formal, informal, and religious). Adolescents who reported higher levels of trait mindfulness had higher insulin pump usage (p =.005), less diabetes-specific stress (p <.001), greater DSM (p =.006), and less A1c (p =.013). Adolescents who reported more types of mindfulness practices had greater DSM scores. DISCUSSION Adolescents with higher levels of trait mindfulness and with more types of mindfulness practices had better diabetes-related outcomes. Introducing mindfulness training tailored to adolescents with T1D should be examined.
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Shukla R, Gupta M, Agarwal N, Bajpai A. Mindfulness Meditation as Adjunctive Therapy to Improve the Glycemic Care and Quality of Life in Patients with Type 1 Diabetes. Med Sci (Basel) 2021; 9:33. [PMID: 34064218 PMCID: PMC8162570 DOI: 10.3390/medsci9020033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Mindfulness Meditation (MM) is known to improve glycemic control and enhance the quality of life (QoL) in type 2 diabetes (T2D) patients. Unfortunately, the role of meditation in type 1 diabetes (T1D) has not been studied extensively. Therefore, we conducted this study to determine the effect of MM on the glycemic control and QoL in people living with T1D. METHODOLOGY Thirty-two adults living with T1D were equally randomized into intervention (meditation) and control groups. The glycemic control and QoL were assessed at the baseline and after six months of intervention. RESULTS A total of thirty-two adults (15 males, 46.9%; mean age 23.8 ± 6.6 years) with type 1 diabetes (mean diabetes duration 12.7 ± 6.2 years) participated in the study. At the end of six months, a statistically significant improvement was seen in the mean blood glucose level in the control group (222.4 ± 77.8 versus 182.6 ± 52.0; p = 0.007) and the intervention group (215.3 ± 50.1 versus 193.2 ± 31.8; p = 0.008). Additionally, there was a significant reduction in the total diabetes distress score in the intervention group (1.6 ± 0.3 versus 1.3 ± 0.3; p = 0.003), while no change was observed in the control group (1.6 ± 0.7 versus 1.7 ± 0.4; p = 0.762). A statistically significant improvement was noticed in the health and functioning domain in the intervention group (p = 0.023). CONCLUSIONS An improvement in the glycemic control and quality of life of the patients was observed in our study. MM certainly plays an important role in attaining peace of mind and helps patients to channel their energy in a positive direction.
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Affiliation(s)
- Rishi Shukla
- Society for Prevention And Awareness of Diabetes, Kanpur 208002, Uttar Pradesh, India; (R.S.); (M.G.)
- Regency Center for Diabetes Endocrinology & Research, Department of Endocrinology, Kanpur 208002, Uttar Pradesh, India;
| | - Manisha Gupta
- Society for Prevention And Awareness of Diabetes, Kanpur 208002, Uttar Pradesh, India; (R.S.); (M.G.)
| | - Neha Agarwal
- Society for Prevention And Awareness of Diabetes, Kanpur 208002, Uttar Pradesh, India; (R.S.); (M.G.)
- Regency Center for Diabetes Endocrinology & Research, Department of Endocrinology, Kanpur 208002, Uttar Pradesh, India;
| | - Anurag Bajpai
- Regency Center for Diabetes Endocrinology & Research, Department of Endocrinology, Kanpur 208002, Uttar Pradesh, India;
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Luo J, Wang H, Li X, Zhou Z, Valimaki M, Whittemore R, Grey M, Guo J. Factors associated with diabetes distress among adolescents with type 1 diabetes. J Clin Nurs 2021; 30:1893-1903. [PMID: 33829586 DOI: 10.1111/jocn.15742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/01/2021] [Accepted: 02/26/2021] [Indexed: 01/20/2023]
Abstract
AIMS To describe the specific domains of diabetes distress and factors associated with these domains. BACKGROUND Diabetes distress is a common problem but not well recognised in adolescents by healthcare providers or adolescents themselves. There is insufficient evidence on how specific domains of diabetes distress exist in adolescents, making it challenging to select precise components to alleviate diabetes stress. DESIGN A quantitative, descriptive and cross-sectional study. METHODS Data were collected on socio-demographic and clinical characteristics, diabetes distress, perceived stress, self-efficacy and diabetes self-management using established questionnaires. Multivariate linear regression was conducted to examine the associations between specific factors and four domains in diabetes distress. STROBE checklist was used as the guideline for this study. RESULTS A total of 100 adolescents with type 1 diabetes aged 12 to 18 years participated in this study. Adolescents experienced the highest levels of distress in the regimen-related distress [2.41 (SD =0.82)] and physician-related distress [2.40 (SD =0.80)] domains. Older age, female gender, more diabetes problem-solving and higher levels of perceived stress were associated with higher regimen-related distress (β = 0.21 ~ 0.45, p < 0.05). Older age, female gender, a lower degree of endorsement of relevant diabetes-related goals and higher levels of perceived stress were associated with higher physician-related distress (β = -0.29 ~ 0.34, p < 0.05). CONCLUSIONS Diabetes distress was reported more on regimen-related and physician-related domains among adolescents with type 1 diabetes in China, associating with older age, female, increased perceived stress and poor diabetes-related problem-solving. RELEVANCE TO CLINICAL PRACTICE Nurses need to screen the specific domains of diabetes distress among adolescents with type 1 diabetes, especially for the older adolescents and girls. This study highlighted the importance of incorporating diabetes-related problem-solving support and stress management strategies into diabetes management for adolescents with type 1 diabetes, which could help relieve diabetes distress.
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Affiliation(s)
- Jiaxin Luo
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hongjuan Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xia Li
- Institute of Metabolism and Endocrinology, The Second Xiangya Hospital, Key Laboratory of Diabetes Immunology, Ministry of Education, Central South University, National Clinical Research Center for Metabolic Diseases, Changsha, China
| | - Zhiguang Zhou
- Institute of Metabolism and Endocrinology, The Second Xiangya Hospital, Key Laboratory of Diabetes Immunology, Ministry of Education, Central South University, National Clinical Research Center for Metabolic Diseases, Changsha, China
| | - Maritta Valimaki
- Xiangya School of Nursing, Central South University, Changsha, China
| | | | - Margaret Grey
- Yale University School of Nursing, New Haven, CT, USA
| | - Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, China
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Rose M, Streisand R, Tully C, Clary L, Monaghan M, Wang J, Mackey E. Risk of Disordered Eating Behaviors in Adolescents with Type 1 Diabetes. J Pediatr Psychol 2020; 45:583-591. [PMID: 32388559 DOI: 10.1093/jpepsy/jsaa027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Management of type 1 diabetes (T1D) may be difficult for adolescents, who often fail to meet glycemic targets. Adolescents are also at an increased risk for negative affect (i.e., anxiety, depressive symptoms) and are prone to disordered eating behaviors (DEB). This study hypothesized that negative affect would be associated with DEB, self-management, and glycemic control, but that this would be moderated by negative urgency (the urge to engage in impulsive behaviors in response to negative affect), such that this relationship would be significant only for those with higher negative urgency. METHODS The Eating in Adolescents with T1D Study recruited 100 caregiver-adolescent dyads (55% male youth, 48% Caucasian) to complete questionnaires reporting on the adolescent's negative affect, negative urgency, DEB, and diabetes management. Glycemic control 3-4 months following survey completion was extracted from the medical record. RESULTS A total of 61% of adolescents reported elevated symptoms of anxiety or depression and 25% reported elevated disordered eating symptoms. A total of 81% of adolescents had an A1c level above recommended targets. Negative affect was associated with DEB, suboptimal T1D self-management, and suboptimal glycemic outcomes, moderated by higher levels of negative urgency. Negative affect was associated directly with suboptimal self-management and glycemic control, but not DEB, at all levels of negative urgency. CONCLUSIONS Adolescents reported high levels of negative affect, DEB, and suboptimal glycemic control. Interventions that target negative affect and negative urgency in adolescents with T1D are needed in order to reduce the risk for DEB and negative diabetes health outcomes.
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Affiliation(s)
| | - Randi Streisand
- Children's National Hospital.,George Washington University School of Medicine
| | - Carrie Tully
- Children's National Hospital.,George Washington University School of Medicine
| | - Lauren Clary
- Children's National Hospital.,George Washington University School of Medicine
| | - Maureen Monaghan
- Children's National Hospital.,George Washington University School of Medicine
| | - Jichuan Wang
- Children's National Hospital.,George Washington University School of Medicine
| | - Eleanor Mackey
- Children's National Hospital.,George Washington University School of Medicine
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