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AlBurno H, Schneider F, de Vries H, Al Mohannadi D, Mercken L. Determinants of adherence to insulin and blood glucose monitoring among adolescents and young adults with type 1 diabetes in Qatar: a qualitative study. F1000Res 2024; 11:907. [PMID: 38515508 PMCID: PMC10955191 DOI: 10.12688/f1000research.123468.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2024] [Indexed: 03/23/2024] Open
Abstract
Background Adherence to insulin and blood glucose monitoring (BGM) is insufficient in adolescents and young adults (AYAs) with type 1 diabetes (T1D) worldwide and in Qatar. Little is known about the factors related to being aware of suboptimal adherence and the beliefs related to suboptimal adherence in this group. This qualitative study investigated factors related to awareness of, and beliefs about suboptimal adherence, as well as the existence of specific action plans to combat suboptimal adherence using the I-Change model. Methods The target group was comprised of 20 Arab AYAs (17-24 years of age) with T1D living in Qatar. Participants were interviewed via semi-structured, face-to-face individual interviews, which were audio-recorded, transcribed verbatim, and analyzed using the Framework Method. Results Suboptimal adherence to insulin, and particularly to BGM, in AYAs with T1D was identified. Some AYAs reported to have little awareness about the consequences of their suboptimal adherence and how this can adversely affect optimal diabetes management. Participants also associated various disadvantages to adherence ( e.g., hypoglycemia, pain, among others) and reported low self-efficacy in being adherent ( e.g., when outside home, in a bad mood, among others). Additionally, goal setting and action-planning often appeared to be lacking. Factors facilitating adherence were receiving support from family and healthcare providers, being motivated, and high self-efficacy. Conclusions Interventions that increase awareness concerning the risks of suboptimal adherence of AYAs with T1D are needed, that increase motivation to adhere by stressing the advantages, creating support and increasing self-efficacy, and that address action planning and goal parameters.
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Affiliation(s)
- Hanan AlBurno
- Care and Public Health Research Institute, Maastricht University, Maastricht, P.O. Box 616, The Netherlands
| | - Francine Schneider
- Care and Public Health Research Institute, Maastricht University, Maastricht, P.O. Box 616, The Netherlands
| | - Hein de Vries
- Care and Public Health Research Institute, Maastricht University, Maastricht, P.O. Box 616, The Netherlands
| | - Dabia Al Mohannadi
- Endocrinology and Diabetes Department, Hamad Medical Corporation, Doha, P.O. Box 3050, Qatar
| | - Liesbeth Mercken
- Care and Public Health Research Institute, Maastricht University, Maastricht, P.O. Box 616, The Netherlands
- Department of Health Psychology, Open University of the Netherlands, Heerlen, P.O. Box 2960, The Netherlands
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Gopalakrishnan TR, Jacob R, Periyandavar I. Does fear drive health app adoption? The role of threat perception in diabetes app usage. Diabetes Metab Syndr 2023; 17:102857. [PMID: 37776693 DOI: 10.1016/j.dsx.2023.102857] [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: 09/06/2021] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND AND AIM This study explores the interplay between fear or threat perception and adoption of health apps among individuals with diabetes. It draws on the concept of "fear" as an emotional response stemming from perceived threat, raising the question of whether threat perception drives the uptake of health apps. METHODS This study investigates the influence of diabetes threat perception on app adoption, akin to the role of fear appeal in behavior change communication. This study employed both a handout questionnaire and an online survey tool, Survey Monkey, for data collection. Using purposive sampling, data were collected from 222 individuals aged 35 years and above with diabetes in Chennai. RESULTS The results indicate that threat perception can trigger health app usage among people with high diabetic conditions, supporting the broader literature on fear appeal. Additionally, the perceived threat of diabetes is elevated among app users. Notably, a significant positive correlation exists between perceived threat of diabetes, daily app usage, and consistent app use. CONCLUSION This study underscores that the extent of perceived harm or vulnerability to threats influences individuals' behavioral changes. It introduces new avenues for encouraging health app usage among high-risk groups.
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Affiliation(s)
- T R Gopalakrishnan
- Department of Journalism and Communication, University of Madras, India.
| | - Rachel Jacob
- Department of Journalism, Madras Christian College, India.
| | - I Periyandavar
- Tamil Nadu Government Multi Super Speciality Hospital, Chennai, India.
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AlBurno H, Mercken L, de Vries H, Al Mohannadi D, Schneider F. Determinants of healthful eating and physical activity among adolescents and young adults with type 1 diabetes in Qatar: A qualitative study. PLoS One 2022; 17:e0270984. [PMID: 35793375 PMCID: PMC9258857 DOI: 10.1371/journal.pone.0270984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 06/21/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In Qatar, as in the rest of the world, the sharp rise in the prevalence of type 1 diabetes (T1D) is a leading cause for concern, in terms associated with morbidity, mortality, and increasing health costs. Besides adhering to medication, the outcome of diabetes management is also dependent on patient adherence to the variable self-care behaviors including healthful eating (HE) and physical activity (PA). Yet, dietary intake and PA in adolescents and young adults (AYAs) with T1D are known to fall short of recommended guidelines. The aim of this study was to develop an in-depth understanding of the behavioral determinants of HE and PA adherence among Arab AYAs within the age range of 17-24 years with T1D attending Hamad General Hospital. METHODS Semi-structured, face-to-face individual interviews were conducted with 20 participants. Interviews were based on an integrative health behavior change model, the I-Change model (ICM). All interviews were audio-recorded, transcribed verbatim, and analyzed using the framework method. RESULTS More participants reported non-adherence than adherence. Several motivational determinants of adherence to HE and PA were identified. The majority of participants were cognizant of their own behaviors towards HE and PA. Yet, some did not link low adherence to HE and PA with increased risks of health problems resulting from T1D. Facilitators to adherence were identified as being convinced of the advantages of HE and PA, having support and high self-efficacy, a high level of intention, and a good health care system. CONCLUSION The suboptimal adherence in AYAs to HE and PA needs more attention. Supportive actions are needed to encourage adherence to a healthy lifestyle to achieve benefits in terms of glycemic control and overall health outcomes, with a special focus on adolescents. Interventions are needed to foster motivation by addressing the relevant determinants in order to promote adherence to these two behaviors in AYAs with T1D.
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Affiliation(s)
- Hanan AlBurno
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Netherlands, The Netherlands
| | - Liesbeth Mercken
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Netherlands, The Netherlands
- Faculty of Psychology, Department of Health Psychology, Open University of The Netherlands, Heerlen, The Netherlands
| | - Hein de Vries
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Netherlands, The Netherlands
| | - Dabia Al Mohannadi
- Department of Endocrinology and Diabetes, Hamad General Hospital, Doha, Qatar
| | - Francine Schneider
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Netherlands, The Netherlands
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Enggarwati P, Dahlia D, Maria R. Social support as a mediator between depressive symptoms and self-care activities in adults patient with type 2 diabetes mellitus. J Public Health Res 2021; 11. [PMID: 35255669 PMCID: PMC8958446 DOI: 10.4081/jphr.2021.2734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND People with type 2 DM are at risk of experiencing depression, which in turn can affect their self-care activities. Recent evidence has shown that social support is beneficial in reducing the risk of depression and positively affecting increases in self-care activities. However, the role of social support in the relationship between depressive symptoms and self-care activities has not been studied. This study aims to determine the mediating effects of social support on the relationship between depressive symptoms and self-care activities of people with type 2 DM. DESIGN AND METHODS A cross-sectional consecutive sampling approach was used with 94 respondents with type 2 diabetes in East Jakarta, Indonesia, who were undergoing diabetes treatments during May-June 2020. The instruments used were the Centre for Epidemiologic Studies-Depression Scale (CES-D), Summary of Diabetes Self Care Activities (SDSCA), and Duke-UNC Functional Social Support Questionnaire (DUFSSQ). All three questionnaires have been tested for validity and reliability. Data analysis was carried out using multiple linear regression, path analysis, and the Sobel test. RESULTS The results of multiple linear regression analysis on the variables age, sex, education level, socioeconomic status, duration of type 2 DM, and complications of type 2 DM showed that only complications of type 2 diabetes affected self-care activities (p = 0,000; R2 = 0.515). The results of the path analysis and Sobel test showed that social support significantly mediated the effects of the relationship between depressive symptoms and self-care activities (z = -0,162 > table 1.96; direct effect = -0,499; indirect effect = -0,0789; total effect = 40, 3%). CONCLUSIONS Screening for depressive symptoms and interventions involving social support are strongly suggested for patients with type 2 DM who are suspected of showing a decline in self-care activities.
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Affiliation(s)
| | | | - Riri Maria
- Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java.
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Almeida AC, Leandro ME, Pereira MG. Individual and Family Management in Portuguese Adolescents with Type 1 Diabetes: a Path Analysis. Int J Behav Med 2020; 27:455-465. [PMID: 32430785 DOI: 10.1007/s12529-020-09884-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND This study evaluates the adequacy of the Revised Self and Family Management Framework (Grey et al., Nurs Outlook 63:162-170, 2015) in Portuguese adolescents with type 1 diabetes and analyzes the effect of parental coping, family support, and adherence in the association between illness representations, school support, metabolic control, quality of life, and family functioning. METHOD One hundred adolescents (aged 12-19) and their parents participated in a cross-sectional study. Adolescents were assessed on school support, adherence to self-care, family support, and quality of life. Parents were assessed on parental coping and family functioning. Both adolescents and parents were assessed on illness representations. Adolescent's metabolic control was evaluated through glycosylate hemoglobin. RESULTS Adolescents' and parents' illness representations were associated with metabolic control, quality of life and family functioning. Parental coping, family support and adherence had an indirect effect between illness representations and diabetes outcomes. CONCLUSION Findings showed the adequacy of Grey and colleagues' model (Nurs Outlook 63:162-170, 2015) in adolescents with type 1 diabetes and how family support, parental coping, and adherence contribute to diabetes management. Interventions to improve adolescents' and family's management of Type 1 diabetes should be designed to change adolescents' and family's representations and enhance their ability and skills in diabetes management.
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Affiliation(s)
- Ana Cristina Almeida
- Institute of Social Sciences, University of Minho - Campus de Gualtar, 4710-057, Braga, Portugal.
| | - M Engrácia Leandro
- Centre for Research and Studies in Sociology/ISCTE, University Institute of Lisbon, Campus da Cidade Universitária de Lisboa, 1649-026, Lisbon, Portugal
| | - M Graça Pereira
- School of Psychology, University of Minho - Campus de Gualtar, 4710-057, Braga, Portugal
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RASHİDİ M, GENÇ A. Tip 1 ve Tip 2 Diyabetli Hastaların Diyabet Tutumlarının Değerlendirilmesi. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2020. [DOI: 10.38079/igusabder.674852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Ledford CJW, Seehusen DA, Crawford PF. The relationship between patient perceptions of diabetes and glycemic control: A study of patients living with prediabetes or type 2 diabetes. PATIENT EDUCATION AND COUNSELING 2019; 102:2097-2101. [PMID: 31176557 DOI: 10.1016/j.pec.2019.05.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 05/03/2019] [Accepted: 05/25/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE This study aims to identify differences in how patients living with prediabetes (preDM) or type 2 diabetes (T2DM) perceive their illness. METHODS Following chart review, a cross-sectional survey was administered to patients diagnosed with preDM or T2DM at two US medical centers. RESULTS Among 757 respondents, multivariate tests demonstrate that patients living with T2DM have an overall different personal model of disease than patients living with preDM. Patients who have been diagnosed with T2DM report a better understanding of their disease and perceive it to be more chronic in nature than patients living with preDM. Findings revealed a potential but less significant difference in perceived seriousness. CONCLUSIONS In this first application of personal models of disease to prediabetes, results inform implications for clinicians to talk with patients about preDM. Patients living with preDM indicate less understanding of the "disease" and perceive it to be less "chronic," which may result from unclear clinician communication about preDM. PRACTICE IMPLICATIONS When clinicians talk to patients about prediabetes, they should present the risk factor within the spectrum of glucose tolerance. Although labeled a risk factor, clinicians should emphasize that prediabetes remains a serious concern that will not lessen without intervention.
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Affiliation(s)
- Christy J W Ledford
- Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, USA.
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Latella LE, Rogers M, Leventhal H, Parker PA, Horwitz S, Matasar MJ, Bylund CL, Kissane DW, Franco K, Banerjee SC. Fear of cancer recurrence in lymphoma survivors: A descriptive study. J Psychosoc Oncol 2019; 38:251-271. [PMID: 31617830 DOI: 10.1080/07347332.2019.1677840] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives: Fear of cancer recurrence (FCR) is a common experience among cancer survivors and often persists after the termination of cancer treatments. The purpose of this paper was to evaluate FCR in survivors of Hodgkin's and diffuse large B-cell lymphomas, given a high rate of survivorship in this patient population.Research Approach: The parent study was a multi-site, cluster-randomized trial to assess a communication skills intervention: survivorship planning consultation (versus a time-attention control - wellness rehabilitation intervention) to promote transition to survivorship.Participants & Methodological Approach: 199 patients enrolled in the study and completed a survivorship (or control) consultation one-month after receiving the news of their survivorship status; 141 of those patients (n = 92 experimental arm, n = 49 control arm) completed an interview at their 6-month follow-up consultation. In the interview, participants described frequency of FCR, causes of FCR, coping mechanisms, and specific things oncologists said to reduce FCR. Both qualitative and quantitative methods were utilized for analyzing participant responses.Findings: The majority (88%) of participants reported experiencing FCR, with a higher number of participants in the experimental arm significantly more likely to endorse FCR compared to the control group participants. The main causes of FCR were having medical appointments and concerns about potential relapse and secondary cancers. Participants endorsed utilizing self-sufficient coping mechanisms. As well, participants reported that oncologists most frequently cited specific cure rates of lymphoma to reduce patients' FCR.Interpretation & Implications for Psychosocial Providers: Communication skills training programs should emphasize FCR in survivorship consultations.
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Affiliation(s)
- Lauren E Latella
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Madeline Rogers
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Howard Leventhal
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA
| | - Patricia A Parker
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | - Steven Horwitz
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Matthew J Matasar
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Carma L Bylund
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Public Relations, University of Florida, Gainesville, Florida, USA
| | - David W Kissane
- Cunningham Centre for Palliative Care Research, University of Notre Dame Australia and St Vincent's Sydney, Sydney, Australia.,Cabrini Health and Monash Health, Monash University, Melbourne, Australia
| | - Kara Franco
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Smita C Banerjee
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
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Guo J, Yang J, Wiley J, Ou X, Zhou Z, Whittemore R. Perceived stress and self-efficacy are associated with diabetes self-management among adolescents with type 1 diabetes: A moderated mediation analysis. J Adv Nurs 2019; 75:3544-3553. [PMID: 31441523 DOI: 10.1111/jan.14179] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 07/15/2019] [Accepted: 08/03/2019] [Indexed: 02/06/2023]
Abstract
AIMS The aims of this study were to: (a) determine if self-efficacy mediates the relationship between perceived stress and diabetes self-management in adolescents with type 1 diabetes (T1D); and (b) explore whether perceived stress moderated the self-efficacy and diabetes self-management relationship. DESIGN Non-experimental, descriptive correlational design, conducted from January-December 2016. METHODS Guided by the Adaptation to Diabetes framework, data on demographic and clinical characteristics, perceived stress, self-efficacy and diabetes self-management were collected. Descriptive analyses and regression analyses were generated by SPSS Version 22. Structural equation modelling was implemented with the MPlus program. RESULTS There was no direct effect of perceived stress on diabetes self-management; however, self-efficacy mediated the relationship between perceived stress and diabetes self-management. Adolescents who had high self-efficacy and low perceived stress demonstrated better diabetes care activities and diabetes communication than would be predicted from the main effects of self-efficacy and perceived stress alone. CONCLUSIONS Decreasing perceived stress and improving self-efficacy are important strategies to improve diabetes self-management in adolescents with T1D. IMPACT Adolescents with T1D experience considerable stress with daily self-management demands. This study highlights the mediating role of self-efficacy on perceived stress and diabetes self-management. Assessment of perceived stress and self-efficacy in self-management tasks in adolescents with T1D may help nurses individualize self-management education and support. Incorporating strategies to promote stress management and self-efficacy in diabetes education may also improve diabetes self-management.
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Affiliation(s)
- Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Jundi Yang
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - James Wiley
- School of Nursing, University of California San Francisco, San Francisco, California
| | - Xiancai Ou
- School of Business, XingJian College of Science and Liberal Arts of Guangxi University, Nanning, Guangxi Province, China
| | - Zhiguang Zhou
- Diabetes Center, Institute of Metabolism and Endocrinology, Second Xiangya Hospital, Central South University, Changsha, China
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Kebede MM, Pischke CR. Popular Diabetes Apps and the Impact of Diabetes App Use on Self-Care Behaviour: A Survey Among the Digital Community of Persons With Diabetes on Social Media. Front Endocrinol (Lausanne) 2019; 10:135. [PMID: 30881349 PMCID: PMC6407478 DOI: 10.3389/fendo.2019.00135] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/13/2019] [Indexed: 12/21/2022] Open
Abstract
Introduction: This study aimed to identify popular diabetes applications (apps) and to investigate the association of diabetes app use and other factors with cumulative self-care behaviour. Methods: From November 2017 to March 2018, we conducted a web-based survey with persons 18 years of age and above. We recruited respondents via diabetes Facebook groups, online patient-forums and targeted Facebook advertisements (ads). Data on participants' demographic, clinical, and self-management characteristics, as well as on self-care behaviour and characteristics of the diabetes apps use were collected. Self-care behaviour was measured using a licensed version of the Summary of Diabetes Self-care Activities (SDSCA) questionnaire. The cumulative self-care score was calculated by summing up scores for "general diet," "specific diet," "exercise," "blood glucose testing," "foot care" and "smoking." To identify popular diabetes apps, users were requested to list all apps they use for diabetes self-management. Two sample t-test and multiple linear regression stratified by type of diabetes were performed to examine associations between app use and self-care behaviour, by controlling for key confounders. Results: One thousand fifty two respondents with type 1 and 630 respondents with type 2 diabetes mellitus (DM) entered the survey. More than half, 549 (52.2%), and one third, 210 (33.3%), of respondents with type 1 and 2 DM, respectively, reported using diabetes apps for self-management. "mySugr" and continuous glucose monitoring apps, such as "Dexcom," "Freestyle Libre," and "Xdrip+" were some of the most popular diabetes apps. In both respondent groups, the cumulative self-care behaviour score was significantly higher among diabetes app users (compared to non-users) and scores for three individual self-care components, namely "blood glucose monitoring," "general diet," and "physical activity" were significantly higher among diabetes app users than among non-users. After adjusting for confounding factors, diabetes app use increased the cumulative self-care score by 1.08 (95%CI: 0.46-1.7) units among persons with type 1 DM and by 1.18 (95%CI: 0.26-2.09) units among persons with type 2 DM, respectively. Conclusion: For both, persons with type 1 and type 2 diabetes, using diabetes apps for self-management was positively associated with self-care behaviour. Our findings suggest that apps can support changes in lifestyle and glucose monitoring in these populations.
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Affiliation(s)
- Mihiretu M. Kebede
- Leibniz Institute for Prevention Research and Epidemiology-BIPSBremen, Germany
- Health Sciences, University of Bremen, Bremen, Germany
- College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
- *Correspondence: Mihiretu M. Kebede
| | - Claudia R. Pischke
- Leibniz Institute for Prevention Research and Epidemiology-BIPSBremen, Germany
- Medical Faculty, Centre for Health and Society, Institute of Medical Sociology, University of Düsseldorf, Düsseldorf, Germany
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11
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Delamater AM, de Wit M, McDarby V, Malik JA, Hilliard ME, Northam E, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2018: Psychological care of children and adolescents with type 1 diabetes. Pediatr Diabetes 2018; 19 Suppl 27:237-249. [PMID: 30058247 DOI: 10.1111/pedi.12736] [Citation(s) in RCA: 157] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 07/16/2018] [Indexed: 01/09/2023] Open
MESH Headings
- Adaptation, Psychological/physiology
- Adolescent
- Burnout, Psychological/psychology
- Burnout, Psychological/therapy
- Child
- Consensus
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/psychology
- Diabetes Mellitus, Type 1/therapy
- Endocrinology/organization & administration
- Endocrinology/standards
- Humans
- International Cooperation
- Neurodevelopmental Disorders/therapy
- Pediatrics/organization & administration
- Pediatrics/standards
- Practice Patterns, Physicians'/standards
- Psychotherapy/methods
- Psychotherapy/standards
- Quality of Life/psychology
- Resilience, Psychological
- Societies, Medical/organization & administration
- Societies, Medical/standards
- Stress, Psychological/etiology
- Stress, Psychological/therapy
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Affiliation(s)
- Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Maartje de Wit
- Department of Medical Psychology, EMGO Institute for Health & Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Vincent McDarby
- National Children's Research Centre and Our Lady's Children's Hospital, Dublin, Ireland
| | - Jamil A Malik
- Center of Excellence, National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | | | - Carlo L Acerini
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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12
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Jones CM, Foli KJ. Maturity in Adolescents with Type 1 Diabetes Mellitus: A Concept Analysis. J Pediatr Nurs 2018; 42:73-80. [PMID: 30219302 DOI: 10.1016/j.pedn.2018.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 12/20/2022]
Abstract
THEORETICAL PRINCIPLES The transition from adolescence to adulthood can be a particularly challenging time for teenagers with type 1 diabetes mellitus (T1DM). Adolescents with T1DM must manage a treatment regimen which requires a high level of responsibility and self-care. Often the responsibilities of self-care are given to these teens without a clear assessment of their maturity, resulting in poor health outcomes. In order to accurately assess a youth's ability to assume self-management of T1DM, a clear understanding of the concept of maturity is needed. PHENOMENA ADDRESSED The purpose of this paper is to provide a theoretical definition of the concept of maturity in the context of adolescents with T1DM and support this definition based on a literature review. This discussion was developed utilizing the Walker and Avant approach to concept analysis. RESEARCH LINKAGES This concept analysis defined maturity in adolescents with T1DM as a multi-dimensional state of development that encompasses the physical, cognitive, psychological, and social dimensions of being. Maturity requires that an individual is capable of functioning with behavioral, cognitive, and emotional autonomy in self-care activities related to TIDM on a consistent basis. This explanation also emphasizes that the process of achieving maturity is gradual and dynamic in nature. Caregivers must understand that physical age alone does not indicate that an adolescent is adequately prepared to assume independent diabetes management. Nurses are in the unique position to assist youth with the transition from dependent diabetes care to independent self-management of the disease; thus, increasing the likelihood of positive outcomes.
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Affiliation(s)
| | - Karen J Foli
- Purdue University School of Nursing, West Lafayette, IN, USA.
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13
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Pan W, Ge S, Xu Y, Toobert D. Cross-Validating a Structural Model of Factors Influencing Diabetes Self-Management in Chinese Americans with Type 2 Diabetes. J Transcult Nurs 2018; 30:163-172. [DOI: 10.1177/1043659618790085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction: The purpose of this study was to cross-validate a structural model depicting the effects of individual and environmental factors on diabetes self-management in Chinese Americans with type 2 diabetes. Methodology: A cross-sectional survey was administered to a convenience sample of 209 Chinese Americans with type 2 diabetes in the Midwest of the United States. Structural equation modeling was used to cross-validate the model fit. Results: Provider–patient communication indirectly influenced self-management via belief in treatment. Knowledge indirectly influenced self-management via belief in treatment and self-efficacy. Social support indirectly influenced self-management via belief in treatment and knowledge. Discussion: This study demonstrated that the structural model, previously tested with Chinese diabetes patients in China, also fits Chinese Americans in the United States with few modifications. The cross-validated model provides a theoretical basis for developing culturally relevant diabetes self-management interventions for Chinese Americans, which may lead to health improvements in this ethnic population.
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Affiliation(s)
- Wei Pan
- Duke University, Durham, NC, USA
| | | | - Yin Xu
- Innovative Spine and Orthopedic Clinic, San Antonio, TX, USA
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Singer J, Levy S, Shimon I. Group versus Individual Care in Patients with Long-Standing Type 1 and Type 2 Diabetes: A One-Year Prospective Noninferiority Study in a Tertiary Diabetes Clinic. J Diabetes Res 2018; 2018:1807246. [PMID: 29998139 PMCID: PMC5994582 DOI: 10.1155/2018/1807246] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 03/22/2018] [Accepted: 04/11/2018] [Indexed: 12/02/2022] Open
Abstract
AIMS To explore the feasibility and noninferiority of group care in a diabetes outpatient clinic in comparison with individual care. METHODS In this prospective, randomized, nonblinded, one center (university hospital) trial, 60 patients (28 with type 1 and 32 with type 2 diabetes) with a mean duration of diabetes of 22.5 ± 11.7 years were randomly assigned to group (6 patients per group) or individual care for one year. The primary endpoints were the change in HbA1c and visits to outpatient clinics. The secondary endpoints were changes in body mass index, blood pressure levels, waist circumference, non-HDL cholesterol, diabetes-related and well-being index questionnaires, and the number of hospitalizations. RESULTS Group care was not inferior to individual care for any of the above parameters except for the number of visits to a primary care physician. CONCLUSION Group care is feasible in a diabetes clinic and is as effective as individual care. Implementation of group care may facilitate access to specialized care to a larger population of patients with diabetes type 1 and 2.
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Affiliation(s)
- Joelle Singer
- Institute of Endocrinology, Diabetes and Metabolism, Beilinson Hospital, Rabin Medical Center, Jabotinski Road 39, 49100 Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Chaim Lebanon 30, 6997801 Tel Aviv, Israel
| | - Sigal Levy
- Statistical Education Unit, The Academic College of Tel Aviv-Yaffo, Khever ha-Le'umim St 10, Tel Aviv-Yafo, Israel
| | - Ilan Shimon
- Institute of Endocrinology, Diabetes and Metabolism, Beilinson Hospital, Rabin Medical Center, Jabotinski Road 39, 49100 Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Chaim Lebanon 30, 6997801 Tel Aviv, Israel
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Ebadi Fardaza F, Heidari H, Solhi M. Effect of educational intervention based on locus of control structure of attribution theory on self-care behavior of patients with type II diabetes. Med J Islam Repub Iran 2017; 31:116. [PMID: 29951417 PMCID: PMC6014766 DOI: 10.14196/mjiri.31.116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Indexed: 12/30/2022] Open
Abstract
Background: Different factors, such as personality and psychological characteristics, are effective in the self-care and control of diabetes. This study aimed at determining the effect of educational intervention based on locus of control structure of attribution theory on the self-care behavior of patients with type II diabetes. Methods: This was a quasi-experimental controlled study performed on 180 patients in Babol Diabetes Association. The sampling method was simple random sampling. Data collection tool was form C of standard questionnaire in multidimensional health locus of control (MHLC) and summary of diabetes self-care activities (SDSCA). Based on the results obtained from the initial completion of the questionnaires, educational intervention was designed as three 60-minute educational sessions using short lectures, question and answer, group discussions, and consultation methods, as well as educational materials, such as films, posters, and pamphlets. Intervention was only performed for the test group. The questionnaires were filled out again 2 and 3 months after the intervention. Results: Before the intervention, there was no significant difference in the mean scores of self-care, internal, chance, and external locus of control between the 2 groups. However, 2 to 3 months after the intervention, the mean scores of self-care (p<0.001) and locus of control (p<0.001) increased in the test group. Moreover, the mean score of chance (p<0.001) and external (p<0.001) locus of control decreased significantly. Conclusion: Educational intervention decreases the mean scores of chance and external locus of control and increases the mean score of internal locus of control; as a result, it improves self-care in patients with diabetes.
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Affiliation(s)
- Farbod Ebadi Fardaza
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Heidari
- Department of Health Services and Health Education, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Solhi
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
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16
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Relationship of depression to diabetes, prediabetes and nondiabetics according to HbA1c classification: Retrospective study on 72,175 patients. JOURNAL OF SURGERY AND MEDICINE 2017. [DOI: 10.28982/josam.370527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Lee SF, Teh XR, Malar LS, Ong SL, James RP. The associations of illness perception with metabolic control (HbA1c) among type 2 diabetes mellitus patients in a district hospital. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2017; 26:442-449. [PMID: 29193388 DOI: 10.1111/ijpp.12413] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 10/14/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Despite the availability of a wide selection of anti-diabetic treatments, many type 2 DM (T2DM) patients still do not have controlled glucose levels. In addition to pharmacological intervention, patients' own implicit beliefs about their illness should be targeted for health intervention. Thus, we conducted a quantitative study to evaluate the associations between illness perception (IP) domains and metabolic control (HbA1c) of T2DM patients in Selama Hospital and to identify patients' perceptions of the causal T2DM factors. METHOD A cross-sectional study was conducted in the outpatient department of Selama Hospital from October to December 2015. A total of 200 T2DM patients were recruited using systematic random sampling. A self-administered validated questionnaire consisting of three sections was used, and the data were analysed using SPSS version 18. The associations between eight IP domains and HbA1c were evaluated via multiple linear regression. P values <0.05 were considered significant. KEY FINDINGS The analysis included data from 200 respondents with a mean age of 57.7 years (SE = 9.8). The majority were women (64.5%) and Malays (86%) with a primary school education (43.5%) and a family history of diabetes (53.5%). The median duration of illness was 5 years (IQR = 7), and the median HbA1c level was 8.15% (IQR = 3.1). The mean score for the eight IP domains was 33.7 (SE = 8.43) out of a total score of 80. Using multiple linear regression, HbA1c was found to be significantly associated with IP domains of identity symptoms at 0.221 (95% CI 0.083-0.358). Moreover, 79.4% of patients ranked diet and eating behaviour as the main factor for T2DM. CONCLUSION The IP domain of identity symptoms was significantly correlated with T2DM metabolic control. By understanding patients' IP, healthcare providers can focus on behavioural approaches to managing T2DM patients. Steps must be taken to educate patients about the importance of diet control in managing T2DM.
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Affiliation(s)
- Soik Fun Lee
- Pharmacy Department, Selama Hospital, Ministry of Health Malaysia, Perak, Malaysia
| | - Xin Rou Teh
- Pharmacy Department, Selama Hospital, Ministry of Health Malaysia, Perak, Malaysia
| | - Louise Santana Malar
- Pathology Department, Selama Hospital, Ministry of Health Malaysia, Perak, Malaysia
| | - Su Ling Ong
- Pharmacy Department, Selama Hospital, Ministry of Health Malaysia, Perak, Malaysia
| | - Rita Pauline James
- Pharmacy Department, Selama Hospital, Ministry of Health Malaysia, Perak, Malaysia
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18
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Gonzalez JS, Tanenbaum ML, Commissariat PV. Psychosocial factors in medication adherence and diabetes self-management: Implications for research and practice. ACTA ACUST UNITED AC 2017; 71:539-551. [PMID: 27690483 DOI: 10.1037/a0040388] [Citation(s) in RCA: 170] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Diabetes is a chronic illness that places a significant self-management burden on affected individuals and families. Given the importance of health behaviors-such as medication adherence, diet, physical activity, blood glucose self-monitoring-in achieving optimal glycemic control in diabetes, interventions designed and delivered by psychologists hold promise in assisting children, adolescents, and adults with diabetes in improving their health status and lowering their risk of serious complications. This article first provides an overview of diabetes self-management and associated challenges and burdens. Socioeconomic status factors that may influence diabetes management and outcomes are briefly highlighted. We then review the evidence base for select psychosocial factors that may be implicated in diabetes self-management. Modifiable targets of psychological intervention are presented across 3 overarching domains: (a) knowledge, beliefs, and related cognitive constructs; (b) emotional distress and well-being; and (c) behavioral skills and coping. Important methodological issues facing future research are discussed, along with opportunities for psychologists in improving the care and treatment outcomes of individuals and families living with diabetes. In conclusion, we advocate for continued research emphasis on improving psychosocial aspects of living with diabetes, with greater attention to the situational context in which the self-regulatory processes underlying self-management occur. Psychologists have important roles to play in reducing emotional distress, improving patient knowledge, and providing training in behavioral skills to promote successful self-management and to support patient-centered diabetes care. (PsycINFO Database Record
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19
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Chyun D, Lacey KO, Katten DM, Talley S, Price WJ, Davey JA, Melkus GD. Glucose and Cardiac Risk Factor Control in Individuals With Type 2 Diabetes. DIABETES EDUCATOR 2016; 32:925-39. [PMID: 17102160 DOI: 10.1177/0145721706295016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The purpose of this descriptive study was to describe attainment of glucose and coronary heart disease (CHD) risk factor goals and to identify factors that were associated with successful goal achievement. Methods A cross-sectional survey enrolled 110 subjects with type 2 diabetes undergoing screening for asymptomatic myocardial ischemia. Results Many participants had HbA1c levels ≥7% (45%), and 46% to 79% were not meeting goals for CHD risk reduction. Individual factors of age, gender, and anxiety; the illness-related factor of lipid-lowering therapy; and the family-related factor of living alone were independently associated with 1 of the 7 outcomes under study. Illness-related factors of a longer duration of diabetes were strongly associated with glucose and blood pressure control, insulin use with glucose control and waist circumference, and antihypertensive use with blood pressure, triglycerides, and body mass index. Family-related factors of higher income were significantly associated with poorer glucose control and higher body mass index, while higher levels of perceived support by family and friends were associated with a lower risk of not meeting lipid goals. However, individual factors, represented by several aspects of personal model beliefs (exercising regularly, testing glucose, and checking one’s feet) and physical activity, were consistently related to lipid and weight control. Conclusions A variety of factors were associated with control of blood glucose and CHD risk factors, suggesting that a one-size-fits-all approach to multiple risk factor reduction efforts may not result in goal attainment.
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Affiliation(s)
- Deborah Chyun
- The Yale University School of Nursing, New Haven, Connecticut (Dr Chyun, Ms Lacey, Dr Talley, Dr Melkus)
| | - Kimberly O Lacey
- The Yale University School of Nursing, New Haven, Connecticut (Dr Chyun, Ms Lacey, Dr Talley, Dr Melkus)
| | | | - Sandra Talley
- The Yale University School of Nursing, New Haven, Connecticut (Dr Chyun, Ms Lacey, Dr Talley, Dr Melkus)
| | - Wendie J Price
- University of Virginia Medical System, Charlottesville (Ms Price)
| | - Janice A Davey
- Yale University School of Medicine, New Haven, Connecticut (Ms Davey)
| | - Gail D Melkus
- The Yale University School of Nursing, New Haven, Connecticut (Dr Chyun, Ms Lacey, Dr Talley, Dr Melkus)
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Martinez K, Frazer SF, Dempster M, Hamill A, Fleming H, McCorry NK. Psychological factors associated with diabetes self-management among adolescents with Type 1 diabetes: A systematic review. J Health Psychol 2016; 23:1749-1765. [PMID: 27663288 DOI: 10.1177/1359105316669580] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This review aims to synthesise the literature examining the psychosocial variables related to self-management (insulin adherence, non-adherence and administration, blood sugar monitoring, dietary behaviour, exercise behaviour) in adolescents with type 1 diabetes. A systematic search of three electronic databases was carried out and, after the application of eligibility criteria, 21 articles were assessed for quality prior to data extraction. Numerous psychological factors were found to be associated with self-management; however, correlations were typically small to moderate. The strongest associations were found between social anxiety and diet (among males); greater intrinsic motivation, conscientiousness and diet; and extraversion and exercise.
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21
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Reid C, Seymour J, Jones C. A Thematic Synthesis of the Experiences of Adults Living with Hemodialysis. Clin J Am Soc Nephrol 2016; 11:1206-1218. [PMID: 27246010 PMCID: PMC4934845 DOI: 10.2215/cjn.10561015] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 03/16/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Patients on in-center dialysis spend significant amounts of time in the dialysis unit; additionally, managing ESRD affects many aspects of life outside the dialysis unit. To improve the care provided to patients requiring hemodialysis, their experiences and beliefs regarding treatment must be understood. This systematic review aimed to synthesize the experiences of patients receiving in-center hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We searched Embase, MEDLINE, CINAHL, PsychINFO, Google Scholar, and reference lists for primary qualitative studies published from 1995 to 2015 that explored the experiences of adult patients receiving treatment with in-center hemodialysis. A thematic synthesis was conducted. RESULTS Seventeen studies involving 576 patients were included in the synthesis. Four analytic themes were developed. The first theme (a new dialysis-dependent self) describes the changes in identity and perceptions of self that could result from dialysis dependence. The second theme (a restricted life) describes the physical and emotional constraints that patients described as a consequence of their dependence. Some patients reported strategies that allowed them to regain a sense of optimism and influence over the future, and these contributed to the third theme (regaining control). The first three themes describe a potential for change through acceptance, adaption, and regaining a sense of control. The final theme (relationships with health professionals) describes the importance of these relationships for in-center patients and their influence on perceptions of power and support. These relationships are seen to influence the other three themes through information sharing, continuity, and personalized support. CONCLUSIONS Our synthesis has resulted in a framework that can be used to consider interventions to improve patients' experiences of in-center hemodialysis care. Focusing on interventions that are incorporated into the established relationships that patients have with their health care professionals may enable patients to progress toward a sense of control and improve satisfaction with care.
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Affiliation(s)
- Claire Reid
- Supportive Care, Early Diagnosis and Advanced Disease Research Group, Hull York Medical School, University of York, York, United Kingdom; and
| | - Julie Seymour
- Supportive Care, Early Diagnosis and Advanced Disease Research Group, Hull York Medical School, University of York, York, United Kingdom; and
| | - Colin Jones
- York Hospitals National Health Service Trust
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22
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Baron JS, Hirani SP, Newman SP. Investigating the behavioural effects of a mobile-phone based home telehealth intervention in people with insulin-requiring diabetes: Results of a randomized controlled trial with patient interviews. J Telemed Telecare 2016; 23:503-512. [DOI: 10.1177/1357633x16655911] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Introduction Evidence supporting home telehealth effects on clinical outcomes in diabetes is available, yet mechanisms of action for these improvements remain poorly understood. Behavioural change is one plausible explanation. This study investigated the behavioural effects of a mobile-phone based home telehealth (MTH) intervention in people with diabetes. It was hypothesized that MTH would improve self-efficacy, illness beliefs, and diabetes self-care. Methods A randomized controlled trial compared standard care to standard care supplemented with MTH (self-monitoring, data transmission, graphical and nurse-initiated feedback, educational calls). Self-report measures of self-efficacy, illness beliefs, and self-care were repeated at baseline, three months, and nine months. MTH effects were based on the group by time interactions in hierarchical linear models and effect sizes with 95% confidence intervals (CIs). Interviews with MTH participants explored the perceived effects of MTH on diabetes self-management. Results Eighty-one participants were randomized to the intervention ( n = 45) and standard care ( n = 36). Significant group by time effects were observed for five out of seven self-efficacy subscales. Effect sizes were large, particularly at nine months. Interaction effects for illness beliefs and self-care were non-significant, but effect sizes and confidence intervals suggested MTH may positively affect diet and exercise. In interviews, MTH was associated with increased awareness, motivation, and a greater sense of security. Improved self-monitoring and diet were reported by some participants. Discussion MTH empowers people with diabetes to manage their condition and may influence self-care. Future MTH research would benefit from investigating behavioural mechanisms and determining patient profiles predictive of greater behavioural effectiveness.
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Affiliation(s)
- Justine Sita Baron
- Institute of Cardiovascular Science, University College London, United Kingdom; Ottawa Hospital Research Institute, Ontario, Canada
| | | | - Stanton Peter Newman
- Centre for Health Services Research, School of Health Sciences, City University London, UK
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Goh CSY, Mohamed A, Lee YS, Loke KY, Wee HL, Khoo EYH, Griva K. The associations of self-care, illness perceptions and psychological distress with metabolic control in Singaporean adolescents with Type 1 Diabetes Mellitus. Health Psychol Behav Med 2016. [DOI: 10.1080/21642850.2015.1115728] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Gucuk S. Effects of the behavior of elderly type 2 diabetic patients and their relatives as caregivers on diabetes follow-up parameters in Bolu, Turkey. Geriatr Gerontol Int 2016; 16:182-90. [PMID: 25613591 DOI: 10.1111/ggi.12449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2014] [Indexed: 01/01/2023]
Abstract
AIM In the present study, patients with type 2 diabetes mellitus and their relatives as caregivers during the treatment period, and the effects on treatment success were evaluated. METHODS A cross-sectional study of type 2 diabetes mellitus patients aged 65 years and older and their relatives as caregivers was carried out. The questionnaire given to the participants consisted of three sections: the first section included questions regarding sociodemographic characteristics; the second section included questions on patient treatment, habits of drug use, lifestyle changes such as dietary habits; and the third section included anthropometric measurements and laboratory evaluations. The questionnaire given to the patients' relatives as caregivers consisted of questions regarding their sociodemographic characteristics and information regarding the patient. RESULTS The present study consisted of 115 patients diagnosed with type 2 diabetes mellitus and their relatives as caregivers. The average duration of diabetes was 12.14 ± 6.74 years. Body mass index was 30.2 ± 4.2 kg/m(2) , average hemoglobin A1c level was 7.09 ± 0.64%, and 40.1% of the patients lived with their partners only. As the frequency of physical exercise increased, hemoglobin A1c levels decreased to <7.5% (P < 0.05).The patients whose caregivers were college-educated or equivalent had a significantly low body mass index (P < 0.05). Patients who lived with their partners showed a significant correlation with lower hemoglobin A1c levels (<7.5%; P = 0.002). CONCLUSION In order to improve diabetic conditions in the elderly and to overcome obstacles to disease management, maximizing the cooperative efforts between the patients and their caregivers is necessary.
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Affiliation(s)
- Sebahat Gucuk
- Family Medicine, Izzet Baysal Family Health Center, Bolu, Turkey
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Developing a Complex Educational-Behavioural Intervention: The TREAT Intervention for Patients with Atrial Fibrillation. Healthcare (Basel) 2016; 4:healthcare4010010. [PMID: 27417598 PMCID: PMC4934544 DOI: 10.3390/healthcare4010010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/04/2016] [Accepted: 01/05/2016] [Indexed: 11/17/2022] Open
Abstract
This article describes the theoretical and pragmatic development of a patient-centred intervention for patients with atrial fibrillation (AF). Theoretical models (Common Sense Model, Necessity-Concerns Framework), clinical frameworks, and AF patient feedback contributed to the design of a one-off hour-long behaviour-change intervention package. Intervention materials consisted of a DVD, educational booklet, diary and worksheet, which were patient-centred and easy to administer. The intervention was evaluated within a randomised controlled trial. Several “active theoretical ingredients” were identified (for e.g., where patients believed their medication was less harmful they spent more time within the therapeutic range (TTR), with general harm scores predicting TTR at 6 months). Allowing for social comparison and adopting behaviour change techniques enabled accurate patient understanding of their condition and medication. The process of developing the intervention using theory-derived content and evaluation tools allowed a greater understanding of the mechanisms by which this intervention was successful. Alleviating concerns about treatment medication by educating patients can help to improve adherence. This process of intervention development could be adopted for a range of chronic illnesses and treatments. Critical elements should include the use of: (1) clinical guidelines; (2) appropriate theoretical models; (3) patient input; and (4) appropriate evaluation tools.
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Voigt A, Madrid E, Pacheco-Huergo V, Rastello A, Castro D, Navarro-Brito I, Oyaneder MJ. Association of glycaemia with perceived threat of illness in patients with type 2 diabetes. Prim Care Diabetes 2015; 9:426-431. [PMID: 25862461 DOI: 10.1016/j.pcd.2015.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 03/02/2015] [Accepted: 03/07/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND It is essential to reach glycaemic control in patients with diabetes mellitus to prevent reduced life expectancy and morbidity related to complications. The aim of this study was to determine whether glycaemic control is associated with the perception of illness in type II diabetes mellitus. METHODOLOGY Illness perception was assessed in a sample of 242 diabetics attending a Family Health Centre in Chile using the Brief Illness Perception Questionnaire (BIPQ). We considered well-controlled individuals to have glycated haemoglobin below 7%, and we assessed association with the BIPQ score. The data were analysed by logistic regression. RESULTS The total BIPQ score was significantly higher (more negative perception) in non-controlled individuals; the most significant differences were found in the following dimensions: consequences (p=0.0003), personal control (p=0.0392), identity (p=0.0006) and emotional affection (p=0.018). The dimensions of timeline, treatment control, concern and coherence showed no differences between the groups. The mean age of well-controlled subjects was significantly higher than the age of non-controlled diabetics. Well-controlled patients had been diagnosed with diabetes for significantly fewer years than had those that were not. CONCLUSIONS Perceiving illness as more negative (BIPQ score >37) is highly associated with being a non-controlled diabetic, with more consequences over their daily life, less control over the disease and a higher number of attributable symptoms. When control variables are considered, a negative perception of diabetes has an adjusted OR of 2.14 (CI 95% 1.17-3.92) to have glycated haemoglobin above 7%.
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Affiliation(s)
- Alejandra Voigt
- Department of Child and Adolescent Psychiatry, Hospital del Salvador, Valparaíso, Chile; Department of Pediatrics, School of Medicine, Universidad de Valparaíso, Valparaíso, Chile
| | - Eva Madrid
- Biomedical Research Centre, School of Medicine, Universidad de Valparaíso, Valparaíso, Chile; Department of Public Health, School of Medicine, Universidad de Valparaíso, Valparaíso, Chile.
| | - Valeria Pacheco-Huergo
- Family Centre of Primary Care, ABS Turó, Catalan Institute of Health, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrea Rastello
- Family Centre of Primary Care, Corporación Municipal de Viña del Mar, Viña del Mar, Chile
| | - Daniela Castro
- Biomedical Research Centre, School of Medicine, Universidad de Valparaíso, Valparaíso, Chile
| | - Ignacio Navarro-Brito
- Biomedical Research Centre, School of Medicine, Universidad de Valparaíso, Valparaíso, Chile
| | - María José Oyaneder
- Biomedical Research Centre, School of Medicine, Universidad de Valparaíso, Valparaíso, Chile
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Esbitt SA, Batchelder AW, Tanenbaum ML, Shreck E, Gonzalez JS. "Knowing That You're Not the Only One": Perspectives on Group-Based Cognitive-Behavioral Therapy for Adherence and Depression (CBT-AD) in Adults With Type 1 Diabetes. COGNITIVE AND BEHAVIORAL PRACTICE 2015; 22:393-406. [PMID: 26279614 PMCID: PMC4531381 DOI: 10.1016/j.cbpra.2014.02.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Depression and illness-specific distress are more common among adults with Type 1 diabetes (T1DM) than the general population and have been associated with poorer control of blood glucose and increased risk for serious diabetes-related complications. Treatment nonadherence has also been associated with depressive symptoms and diabetes-related distress, and has repeatedly been suggested as an important modifiable behavioral pathway linking depression and diabetes outcomes. The present study reports on the feasibility and acceptability of a pilot intervention using group-based cognitive-behavioral therapy to improve treatment adherence among adults with T1DM and elevated levels of diabetes-related distress or depressive symptoms. We describe the components of the intervention and utilize qualitative data along with descriptive outcome data. Our findings suggest that participation in the group was acceptable and associated with reductions in depressive symptoms and diabetes-specific distress. Challenges to feasibility and future directions are discussed.
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Affiliation(s)
| | | | | | - Erica Shreck
- Ferkauf Graduate School of Psychology, Yeshiva University
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, and Albert Einstein College of Medicine, Yeshiva University
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Gonzalez JS, Shreck E, Psaros C, Safren SA. Distress and type 2 diabetes-treatment adherence: A mediating role for perceived control. Health Psychol 2015; 34:505-13. [PMID: 25110840 PMCID: PMC4324372 DOI: 10.1037/hea0000131] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To better understand independent pathways linking emotional distress, medication adherence, and glycemic control in adults with Type 2 diabetes, as well as the potential mediating effects of perceived control over illness and self-efficacy. METHOD Adults with Type 2 diabetes (N = 142) were recruited for an intervention study evaluating cognitive-behavioral therapy for adherence and depression. Depressive symptom severity was assessed via semistructured interview. Validated self-reports assessed diabetes-related distress, perceived control over diabetes (perceived control), self-efficacy for diabetes self-management, and medication adherence. Glycemic control was evaluated by hemoglobin A1C. Only baseline data were included in correlational and linear regression analyses. RESULTS Perceived control was an important mediator of emotional distress for both medication adherence and A1C outcomes. Specifically, regression analyses demonstrated that diabetes distress, but not depression severity, was significantly related to medication adherence and A1C. Self-efficacy and perceived control were also independently associated with medication adherence and A1C. Mediation analyses demonstrated a significant indirect effect for diabetes distress and medication adherence through perceived control and self-efficacy. The relationship between distress and A1C was accounted for by an indirect effect through perceived control. CONCLUSION Results demonstrated that diabetes-related emotional distress is associated with poorer treatment adherence and glycemic control among adults with Type 2 diabetes; these relationships were partially mediated through perceived control over diabetes. Perceptions of one's personal ability to influence the course of diabetes may be important in understanding the pathway between emotional distress and poor diabetes-treatment outcomes.
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Affiliation(s)
- Jeffrey S. Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Diabetes Research Center, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
| | - Erica Shreck
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | - Christina Psaros
- Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Steven A. Safren
- Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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Baron J, Hirani S, Newman S. A mobile telehealth intervention for adults with insulin-requiring diabetes: early results of a mixed-methods randomized controlled trial. JMIR Res Protoc 2015; 4:e27. [PMID: 25803226 PMCID: PMC4376177 DOI: 10.2196/resprot.4035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 12/16/2014] [Accepted: 12/16/2014] [Indexed: 11/13/2022] Open
Abstract
Background The role of technology in health care delivery has grown rapidly in the last decade. The potential of mobile telehealth (MTH) to support patient self-management is a key area of research. Providing patients with technological tools that allow for the recording and transmission of health parameters to health care professionals (HCPs) may promote behavior changes that result in improved health outcomes. Although for some conditions the evidence of the effectiveness of MTH is clear, to date the findings on the effects of MTH on diabetes management remain inconsistent. Objective This study aims to evaluate an MTH intervention among insulin-requiring adults with diabetes to establish whether supplementing standard care with MTH results in improved health outcomes—glycated hemoglobin (HbA1c), blood pressure (BP), health-related quality of life (HRQoL), diabetes self-management behaviors, diabetes health care utilization, and diabetes self-efficacy and illness beliefs. An additional objective was to explore the acceptability of MTH and patients’ perceptions of, and experience, using it. Methods A mixed-method design consisting of a 9-month, two-arm, parallel randomized controlled trial (RCT) was used in combination with exit qualitative interviews. Quantitative data was collected at baseline, 3 months, and 9 months. Additional intervention fidelity data, such as participants’ MTH transmissions and contacts with the MTH nurse during the study, were also recorded. Results Data collection for both the quantitative and qualitative components of this study has ended and data analysis is ongoing. A total of 86 participants were enrolled into the study. Out of 86 participants, 45 (52%) were randomized to the intervention group and 36 (42%) to the control group. Preliminary data on MTH training sessions and MTH usage by intervention participants are presented in this paper. We expect to publish complete study results in 2015. Conclusions The range of data collected in this study will allow for a comprehensive evaluation of processes and outcomes. The early results presented suggest that MTH usage decreases over time and that MTH participants would benefit from attending more than one training session. Trial Registration ClinicalTrials.gov NCT00922376; http://clinicaltrials.gov/ct2/show/NCT00922376 (Archived by WebCite at http://www.webcitation.org/6Vu4nhLI6).
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Affiliation(s)
- Justine Baron
- Institute of Cardiovascular Science, University College London, London, United Kingdom
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Clarke A. Effects of routine education on people newly diagnosed with type 2 diabetes. ACTA ACUST UNITED AC 2015. [DOI: 10.1002/edn.142] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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31
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Hofer SE, Raile K, Fröhlich-Reiterer E, Kapellen T, Dost A, Rosenbauer J, Grulich-Henn J, Holl RW. Tracking of metabolic control from childhood to young adulthood in type 1 diabetes. J Pediatr 2014; 165:956-61.e1-2. [PMID: 25151197 DOI: 10.1016/j.jpeds.2014.07.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 06/11/2014] [Accepted: 07/01/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This prospective longitudinal survey was designed to follow patients with diabetes from disease onset in childhood over an extended period of time including puberty until young adulthood with respect to metabolic control. STUDY DESIGN An electronic diabetes patient documentation system used in diabetes centers in Austria and Germany was utilized for standardized data collection. Complete documentation of metabolic control for prepuberty (≤ 13 years), puberty (14-19 years), and adulthood (≥ 20 years) was available in 1146 patients. RESULTS Median age at diabetes manifestation was 7.2 (IQR 4.7-9.4) years; 49% were male. In the prepubertal stage, median glycated hemoglobin A1c (HbA1c) was 7.5 (IQR 6.8-8.3), during puberty 8.0 (IQR 7.3-8.9), and after puberty 7.8 (IQR 7.1-9.0). A significant intra-individual correlation was found for prepuberty to puberty HbA1c levels (R = 0.55, P < .001), puberty to adulthood (R = 0.59, P < .001), as well as prepuberty to adulthood (R = 0.30, P < .001). When patients were divided into tertiles of prepubertal HbA1c, HbA1c increased in all 3 groups over time, however, significant group differences tracked into adulthood (P < .001 at all stages). A regression model identified pre-pubertal HbA1c as a significant and relevant predictor of metabolic control in young adulthood adjusted for confounders (P < .001). CONCLUSIONS This survey provides evidence for long-term tracking of metabolic control from childhood until adulthood, suggesting an early focus on metabolic control.
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Affiliation(s)
- Sabine E Hofer
- Department of Pediatrics 1, Medical University of Innsbruck, Innsbruck, Austria.
| | - Klemens Raile
- Department of Pediatrics, Experimental and Clinical Research Center, Charite, Berlin, Germany
| | | | - Thomas Kapellen
- Department of Pediatrics, University of Leipzig, Leipzig, Germany
| | - Axel Dost
- Department of Pediatrics, University of Jena, Jena, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Center at Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | | | - Reinhard W Holl
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
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Guo J, Whittemore R, Jeon S, Grey M, Zhou ZG, He GP, Luo ZQ. Diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life over time in Chinese youth with type 1 diabetes. J Clin Nurs 2014; 24:1258-68. [DOI: 10.1111/jocn.12698] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Jia Guo
- School of Basic Medicine; Central South University; Changsha Hunan Province China
- School of Nursing; Central South University; Changsha Hunan Province China
| | | | | | | | | | - Guo-Ping He
- School of Nursing; Central South University; Changsha Hunan Province China
| | - Zi-Qiang Luo
- School of Basic Medicine; Central South University; Changsha Hunan Province China
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33
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Delamater AM, de Wit M, McDarby V, Malik J, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2014. Psychological care of children and adolescents with type 1 diabetes. Pediatr Diabetes 2014; 15 Suppl 20:232-44. [PMID: 25182317 DOI: 10.1111/pedi.12191] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 06/17/2014] [Indexed: 02/06/2023] Open
Affiliation(s)
- Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
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Freckleton E, Sharpe L, Mullan B. Reasons for the overly optimistic beliefs of parents of children with diabetes. J Paediatr Child Health 2014; 50:294-300. [PMID: 24372734 DOI: 10.1111/jpc.12489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2013] [Indexed: 11/27/2022]
Abstract
AIMS The purposes of this study are to investigate parents' beliefs about the likelihood of diabetes outcomes for their child, the reasons that they give for these beliefs and the relationship between the beliefs and parental psychopathology. METHODS Seventy-one mothers of children with diabetes completed a questionnaire about the likelihood of certain diabetes outcomes and measures of psychopathology. Both qualitative and quantitative data were collected at a single time point. RESULTS Mothers generally held very optimistic views about their children's future, and this was associated with less maternal depressive symptoms. Mothers typically used their previous experiences and belief that diabetes is controllable to justify optimistic beliefs about short-term consequences. In contrast, formation of mothers' views on long-term consequences generally relied on information from a variety of sources. CONCLUSION The results suggest that it is usual and helpful for mothers of children with diabetes to hold overly optimistic views about their children's futures. Medical evidence appears to have little influence on mothers' beliefs about likely outcomes for their children.
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Affiliation(s)
- Evril Freckleton
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
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35
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McGrady ME, Peugh JL, Hood KK. Illness representations predict adherence in adolescents and young adults with type 1 diabetes. Psychol Health 2014; 29:985-98. [DOI: 10.1080/08870446.2014.899361] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ağralı H, Akyar İ. Older diabetic patients' attitudes and beliefs about health and illness. J Clin Nurs 2014; 23:3077-86. [DOI: 10.1111/jocn.12540] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Hatice Ağralı
- Faculty of Nursing; Hacettepe University; Sıhhıye, Ankara Turkey
| | - İmatullah Akyar
- Faculty of Nursing; Hacettepe University; Sıhhıye, Ankara Turkey
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Williams C, Sharpe L, Mullan B. Developmental challenges of adolescents with type 1 diabetes: the role of eating attitudes, family support and fear of negative evaluation. PSYCHOL HEALTH MED 2013; 19:324-34. [PMID: 23786542 DOI: 10.1080/13548506.2013.808750] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Young people with chronic illnesses including type 1 diabetes mellitus (T1DM) are at increased risk of developing psychological problems during adolescence. The aim of the present study was to explore whether a relationship exists between developmental challenges of adolescence (eating attitudes, family support and fear of negative evaluation) and psychopathology in adolescents with T1DM, and the nature of such a relationship. Sixty-one adolescents with T1DM completed a series of questionnaires assessing illness beliefs, eating attitudes, family support, Fear of Negative Evaluation (FNE) and psychopathology. The study was of a correlational design, and also included a seven-day diabetes management diary in order to collect blood glucose levels over this time. Results demonstrated the relevance of all three developmental challenges. In multiple regression analyses, FNE and eating attitudes independently predicted current levels of depressive symptomatology. Current levels of anxiety were predicted by FNE and family support, but not eating attitudes. The results support the relevance of all three developmental challenges of adolescence to psychopathology in young people with diabetes. These results suggest that in working with adolescents who are having difficulty coping with diabetes; it may be beneficial to focus on the developmental issues that commonly face adolescents.
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Abstract
Technology-enabled support services for diabetes can fulfill patient demand to care for diabetes independently. Patients benefit from such services after greater adoption of the services in healthcare systems. Unfortunately, conventional service development fails to thoroughly understand patient care support, making it difficult to achieve the desired design, and posing substantial challenges in adopting these services. Thus, previously developed services in many cases are not as patients expected, as evidenced by their low acceptance among patients. To solve this problem, adequate strategies must be developed by incorporating theoretical knowledge as a solid foundation in order to improve service design. This study develops technology-enabled diabetes support services based on the self-care theory. A set of self-care service scenarios is also established and combined with theoretical concepts. The developed services consist of a nurse-led consultation service and a mobile application service. Additionally, user acceptance is confirmed by assessing patient perceptions of the diabetes support services in a group of patients with diabetes (N=27). Results of analysis reveal that patients respond favorably toward the services. Patient preference and perceived ease of use attest to their intention to use the services. Greater adoption of the services can be anticipated, owing to a higher levels of preference and higher perceived ease of use. This study demonstrated that the self-care theory can be linked to nursing informatics research and chronic care clinical practices.
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Law GU, Tolgyesi CS, Howard RA. Illness beliefs and self-management in children and young people with chronic illness: a systematic review. Health Psychol Rev 2012; 8:362-80. [DOI: 10.1080/17437199.2012.747123] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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40
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Guo J, Whittemore R, Grey M, Wang J, Zhou ZG, He GP. Diabetes self-management, depressive symptoms, quality of life and metabolic control in youth with type 1 diabetes in China. J Clin Nurs 2012; 22:69-79. [DOI: 10.1111/j.1365-2702.2012.04299.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2012] [Indexed: 12/18/2022]
Affiliation(s)
- Jia Guo
- School of Nursing; Central South University; Changsha; Hunan Province; China
| | | | | | - Jing Wang
- School of Nursing; Central South University; Changsha; Hunan Province; China
| | - Zhi-Guang Zhou
- Diabetes Center; Central South University; Changsha; Hunan Province; China
| | - Guo-Ping He
- School of Nursing; Central South University; Changsha; Hunan Province; China
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41
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Guo J, Dixon JK, Whittemore R, He GP. Instrument translation and initial psychometric evaluation of the Chinese version of the Self-Management of Type 1 Diabetes for Adolescents scale. J Adv Nurs 2012; 69:960-9. [PMID: 22931463 DOI: 10.1111/j.1365-2648.2012.06129.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2012] [Indexed: 12/01/2022]
Abstract
AIM To translate the validated measure, Self-Management of Type 1 Diabetes in Adolescents, into the Mandarin Chinese language and to test the psychometric properties of the Chinese version. BACKGROUND Although research on self-management of Type 1 diabetes has been increasing over the past 20 years, few health-related instruments have been available in the Chinese language for youth with Type 1 diabetes. DESIGN A two-phase design was used in this study, including instrument translation and psychometric testing. METHODS The instrument translation, from October 2008-April 2009, included three steps: forward translation, back translation, and comparison of versions via Translation Validity Index - with multiple rounds, group discussion, and achievement of consensus at each step. Psychometric properties of the Chinese version Schilling's Self-Management of Type 1 Diabetes for Adolescents scale was assessed in a convenience sample of 136 Chinese youth (ages 8-19) with Type 1 diabetes between June 2009-August 2009. RESULTS The internal consistency and test-retest reliabilities indicated generally good consistency and temporal stability of the Chinese version. Evidence of construct validity and criterion-related validity was obtained via correlations of subscales with established measures of diabetes adherence and quality of life and also with haemoglobin A1c. Results from hypothesis testing also supported construct validity. CONCLUSION The Chinese version of Self-Management of Type 1 Diabetes for Adolescents scale is sound and will facilitate cross-cultural studies, while also enabling nurses to monitor and enhance the diabetes self-management of Chinese youth with Type 1 diabetes.
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Affiliation(s)
- Jia Guo
- School of Nursing, Central South University, Changsha, Hunan Province, China
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42
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Scholes C, Mandleco B, Roper S, Dearing K, Dyches T, Freeborn D. A qualitative study of young people's perspectives of living with type 1 diabetes: do perceptions vary by levels of metabolic control? J Adv Nurs 2012; 69:1235-47. [DOI: 10.1111/j.1365-2648.2012.06111.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2012] [Indexed: 11/29/2022]
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Gaston AM, Cottrell DJ, Fullen T. An examination of how adolescent-caregiver dyad illness representations relate to adolescents' reported diabetes self-management. Child Care Health Dev 2012; 38:513-9. [PMID: 21722157 DOI: 10.1111/j.1365-2214.2011.01269.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Adolescence is a period associated with poor glycaemic control. The key developmental concerns of young people are in conflict with the requirements of diabetes self-management. This study explores the relative influence of adolescents' and caregivers' illness representations and how any difference/similarity in their representations may be related to adolescents' diabetes self-management. METHODS Fifty-five adolescents between 12 and 16 years of age were asked to complete the Diabetes Illness Representation Questionnaire and Summary of Diabetes Self-Care Activities Questionnaire. Their primary caregivers were asked to complete a caregivers' version of the Diabetes Illness Representation Questionnaire. RESULTS Caregivers believed diabetes to be more chronic, to have a more negative impact, pose more of a threat to adolescents' health and believed more strongly in the effectiveness of treatment than did adolescents. Caregivers' representations about the impact of diabetes and the ability of treatment to prevent future complications were related to adolescents' dietary self-management. CONCLUSIONS This study emphasizes the important role of significant others illness representations in adolescent self-management of diabetes.
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Affiliation(s)
- A M Gaston
- Department of Health and Clinical Psychology, Leeds Teaching Hospital NHS Trust School of Medicine, University of Leeds, Leeds, UK.
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Malanda UL, Bot SD, French DP, Kostense PJ, Wade AN, Dekker JM, Nijpels G, Farmer AJ. Experience of hypoglycaemia is associated with changes in beliefs about diabetes in patients with type 2 diabetes. Diabet Med 2011; 28:1395-400. [PMID: 21627685 DOI: 10.1111/j.1464-5491.2011.03340.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Hypoglycaemia may have a detrimental impact on quality of life for patients with Type 2 diabetes. There are few clinical studies exploring the impact of experiencing hypoglycaemia on beliefs about diabetes and health status. The aim of this study was to explore associations between experience of hypoglycaemia and changes in diabetes beliefs and self-reported health status in patients with non-insulin-treated Type 2 diabetes using a blood glucose meter. METHODS One-year prospective cohort analysis of 226 patients recruited to a randomized trial evaluating the impact of self-monitoring of blood glucose. Self-reported hypoglycaemia over 1 year was categorized into three groups: (1) no experience of hypoglycaemia; (2) blood glucose measurements < 4 mmol/l with no associated symptoms of hypoglycaemia (grade 1); and (3) symptomatic hypoglycaemia (grade 2 and 3). Measures of beliefs about diabetes (Revised Illness Perception Questionnaire) and health status (EuroQol-5D) were assessed at baseline and 1 year. Differences in mean changes over 1 year were explored with analyses of covariance. RESULTS There was a significant increase in mean score in beliefs about personal control (1.14; 95%CI 0.14-2.14) among those experiencing grade 1 hypoglycaemia compared with those not experiencing hypoglycaemia. There were no significant differences in changes in health status between groups, with small overall changes that were inconsistent between groups. CONCLUSIONS This study does not provide support for a long-term adverse impact on beliefs about diabetes or health status from the experience of mild symptomatic hypoglycaemia, in well-controlled, non-insulin-treated patients with Type 2 diabetes using self-monitoring of blood glucose.
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Affiliation(s)
- U L Malanda
- Department of General Practice, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
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Rubak S, Sandbæk A, Lauritzen T, Borch-Johnsen K, Christensen B. Effect of "motivational interviewing" on quality of care measures in screen detected type 2 diabetes patients: a one-year follow-up of an RCT, ADDITION Denmark. Scand J Prim Health Care 2011; 29:92-8. [PMID: 21306296 PMCID: PMC3347945 DOI: 10.3109/02813432.2011.554271] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE. "Motivational interviewing" (MI) has shown to be broadly applicable in the management of behavioural problems and diseases. Only a few studies have evaluated the effect of MI on type 2 diabetes treatment and none has explored the effect of MI on target-driven intensive treatment. METHODS. Patients were cluster-randomized by GPs, who were randomized to training in MI or not. Both groups received training in target-driven intensive treatment of type 2 diabetes. The intervention consisted of a 1½-day residential course in MI with half-day follow-up twice during the first year. Blood samples, case record forms, national registry files, and validated questionnaires from patients were obtained. RESULTS. After one year significantly improved metabolic status measured by HbA1c (p < 0.01) was achieved in both groups. There was no difference between groups. Medication adherence was close to 100% within both treatment groups. GPs in the intervention group did not use more than an average of 1.7 out of three possible MI consultations. CONCLUSION. The study found no effect of MI on metabolic status or on adherence of medication in people with screen detected type 2 diabetes. However, there was a significantly improved metabolic status and excellent medication adherence after one year within both study groups. An explanation may be that GPs in the control group may have taken up core elements of MI, and that GPs trained in MI used less than two out of three planned MI consultations. The five-year follow-up of this study will reveal whether MI has an effect over a longer period.
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Affiliation(s)
- Sune Rubak
- Department General Practice and Research Unit of General Medical Practice, Institute of Public Health University of Aarhus, Denmark.
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Novato TDS, Grossi SAA. Fatores associados à qualidade de vida de jovens com diabetes mellitus do tipo 1. Rev Esc Enferm USP 2011; 45:770-6. [DOI: 10.1590/s0080-62342011000300032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Accepted: 09/06/2010] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi realizar a revisão bibliográfica acerca dos fatores que podem influenciar a Qualidade de Vida Relacionada à Saúde (QV) dos adolescentes com diabetes mellitus tipo 1, por meio da estratégia de PICO. As bases de dados utilizadas foram PubMed/MEDLINE, ISI Web of Knowledge e EMBASE. O maior levantamento dos artigos foi possível com a combinação de descritores padronizados e não padronizados. Apesar da QV ser um construto específico de avaliação dos aspectos relacionados às repercussões da saúde, doença e tratamento, os fatores sócio-demográficos, psicossociais e relacionados à família parecem influenciar de forma significativa na QV.
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Guo J, Whittemore R, He GP. The relationship between diabetes self-management and metabolic control in youth with type 1 diabetes: an integrative review. J Adv Nurs 2011; 67:2294-310. [PMID: 21615460 DOI: 10.1111/j.1365-2648.2011.05697.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIMS The purpose of this integrative review was to describe the relationship between diabetes self-management and metabolic control in youth with type 1 diabetes and to explore factors which affect this relationship. BACKGROUND In the past 15 years, research has indicated that youth with type 1 diabetes face considerable self-management challenges and are at increased risk for poor metabolic control. To enhance the development of behavioural interventions for youth with type 1 diabetes, the relationship between diabetes self-management and metabolic control needs to be more clearly elucidated. DATA SOURCES Research studies that examined the relationship between diabetes self-management and metabolic control in youth with type 1 diabetes were included (n = 18). The electronic databases searched included OVID, MEDLINE (1996 to present), SCOPUS (1996 to January 2010) and PubMed (1996 to January 2010). REVIEW METHOD An integrative literature review was carried out using Whittemore's modified framework for data collection, analysis and synthesis. RESULTS A positive relationship between diabetes self-management and metabolic control in youth with type 1 diabetes was supported in longitudinal studies and in studies where the mean age was >13 years. Factors influencing this relationship are identified. Measurement of self-management was quite variable. CONCLUSION Interventions targeting self-management in youth with type 1 diabetes are indicated, particularly in families of diverse race and ethnicity globally. Further evaluation of the measures of self-management and more longitudinal research are also indicated.
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Affiliation(s)
- Jia Guo
- School of Nursing, Central South University, Changsha, Hunan Province, China
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Ratcliff MB, Blount RL, Mee LL. The relationship between adolescent renal transplant recipients' perceived adversity, coping, and medical adherence. J Clin Psychol Med Settings 2010; 17:116-24. [PMID: 20386962 DOI: 10.1007/s10880-010-9194-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of the present study was to assess adolescent renal transplant recipients' perceived adversity (PA) for various aspects of living with a transplant, including its association with coping and medication non-adherence, from a theoretical perspective. Thirty-three adolescent renal transplant recipients were interviewed using structured questionnaires and medical record reviews. Health care provider ratings of adversity were also collected. Participants reported moderate levels of PA, with those who received a transplant at an older age reporting more adversity on several domains and girls reporting more adversity for missing school. Ratings of adversity for specific aspects of living with a transplant differed depending on age and medical factors and were related to specific coping strategies and measures of non-adherence. Consistent with the Self-Regulation Model, perceived consequences (represented as PA) appears to be related to coping and illness outcomes. Assessing PA and teaching appropriate coping strategies may yield better medical outcomes among this at-risk population.
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Affiliation(s)
- Megan Benoit Ratcliff
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital and Medical Center, MLC 3015, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
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Croom A, Wiebe DJ, Berg CA, Lindsay R, Donaldson D, Foster C, Murray M, Swinyard MT. Adolescent and parent perceptions of patient-centered communication while managing type 1 diabetes. J Pediatr Psychol 2010; 36:206-15. [PMID: 20719752 DOI: 10.1093/jpepsy/jsq072] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To examine whether adolescents' and parents' perceptions of patient-centered communication (PCC) with the physician may be associated with aspects of patient empowerment (e.g., perceptions of competence) and diabetes management (i.e., adherence and HbA1c). METHODS One hundred and ninety adolescents with type 1 diabetes and their parents rated perceptions of PCC following a clinic visit and completed measures of competence, illness perceptions, self-efficacy, and adherence in the weeks following their clinic visit, and again 6 months later. Metabolic control was indexed from medical records. RESULTS Higher levels of PCC with physicians were associated cross-sectionally and longitudinally with greater perceptions of control and competence for both adolescents and parents. Mediation analyses indicated that PCC was indirectly related to subsequent adherence and metabolic control through perceptions of the adolescent's competence in diabetes management. CONCLUSIONS Perceptions of PCC with healthcare providers may empower adolescents and parents in their diabetes management.
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Affiliation(s)
- Andrea Croom
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, USA
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50
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Hart PL, Grindel CG. Illness representations, emotional distress, coping strategies, and coping efficacy as predictors of patient outcomes in type 2 diabetes. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.1752-9824.2010.01062.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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