针对 1 型糖尿病的 FAMS-T1D 干预试点项目中新成人的目标变化和目标实现情况

Cynthia A. Berg, Jessica H Mansfield, Silas B. Boggess, Julia V. Martin, Benjamin Creer, Torri K. Peck, Deborah J. Wiebe, J. Butner, Lindsay S. Mayberry
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摘要

对患有 1 型糖尿病(T1D)的新成人(EAs)的干预主要集中在目标设定上,但对于目标实现与干预结果之间的关系却知之甚少。在为期 3 个月的可行性试验中,我们每月对患有 T1D 的新成人(29 人,平均年龄 21.6 岁,57% 为女性)进行辅导,帮助他们设定行为目标。辅导记录对目标的类型、复杂程度和变化进行定性编码。目标实现情况通过每天对短信的回复进行测量。干预前后对 HbA1c、自我效能、糖尿病困扰和自我护理进行了评估。绝大多数 EAs 都改变了目标(90%),其中大多数都增加了目标的复杂性。目标实现率很高(79% 的天数),且不受目标变化或目标复杂程度的影响。目标的实现与自我效能感和自理能力的提高息息相关。定性主题揭示了自我调节和社会调节对目标实现的重要性。实现每日糖尿病目标可提高糖尿病患者的自我效能和自我护理。
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Goal change and goal achievement for emerging adults across the pilot FAMS-T1D intervention for type 1 diabetes
Interventions for emerging adults (EAs) with type 1 diabetes (T1D) focus on goal setting, but little is known about how goal achievement relates to intervention outcomes. We examined how goals change, how goal achievement relates to diabetes outcomes, and identified barriers and facilitators to goal achievement.EAs with T1D (N=29, M age=21.6 years, 57% female) were coached monthly to set a behavioral goal across a 3-month feasibility trial. Coaching notes were qualitatively coded regarding type, complexity, and changes in goals. Goal achievement was measured via daily responses to texts. HbA1c, self-efficacy, diabetes distress, and self-care were assessed pre- and post-intervention.EAs frequently set food goals (79%) in combination with other goals. EAs overwhelmingly changed their goals (90%), with most increasing goal complexity. Goal achievement was high (79% of days) and not affected by goal change or goal complexity. Goal achievement was associated with increases in self-efficacy and self-care across time. Qualitative themes revealed that aspects of self-regulation and social-regulation were important for goal achievement.Meeting daily diabetes goals may enhance self-efficacy and self-care for diabetes.Assisting EAs to reduce self-regulation challenges and enhance social support for goals may lead to better diabetes outcomes.
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