van der Ven Nicole C W, Lubach Caroline H C, Hogenelst Marloes H E, van Iperen Ada, Tromp-Wever Anita M E, Vriend Annelies, van der Ploeg Henk M, Heine Robert J, Snoek Frank J
Diabetes Research Group, Department of Medical Psychology, VU University Medical Centre, vd Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
Patient Educ Couns. 2005 Mar;56(3):313-22. doi: 10.1016/j.pec.2004.03.005.
Approximately a quarter of adults with type 1 diabetes do not succeed in achieving satisfactory glycaemic control, partly due to problems with the demanding self-management regimen. To improve glycaemic control, interventions with a cognitive behavioural approach, aimed at modifying dysfunctional beliefs, reducing negative emotions and enhancing self-care practices are a potentially successful tool. Little is known about the reach of such an approach. This article describes characteristics of participants in a randomized, controlled trial of cognitive behavioural group training for patients with type 1 diabetes in poor glycaemic control. Results show that outpatients from seven hospitals in the area of Amsterdam, selected on long-standing high HbA1c and volunteering to participate, report high levels of psychological distress and depressive symptoms. Furthermore, self-care behaviours were perceived as important, but burdensome. Diabetes-specific self-efficacy was relatively low. It is concluded that this selected group of adults with type 1 diabetes would potentially benefit from a cognitive-behavioural intervention in order to reduce negative emotions, enhance diabetes self-efficacy, self-care behaviour and glycaemic outcomes.
大约四分之一的1型糖尿病成年人未能成功实现令人满意的血糖控制，部分原因是这种要求苛刻的自我管理方案存在问题。为了改善血糖控制，采用认知行为方法的干预措施，旨在改变功能失调的信念、减少负面情绪并加强自我护理行为，是一种潜在的成功工具。对于这种方法的适用范围知之甚少。本文描述了在一项针对血糖控制不佳的1型糖尿病患者的认知行为团体训练随机对照试验中参与者的特征。结果显示，从阿姆斯特丹地区七家医院挑选出的门诊患者，他们因长期高糖化血红蛋白且自愿参与，报告了高水平的心理困扰和抑郁症状。此外，自我护理行为被认为很重要，但负担很重。糖尿病特异性自我效能相对较低。得出的结论是，这群经过挑选的1型糖尿病成年人可能会从认知行为干预中受益，以减少负面情绪、提高糖尿病自我效能、自我护理行为和血糖结果。
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