Diabetes-related symptoms and negative mood in participants of a targeted population-screening program for type 2 diabetes: The Hoorn Screening Study.
ABSTRACT To determine the level of diabetes-related symptom distress and its association with negative mood in subjects participating in a targeted population-screening program, comparing those identified as having type 2 diabetes vs. those who did not.
This study was conducted within the framework of a targeted screening project for type 2 diabetes in a general Dutch population (age 50-75 years). The study sample consisted of 246 subjects, pre-selected on the basis of a high-risk profile; 116 of whom were subsequently identified as having type 2 diabetes, and 130 who were non-diabetic subjects. Diabetes-related symptom distress and negative mood was assessed approximately 2 weeks, 6 months, and 12 months after the diagnosis of type 2 diabetes, with the Type 2 Diabetes Symptom Checklist and the Negative well-being sub scale of the Well-being Questionnaire (W-BQ12), respectively.
Screening-detected diabetic patients reported significantly greater burden of hyperglycemic (F = 6.0, df = 1, p = 0.015) and of fatigue (F = 5.3, df = 1, p = 0.023) symptoms in the first year following diagnosis type 2 diabetes compared to non-diabetic subjects. These outcomes did not change over time. The total symptom distress (range 0-4) was relatively low for both screening-detected diabetic patients (median at approximately 2 weeks, 6 months, and 12 months; 0.24, 0.24, 0.29) and non-diabetic subjects (0.15, 0.15, 0.18), and not significantly different. No average difference and change over time in negative well-being was found between screening-detected diabetic patients and non-diabetic subjects. Negative well-being was significantly positive related with the total symptom distress score (regression coefficient beta = 2.86, 95% CI 2.15-3.58).
The screening-detected diabetic patients were bothered more by symptoms of hyperglycemia and fatigue in the first year following diagnosis type 2 diabetes than non-diabetic subjects. More symptom distress is associated with increased negative mood in both screening-detected diabetic patients and non-diabetic subjects.
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ABSTRACT: The aim of the study was to identify symptoms in people with impaired glucose tolerance (IGT) and describe their experiences of living with the symptoms which they related to their condition. Twenty-one participants, from a cross-sectional population-based study, diagnosed as having IGT, were invited for an interview. The interviews were analyzed in two phases by means of a manifest and latent content analysis. The narratives included seven categories of symptoms (and more than 25 different symptoms) presented by the respondents. This study shows that symptoms such as the patient's own interpretation of different perceptions in the body must be considered, as well as signs and/or objective observations. Symptoms ought to be seen as complementary components in the health encounter and health conversation. The results of this study indicate that health professionals should increase their awareness of the balance between the implicit and the explicit bodily sensations that individuals communicate. Further studies are needed.07/2011; 2011:937038. DOI:10.1155/2011/937038
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ABSTRACT: The purpose of this study was to examine reasons for nonparticipation and drop out in a diabetes self-management intervention. A total of 468 recently screen-detected patients, receiving usual care or intensive pharmacological treatment, were invited and randomized into either a control or intervention condition, consisting of a brief self-management course. A nonresponse survey was conducted, and participants, nonparticipants, and dropouts were compared on sociodemographic variables, diabetes attitudes, and self-care. A total of 227 patients consented and were allocated to the control (n=108) or intervention group (n=119). Two hundred forty-one patients declined participation, 41 dropped out, and 78 completed the intervention. Major reasons for refusal and drop out were hesitancy toward research and practical barriers. Nonparticipants were less educated and reported higher self-management, while participation also varied by treatment and disease duration: intensively treated patients were more likely to participate in their first year, and usual-care patients participated more often 2 to 3 years after diagnosis. Dropouts had a lower education level but did not differ on any other measure. Participants, nonparticipants, and dropouts did not differ in their attitudes toward diabetes, but the intervention did attract patients with lower self-care. Variations in participation by treatment and disease duration suggest that patients prefer self-management interventions at different times depending on their medical treatment. Finally, education appears to be the most important factor determining participation. Alternative strategies are needed to attract and retain patients with low education.The Diabetes Educator 05/2007; 33(3):465-74. DOI:10.1177/0145721707301491 · 1.92 Impact Factor
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ABSTRACT: This prospective randomized controlled trial evaluated a theory-driven group-based self-management course for patients with screen-detected type 2 diabetes. 227 patients receiving either intensive pharmacological or usual-care treatment since diagnosis (3-33 months previously) agreed to participate and were subsequently randomized to a control or intervention condition (3-month, nurse-lead, self-management course). Based on self-regulation theory and proactive coping, the course incorporated elements of anticipation, goal-setting and planning in a proactive 5-step plan to help patients translate their good intentions into sustained self-management behaviors. A 2x2 factorial design evaluated the behavioral intervention (self-management course versus control) nested within the medical treatment (intensive versus usual-care) and included a baseline psychological assessment, a preliminary assessment of psychological outcomes at 3-months, and changes in self-management behaviors and cardiovascular outcomes (BMI, blood pressure, Hba1c and lipid profiles) from 0-12 months. At baseline, most patients experienced little emotional distress but also generally underestimated their condition and reported low self-management behavior. At 3-months, course completers evaluated the course and the 5-step plan very positively and showed significant improvements in their proactive coping, self-efficacy and goal-attainment. 12-month evaluations revealed that the intervention group experienced significant and sustained improvements in their self-management behaviors, BMI (-0.77 kg/m2) and systolic blood pressure (-6.2 mmHg). In all aspects, the self-management course was effective independent of medical treatment; however, those patients receiving both intensive pharmacological treatment and the course showed greatest reduction in their cardiovascular risk, suggesting that a combination of medical and behavioral treatments may be particularly effective in newly diagnosed type 2 diabetes.