通过远程医疗网络提供的低强度心理健康支持（LISTEN）对患有糖尿病困扰的成年人的有效性：一项平行组实用随机对照试验。

Effectiveness of Low Intensity Mental Health Support via a Telehealth Enabled Network (LISTEN) for Adults With Diabetes Distress: A Parallel Group, Pragmatic Randomized Controlled Trial.

作者信息

Holloway Edith E, Jenkins Laura, Agius Paul A, Manallack Sarah, Le Gautier Roslyn, Mihalopoulos Cathrine, Chatterton Mary Lou, Versace Vincent L, Halliday Jennifer, Hagger Virginia, Gray Shikha, Henshaw Kim, Harrap Ben, Van Bruggen Natasha, Black Taryn, Noonan Glen, Hines Carolyn, O'Neil Adrienne, Skinner Timothy C, Speight Jane, Hendrieckx Christel

机构信息

School of Psychology, Deakin University, Geelong, Victoria, Australia.

The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Carlton, Victoria, Australia.

出版信息

Diabetes Care. 2025 Jun 1;48(6):955-965. doi: 10.2337/dc24-2525.

DOI:10.2337/dc24-2525

PMID:40392991

Abstract

OBJECTIVE

To assess the effectiveness of Low Intensity mental health Support via a Telehealth Enabled Network (LISTEN), facilitated by diabetes health professionals, for reducing diabetes distress among adults with type 1 or type 2 diabetes.

RESEARCH DESIGN AND METHODS

A two-arm, parallel group, pragmatic randomized controlled trial. Adults with diabetes distress (20-item Problem Areas in Diabetes [PAID] score ≥25, or ≥2 on three or more items) were recruited via the National Diabetes Services Scheme (NDSS) and randomized (1:1) via central randomization by computer to LISTEN (maximum four sessions of problem-solving therapy) or usual care (web-based resources about diabetes and emotional health). Participants completed self-report online surveys at baseline and at 8 and 26 weeks. The primary outcome was the change in diabetes distress (PAID) from baseline to 26 weeks. Secondary outcomes included psychological distress (10-item Kessler Psychological Distress Scale), general emotional well-being (World Health Organization 5-item Well-being Index) and coping self-efficacy at 8 and 26 weeks. Data were analyzed using intention-to-treat principles.

RESULTS

Participants (n = 429, 59% women, 40% men, 1% nonbinary; median age 54 [interquartile range 42.0-63.5]; 37% type 1 diabetes, 63% type 2 diabetes) were enrolled and randomized to the intervention (n = 216) or control group (n = 213). Over 26 weeks, there was a greater reduction in diabetes distress among the LISTEN group versus the control group (mean difference -7.2 [95% CI -11.6, -2.8]; P < 0.001; Cohen f2 = 0.03) and greater improvements in general emotional well-being and coping self-efficacy. No adverse events were reported.

CONCLUSIONS

LISTEN is an effective, low-intensity program, addressing the unmet needs of adults with type 1 and type 2 diabetes experiencing mild-to-moderate diabetes distress.

摘要

目的

评估由糖尿病健康专业人员推动的、通过远程医疗网络提供的低强度心理健康支持（LISTEN）对减轻1型或2型糖尿病成人患者糖尿病困扰的有效性。

研究设计与方法

一项双臂、平行组、实用随机对照试验。通过国家糖尿病服务计划（NDSS）招募有糖尿病困扰的成年人（糖尿病问题领域20项量表[PAID]得分≥25，或三项及以上项目得分≥2），并通过计算机集中随机化以1:1的比例将其随机分为LISTEN组（最多四次解决问题疗法疗程）或常规护理组（关于糖尿病和情绪健康的网络资源）。参与者在基线、8周和26周时完成自我报告在线调查。主要结局是从基线到26周糖尿病困扰（PAID）的变化。次要结局包括8周和26周时的心理困扰（10项凯斯勒心理困扰量表）、总体情绪幸福感（世界卫生组织5项幸福感指数）和应对自我效能感。采用意向性分析原则对数据进行分析。

结果

共纳入参与者429名（59%为女性，40%为男性，1%为非二元性别；年龄中位数54岁[四分位间距42.0 - 63.5]；37%为1型糖尿病，63%为2型糖尿病），并随机分为干预组（n = 216）或对照组（n = 213）。在26周内，LISTEN组的糖尿病困扰减轻程度大于对照组（平均差值 -7.2 [95%置信区间 -11.6, -2.8]；P < 0.001；科恩f2 = 0.03），总体情绪幸福感和应对自我效能感也有更大改善。未报告不良事件。