为患有慢性健康和心理健康合并症的退伍军人加强糖尿病自我管理教育和心理服务。

Enhancing Diabetes Self-Management Education and Psychological Services for Veterans With Comorbid Chronic Health and Mental Health Conditions.

作者信息

Kane Naomi S, Bloor Lindsey E, Michaels Jamie

机构信息

is a Clinical Psychology Postdoctoral Fellow in behavioral medicine and postdeployment health at the New Jersey VA War Related Illness and Injury Study Center in East Orange. Naomi Kane was previously a Psychology Intern; is a Clinical Health Psychologist and the Health Behavior Coordinator; is a Registered Dietician and Certified Diabetes Educator; all at the VA Ann Arbor Healthcare System in Michigan. Lindsey Bloor is a Clinical Assistant Professor in Psychiatry at the University of Michigan Medical School in Ann Arbor.

出版信息

Fed Pract. 2021 Apr;38(4):e22-e28. doi: 10.12788/fp.0106.

DOI:10.12788/fp.0106

PMID:34177225

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8221919/

Abstract

BACKGROUND

Veterans experience a higher prevalence of type 2 diabetes mellitus (T2DM) compared with the rate of their civilian counterparts. Veterans may experience vulnerability to chronic stress, in particular comorbid mental health conditions, and may not benefit from traditional diabetes education.

METHODS

This study evaluated clinical and psychological measures among veterans engaged in health psychology services. Individualized motivational interviewing and cognitive behavioral interventions were provided to address T2DM distress and promote veterans' diabetes self-management. Pre-/postobjective and self-report measures were evaluated for clinical relevancy and statistically significant changes.

RESULTS

The sample consisted of 13 older adults: mean age 62.8 years; 12 were male and 9 were prescribed insulin. More than half had comorbid hypertension, hyperlipidemia, and/or a diagnosis of chronic pain. Eleven participants were diagnosed with a mental health disorder. Baseline measures indicated mild depressive symptoms, mild anxiety symptoms, and moderate levels of T2DM distress. Postintervention reductions were shown for T2DM distress; emotional burden, and regimen-related distress, depressive symptoms, and enhanced diabetes empowerment.

CONCLUSIONS

Veterans with comorbid conditions may benefit from individualized psychology services that offer cognitive behavioral strategies for self-management of T2DM-related distress, integrated with traditional primary care and diabetes education.

摘要

背景

与普通民众相比，退伍军人患2型糖尿病（T2DM）的比例更高。退伍军人可能更容易受到慢性压力的影响，尤其是合并心理健康问题，并且可能无法从传统的糖尿病教育中受益。

方法

本研究评估了接受健康心理学服务的退伍军人的临床和心理指标。提供个性化的动机性访谈和认知行为干预，以解决T2DM困扰并促进退伍军人的糖尿病自我管理。对客观和自我报告指标的前后变化进行评估，以确定临床相关性和统计学上的显著变化。

结果

样本包括13名老年人，平均年龄62.8岁；12名男性，9名使用胰岛素治疗。超过一半的人合并高血压、高脂血症和/或患有慢性疼痛。11名参与者被诊断患有心理健康障碍。基线指标显示有轻度抑郁症状、轻度焦虑症状和中度T2DM困扰。干预后，T2DM困扰、情绪负担、治疗方案相关困扰、抑郁症状均有所减轻，糖尿病自我管理能力增强。