Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (Dr DiNardo, Mr Saba, Dr Broyles, Ms Bair).
Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Mr Saba).
Diabetes Educ. 2017 Dec;43(6):608-620. doi: 10.1177/0145721717738019. Epub 2017 Oct 27.
Purpose The purpose of this study is to determine feasibility, satisfaction, and preliminary effects of Mindful Stress Reduction in Diabetes Education (Mind-STRIDE), a mindfulness-based intervention for veterans. Methods The study used a single-group pretest-posttest repeated-measures design. The 90-minute Mind-STRIDE training, adapted from Mindfulness Based Stress Reduction (MBSR), was provided as the final component of a half-day diabetes self-management education class at a Veterans Affairs (VA) outpatient diabetes clinic. Following initial training, participants were asked to practice mindfulness at home for 10 minutes each day during the 3-month study. Study recruitment and retention were calculated as rates. Veteran and diabetes educator satisfaction were assessed by rating scales and open-ended comments. Psychosocial-behavioral and metabolic outcomes were assessed at baseline and 3 months after initial training. Bivariate correlations were performed to describe relationships between mindfulness and other outcome variables. Gain scores and Wilcoxon matched-pair signed rank tests were used to assess pre to post changes; Cohen's d was applied to estimate the magnitude of effects. Results Twenty-eight of 49 eligible veterans (57%) enrolled in the study. Of those, 11 veterans (39%) demonstrated participation in home practice, and 20 veterans (71%) completed the study. Overall, participants and diabetes educators were highly satisfied with the Mind-STRIDE intervention. Significant improvements were found in diabetes distress, diabetes self-efficacy, diabetes self-management behaviors, mindful-describing, and A1C. Conclusion Results suggest feasibility, satisfaction, and positive preliminary effects. Efficacy testing by randomized controlled trial with analysis of covariance structures is warranted.
目的 本研究旨在确定 Mindful Stress Reduction in Diabetes Education（Mind-STRIDE）在退伍军人中的可行性、满意度和初步效果，Mind-STRIDE 是一种基于正念的干预措施。
方法 该研究采用单组前后测重复测量设计。90 分钟的 Mind-STRIDE 培训，改编自正念减压（MBSR），是在退伍军人事务部（VA）门诊糖尿病诊所半天糖尿病自我管理教育课程的最后一个组成部分。初始培训后，参与者被要求在 3 个月的研究期间每天在家中进行 10 分钟的正念练习。招募和保留退伍军人的比例作为研究结果进行评估。退伍军人和糖尿病教育者的满意度通过评分量表和开放性评论进行评估。在基线和初始培训后 3 个月评估心理社会行为和代谢结果。进行了双变量相关性分析，以描述正念与其他结果变量之间的关系。使用增益分数和 Wilcoxon 配对符号秩检验评估前后变化；应用 Cohen's d 估计效应的大小。
结果 在 49 名符合条件的退伍军人中，有 28 名（57%）参加了研究。其中，有 11 名退伍军人（39%）参与了家庭练习，有 20 名退伍军人（71%）完成了研究。总体而言，参与者和糖尿病教育者对 Mind-STRIDE 干预非常满意。糖尿病困扰、糖尿病自我效能、糖尿病自我管理行为、正念描述和 A1C 都有显著改善。
结论 结果表明该方案具有可行性、满意度和积极的初步效果。需要通过随机对照试验和协方差结构分析来检验疗效。
