School of Nursing, Yale University, New Haven, Connecticut, USA.
Nurs Res. 2012 Nov-Dec;61(6):395-404. doi: 10.1097/NNR.0b013e3182690a29.
Managing Type 1 diabetes (T1D) during adolescence can be challenging, and there is a need for accessible interventions to help adolescents cope with diabetes-related stress.
The aim of this study was to compare an Internet coping skills training (TEENCOPE) intervention to an Internet educational intervention (Managing Diabetes) for adolescents with T1D. Moderators of program efficacy were evaluated.
The study was a multisite clinical trial (n = 320) with data collected at baseline, 3 months, and 6 months. Data were collected on the primary outcomes of physiologic (A1C) and psychosocial (quality of life) and on the secondary outcomes of behavioral (self-management) and psychosocial (stress, coping self-efficacy, social competence, family conflict) variables consistent with the conceptual framework. Data were analyzed using mixed-model analyses with an intent-to-treat approach.
There were no significant between-group treatment effects 6 months postintervention on primary outcomes. The Managing Diabetes youth showed a significant increase in social competence compared to the TEENCOPE youth. There were significant time effects for TEENCOPE (decreased stress and increased coping) and Managing Diabetes (improved diabetes quality of life).
Youth with T1D transitioning to adolescence may need both structured diabetes education and coping skills to improve health outcomes. There may be a higher potential to reach adolescents with Type 1 diabetes of varying race and ethnicity via Internet interventions.
青少年时期管理 1 型糖尿病(T1D)具有挑战性,需要有易于获取的干预措施来帮助青少年应对与糖尿病相关的压力。
本研究旨在比较针对 T1D 青少年的互联网应对技能培训(TEENCOPE)干预与互联网教育干预(Managing Diabetes)。评估了方案疗效的调节因素。
该研究是一项多站点临床试验(n=320),在基线、3 个月和 6 个月时收集数据。根据概念框架,收集了主要结局(生理指标[糖化血红蛋白]和心理社会指标[生活质量])和次要结局(行为指标[自我管理]和心理社会指标[压力、应对自我效能、社会能力、家庭冲突])的数据。采用混合模型分析进行数据分析,采用意向治疗方法。
干预后 6 个月,两组在主要结局上无显著的治疗效果差异。与 TEENCOPE 组相比,Managing Diabetes 组的青少年社会能力显著提高。TEENCOPE 组(压力降低和应对能力提高)和 Managing Diabetes 组(糖尿病生活质量改善)均有显著的时间效应。
正在向青春期过渡的 T1D 青少年可能需要结构化的糖尿病教育和应对技能,以改善健康结局。通过互联网干预,可能更容易接触到不同种族和族裔的 1 型糖尿病青少年。