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糖尿病心理健康服务(MINDS)以促进心理社会健康:一项随机对照试验的研究方案

The Mental Health in Diabetes Service (MINDS) to enhance psychosocial health: study protocol for a randomized controlled trial.

作者信息

O'Brien Casey L, Ski Chantal F, Thompson David R, Moore Gaye, Mancuso Serafino, Jenkins Alicia, Ward Glenn, MacIsaac Richard J, Loh Margaret, Knowles Simon R, Rossell Susan L, Castle David J

机构信息

Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia.

Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia.

出版信息

Trials. 2016 Sep 9;17(1):444. doi: 10.1186/s13063-016-1561-4.

Abstract

BACKGROUND

After a diagnosis of diabetes mellitus, people not only have to cope with the physical aspects and common complications that require daily self-management, they are also faced with ongoing psychosocial challenges. Subsequently they find themselves having to navigate the health system to engage multidisciplinary supports; the combination of these factors often resulting in reduced health-related quality of life. To maintain optimal diabetes control, interventions need to incorporate psychosocial supports and a skill base for disease management. Therefore, our aim was to evaluate an 'Optimal Health Program' that adopts a person-centred approach and engages collaborative therapy to educate and support the psychosocial health of people diagnosed with type I or II diabetes.

METHODS

This prospective randomised controlled trial will include 166 people diagnosed with diabetes: 83 in the intervention (Optimal Health Program) and 83 in the control (usual care) group. Participants with type diabetes mellitus will be recruited through hospital outpatient clinics and diabetes community organisations. Participants in the intervention group will receive nine (8 + 1 booster session) sequential sessions, based on a structured treatment manual emphasising educational and psychosocial support self-efficacy and skills building. The primary outcome measures will be generalised self-efficacy (GSE) and health-related quality of life (AQoL-6D and EQ-5D). Secondary measures will be anxiety and depression (HADS), social and workplace functioning (WSAS), diabetes-related quality of life (DQoL), diabetes-related distress (PAID), and type of coping strategies (Brief COPE). In addition, a health economic cost analysis and process evaluations will be performed to assess the economic cost and efficacy of the program's operations, implementation and service delivery.

DISCUSSION

We envisage that the Optimal Health Program's emphasis on self-efficacy and self-management will provide participants with the skills and knowledge to achieve increased empowerment and independence in aspects of health, which in turn, will help participants deal more effectively with the physical and psychosocial complexities of diabetes.

TRIAL REGISTRATION

ACTRN12614001085662 . Registered on 10 October 2014.

摘要

背景

在被诊断患有糖尿病后,人们不仅要应对需要日常自我管理的身体方面问题和常见并发症,还面临持续的心理社会挑战。随后,他们发现自己必须在医疗系统中寻求多学科支持;这些因素综合起来往往导致健康相关生活质量下降。为维持最佳的糖尿病控制,干预措施需要纳入心理社会支持以及疾病管理的技能基础。因此,我们的目标是评估一项“最佳健康计划”,该计划采用以患者为中心的方法并开展协作治疗,以教育和支持被诊断患有I型或II型糖尿病的患者的心理社会健康。

方法

这项前瞻性随机对照试验将纳入166名被诊断患有糖尿病的患者:83名在干预组(最佳健康计划),83名在对照组(常规护理)。患有糖尿病的参与者将通过医院门诊和糖尿病社区组织招募。干预组的参与者将根据一份强调教育和心理社会支持、自我效能感和技能培养的结构化治疗手册接受九个(8个疗程加1个强化疗程)连续疗程。主要结局指标将是一般自我效能感(GSE)和健康相关生活质量(AQoL - 6D和EQ - 5D)。次要指标将是焦虑和抑郁(HADS)、社交和工作场所功能(WSAS)、糖尿病相关生活质量(DQoL)、糖尿病相关困扰(PAID)以及应对策略类型(简易应对方式问卷)。此外,将进行健康经济成本分析和过程评估,以评估该计划运营、实施和服务提供的经济成本和效果。

讨论

我们设想,最佳健康计划对自我效能感和自我管理的强调将为参与者提供技能和知识,使其在健康方面获得更多的自主权和独立性,这反过来将帮助参与者更有效地应对糖尿病的身体和心理社会复杂性。

试验注册

ACTRN12614001085662。于2014年10月10日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ff4/5018192/6900d1382fb2/13063_2016_1561_Fig1_HTML.jpg

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