Rees Gwyneth, O'Hare Fleur, Saeed Marian, Sudholz Bronwyn, Sturrock Bonnie A, Xie Jing, Speight Jane, Lamoureux Ecosse L
Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne , Melbourne , Australia.
Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia; Deakin University, School of Psychology,Geelong, Australia.
BMJ Open Diabetes Res Care. 2017 Feb 9;5(1):e000307. doi: 10.1136/bmjdrc-2016-000307. eCollection 2017.
To provide preliminary evidence for the impact of problem-solving therapy for diabetes (PST-D) in adults with diabetic retinopathy (DR) and diabetes distress.
In a pilot randomized controlled trial, 40 participants with DR and diabetes distress were allocated to the PST-D or control groups. Diabetes distress (DDS), depressive symptoms (PHQ-9), self-care activities (SDSCA), and HbA were assessed at baseline, and 3 and 6-month follow-ups.
At the 6-month follow-up, the PST-D group showed significant improvements relative to the control group, in 'regimen-related distress' (PST-D: -1.3±1.4; control: -0.4±1.1), depressive symptoms (PST-D: -4.3±6.1; control: -0.3±4.6), and HbA (PST-D: -1.2%±1.01; control: 0.2%±1.2%) (all p<0.05). In multiple regression analysis, adjusting for baseline values and sociodemographic factors, PST-D was associated with significant improvement in 'regimen-related distress', depressive symptoms, and HbA at the 6-month follow-up (p<0.05).
PST-D is a promising intervention for improving psychological outcomes and glycemic control. A fully powered study is required to confirm these findings and examine mechanisms of change in HbA1c.
ACTRN12616001010482; results.
为解决糖尿病问题疗法（PST-D）对患有糖尿病视网膜病变（DR）和糖尿病困扰的成年人的影响提供初步证据。
在一项试点随机对照试验中，40名患有DR和糖尿病困扰的参与者被分配到PST-D组或对照组。在基线、3个月和6个月随访时评估糖尿病困扰（DDS）、抑郁症状（PHQ-9）、自我护理活动（SDSCA）和糖化血红蛋白（HbA）。
在6个月随访时，PST-D组相对于对照组在“治疗方案相关困扰”（PST-D组：-1.3±1.4；对照组：-0.4±1.1）、抑郁症状（PST-D组：-4.3±6.1；对照组：-0.3±4.6）和糖化血红蛋白（PST-D组：-1.2%±1.01；对照组：0.2%±1.2%）方面均有显著改善（所有p<0.05）。在多元回归分析中，校正基线值和社会人口学因素后，PST-D与6个月随访时“治疗方案相关困扰”、抑郁症状和糖化血红蛋白的显著改善相关（p<0.05）。
PST-D是一种有前景的干预措施，可改善心理结局和血糖控制。需要进行一项充分有力的研究来证实这些发现并研究糖化血红蛋白变化的机制。
ACTRN12616001010482；结果
