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基于正念的团体干预在 1 型糖尿病青少年中的应用:一项初步的试点和可行性随机对照试验结果。

Mindfulness-based group intervention for adolescents with type 1 diabetes: initial findings from a pilot and feasibility randomized controlled trial.

机构信息

Center for Translational Research, Children's National Hospital, Washington, DC, United States.

Psychiatry & Behavioral Sciences, The George Washington University School of Medicine, Washington, DC, United States.

出版信息

J Pediatr Psychol. 2024 Oct 1;49(10):769-779. doi: 10.1093/jpepsy/jsae071.

Abstract

OBJECTIVE

To evaluate feasibility/acceptability of a virtual, group mindfulness-based intervention (MBI) adapted for pediatric type 1 diabetes (T1D).

METHODS

This two-way controlled trial randomized adolescents 1:1 to MBI (n = 20) or health education (HE; n = 22) groups lasting 6-7 weeks. Eligibility included 12-17 years, T1D ≥ 1 year, and elevated scores on PROMIS depression or anxiety measures. Recruitment, retention, and session attendance were tracked to measure feasibility. Acceptability was measured via youth-reported post-session surveys. Adolescents completed depression, anxiety, and diabetes-specific surveys at baseline, immediately post-program, and 3 months post-program completion. HbA1c values approximating these timeframes were obtained from chart review.

RESULTS

55% of screened participants were eligible to participate, and 100% of eligible youth enrolled. There was 93% study retention and 96% session attendance rates. Survey data were 100% complete at baseline, and 93% complete at post-program and 3-month follow-ups; 83% and 78% of MBI participants rated sessions as at least somewhat enjoyable and helpful, respectively, and 91% and 82% of HE participants rated sessions as at least somewhat enjoyable and helpful, respectively. Mean scores showed declines in depression, anxiety, disordered eating, diabetes distress, and HbA1c in both groups across time, with trends toward potential greater reductions in depression and HbA1c in MBI.

CONCLUSIONS

This pilot provides preliminary evidence that virtual MBI and HE groups adapted for adolescents with T1D are feasible to deliver and acceptable, with potential improvement in psychosocial, behavioral, and diabetes-specific outcomes. Whether MBI is more effective for targeting negative affect and glycemic control in the context of adolescent T1D requires testing in a full-scale efficacy trial.

摘要

目的

评估为儿科 1 型糖尿病(T1D)患者改编的虚拟团体正念干预(MBI)的可行性/可接受性。

方法

本双向对照试验将符合条件的青少年随机分为 MBI 组(n=20)或健康教育(HE;n=22)组,持续 6-7 周。纳入标准包括 12-17 岁、T1D 患病时间≥1 年以及 PROMIS 抑郁或焦虑量表评分升高。招募、保留和课程出勤率都被跟踪记录,以评估可行性。接受度则通过青少年报告的课后调查来衡量。青少年在基线、即刻项目结束后和项目完成后 3 个月完成抑郁、焦虑和糖尿病特定的问卷调查。从图表回顾中获取接近这些时间的 HbA1c 值。

结果

筛查出的参与者中 55%符合参与条件,且 100%符合条件的青少年均入组。研究保留率为 93%,课程出勤率为 96%。基线时的调查数据完成率为 100%,项目结束后和 3 个月随访时的完成率分别为 93%和 96%;83%和 78%的 MBI 参与者分别对课程评价为至少有些有趣和有用,91%和 82%的 HE 参与者分别对课程评价为至少有些有趣和有用。两组的抑郁、焦虑、饮食失调、糖尿病困扰和 HbA1c 评分在时间上均呈下降趋势,MBI 组在抑郁和 HbA1c 方面的下降趋势可能更明显。

结论

该试验提供了初步证据,表明为 T1D 青少年改编的虚拟 MBI 和 HE 小组是可行且可接受的,可能改善心理社会、行为和糖尿病特定的结果。MBI 是否更能针对青少年 T1D 患者的负面情绪和血糖控制效果需要在全规模疗效试验中进行测试。

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