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针对老年糖尿病精神分裂症患者的生活方式干预:一项随机对照试验。

A lifestyle intervention for older schizophrenia patients with diabetes mellitus: a randomized controlled trial.

作者信息

McKibbin Christine L, Patterson Thomas L, Norman Gregory, Patrick Kevin, Jin Hua, Roesch Scott, Mudaliar Sunder, Barrio Concepcion, O'Hanlon Kathleen, Griver Kay, Sirkin A'verria, Jeste Dilip V

机构信息

University of California, San Diego, CA, USA.

出版信息

Schizophr Res. 2006 Sep;86(1-3):36-44. doi: 10.1016/j.schres.2006.05.010. Epub 2006 Jul 12.

Abstract

PURPOSE

We tested the feasibility and preliminary efficacy of a lifestyle intervention for middle-aged and older patients with schizophrenia and type-2 diabetes mellitus, using a randomized pre-test, post-test control group design.

METHOD

Individuals with a diagnosis of schizophrenia or schizoaffective disorder over the age of 40 were randomly assigned to 24-week Diabetes Awareness and Rehabilitation Training (DART; n=32) groups or Usual Care plus Information (UCI; n=32) comparison groups. Participants were recruited from board-and-care facilities and day treatment programs. Fifty-seven patients completed baseline and 6-month assessments consisting of an interview, measures of body mass index, blood pressure, fasting blood chemistry, and accelerometry. A mixed-model analysis of variance was used to analyze the data.

RESULTS

A significant group x time interaction was found for body weight, with patients in the DART group losing a mean of 5 lb and those in the UCI gaining a mean 6 lb. Significant group x time interactions were also found for triglycerides, diabetes knowledge, diabetes self-efficacy, and self-reported physical activity, but not for fasting plasma glucose or glycosylated hemoglobin.

CONCLUSIONS

Group-based lifestyle interventions are feasible and produce positive health changes in middle-aged and older patients with schizophrenia and diabetes mellitus.

摘要

目的

我们采用随机前测、后测对照组设计,测试了一种生活方式干预对中年及老年精神分裂症和2型糖尿病患者的可行性和初步疗效。

方法

40岁以上诊断为精神分裂症或分裂情感性障碍的个体被随机分配到24周的糖尿病认知与康复训练(DART;n = 32)组或常规护理加信息(UCI;n = 32)对照组。参与者从寄宿护理机构和日间治疗项目中招募。57名患者完成了基线和6个月的评估,包括访谈、体重指数、血压、空腹血液化学指标和加速度测量。采用混合模型方差分析来分析数据。

结果

在体重方面发现了显著的组×时间交互作用,DART组患者平均体重减轻5磅,UCI组患者平均体重增加6磅。在甘油三酯、糖尿病知识、糖尿病自我效能和自我报告的身体活动方面也发现了显著的组×时间交互作用,但空腹血糖或糖化血红蛋白方面未发现。

结论

基于小组的生活方式干预对中年及老年精神分裂症和糖尿病患者是可行的,并能产生积极的健康变化。

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