糖尿病调整组:改善成人1型和2型糖尿病患者糖尿病窘迫和糖化血红蛋白的多学科方法

Mary de Groot, Barbara A Myers, Lauren Baker, Elizabeth Daily, Melissa Cavaghan
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摘要

目的:本研究的目的是评估糖尿病调整组(DTU)的可行性,DTU是一种基于认知行为治疗(CBT)的多学科干预,用于治疗糖尿病困扰和A1C升高的成年人,采用小组面对面交付的形式。方法:DTU干预包括6个每周小组会议(每次会议持续时间90分钟)。这些小组由一位糖尿病护理和教育专家(DCES)和一位硕士水平的临床心理学实习生共同指导。干预将CBT与以患者为中心的糖尿病教育相结合。采用前后研究设计,参与者在基线、干预后和干预后3个月完成评估。结果:样本包括29名患有1型糖尿病(N = 8)或2型糖尿病(N = 21)的成年人,主要是女性(79%),白人(59%)和受过教育(56%具有大学或更高学位)。在174个可能的会议中,参与者共参加了131个会议,总体出席率为75.3%。在3个月的随访中,A1C值显著改善(平均下降0.39%)。从基线(平均= 3.44,SD = 0.68)到干预后(平均= 2.94,SD = 0.68),以及3个月的随访(平均= 2.55,SD = 0.75),糖尿病困扰显著改善。从基线到干预后和3个月随访,糖尿病自我效能也有显著改善。结论:这种以组为基础的多学科干预可改善A1C、糖尿病窘迫和患者在糖尿病护理方面的自我效能。未来的研究需要跨环境和交付平台验证这种干预方法。
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The Diabetes Tune-Up Group: A Multidisciplinary Approach to Improve Diabetes Distress and A1C Among Adults With Type 1 and Type 2 Diabetes.

Purpose: The purpose of this study was to assess the feasibility of delivering the Diabetes Tune-Up Group (DTU), a cognitive-behavioral-therapy-based (CBT) multidisciplinary intervention for adults with diabetes distress and elevated A1C using a group in-person delivery format.

Methods: The DTU intervention consisted of 6 weekly group sessions (90 minutes in duration per session). The groups were cofacilitated by a diabetes care and education specialist (DCES) and a master's-level clinical psychology trainee. The intervention integrated CBT with patient-centered diabetes education. Using a pre/post study design, participants completed assessments at baseline, post-intervention, and 3 months following the intervention.

Results: The sample consisted of 29 adults with type 1 diabetes (N = 8) or type 2 diabetes (N = 21) who were predominantly female (79%), White (59%), and educated (56% with a college degree or greater). Participants attended 131 total sessions out of 174 possible sessions, for an overall attendance rate of 75.3%. At 3-month follow-up, significant improvements were observed in A1C values (mean decrease = 0.39%). Diabetes distress improved significantly from baseline (mean = 3.44, SD = 0.68) to post-intervention (mean = 2.94, SD = 0.68), and 3-month follow-up (mean = 2.55, SD = 0.75). Significant improvements were also observed in diabetes self-efficacy from baseline to post-intervention and at 3-month follow-up.

Conclusions: This group-based, multidisciplinary intervention resulted in improvements in A1C, diabetes distress, and patient self-efficacy in caring for diabetes. Future studies to validate this intervention approach across settings and delivery platforms are needed.

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