Clermont University, Blaise Pascal University, 63000 Clermont-Ferrand, France; CNRS, UMR 6024, Social and COgnitive Psychology LAboratory (LAPSCO), 63000 Clermont-Ferrand, France.
Diabetes Metab. 2013 Oct;39(5):432-8. doi: 10.1016/j.diabet.2013.05.003. Epub 2013 Oct 2.
Diabetes perceptions, acceptance and treatment motivation are changeable factors of adherence. This study aimed to test the effects of brief psychological interventions based on diabetes threat and mastery perceptions in terms of adherence, acceptance and motivation. Physicians may find such interventions useful during a 15-minute consultation with diabetes patients.
This randomized controlled study included 80 patients with type 2 diabetes, recruited from the hospital diabetes department, who were randomly assigned to four intervention groups based on autobiographical recall. Those in the two intervention groups were asked to recall diabetic events based on mastery and threat perceptions, respectively, whereas those in the two control groups recalled non-diabetic events based on positive and negative emotions, respectively. Following this, all participants completed validated self-questionnaires assessing diabetes perceptions, acceptance, treatment motivation and adherence.
Patients in the threat group reported less adherence (P<0.01) and less avoidance (P<0.05), and perceived diabetes as less threatening (P<0.05) than those in the mastery group. Similar results were obtained when the threat group was compared with its matched negative-emotion control group (P<0.05, P<0.05 and P=0.087, respectively). Patients in the mastery group reported feeling a stronger sense of mastery (P<0.05) than those in their positive-emotion control group and greater treatment acceptance than those in the threat group (P<0.01).
Contrary to conventional medical belief, discussing threatening personal events with patients can yield positive results. Health professionals should take threat and mastery perceptions of diabetes into account during regular consultations with a view to improving treatment acceptance and adherence. With this brief intervention of type 2 diabetes patients, it was also more effective to alleviate their emotional difficulties than to enhance their perception of mastery.
糖尿病认知、接受和治疗动机是影响依从性的可变因素。本研究旨在测试基于糖尿病威胁和掌控感的简短心理干预对依从性、接受度和动机的影响。医生可能会在与糖尿病患者的 15 分钟咨询中发现此类干预措施有用。
这项随机对照研究纳入了 80 名 2 型糖尿病患者，他们来自医院的糖尿病科，根据自传体回忆随机分为四组干预。两组干预组分别根据掌控感和威胁感回忆糖尿病事件，而两组对照组则分别根据积极和消极情绪回忆非糖尿病事件。之后，所有参与者都完成了评估糖尿病认知、接受度、治疗动机和依从性的有效自测量表。
与掌控感组相比，威胁感组患者的依从性更低（P<0.01），回避行为更少（P<0.05），且对糖尿病的威胁感更低（P<0.05）。当将威胁感组与匹配的消极情绪对照组进行比较时，也得到了类似的结果（P<0.05、P<0.05 和 P=0.087）。与积极情绪对照组相比，掌控感组患者报告更强烈的掌控感（P<0.05），治疗接受度更高（P<0.01）。
与传统医学观念相反，与患者讨论威胁性的个人事件可能会产生积极的结果。医疗保健专业人员在进行常规咨询时应考虑到糖尿病的威胁和掌控感，以提高治疗接受度和依从性。通过对 2 型糖尿病患者进行这种简短的干预，缓解他们的情绪困难比增强他们的掌控感更有效。
