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Peyrot, M. & Rubin, R. R. Behavioral and psychosocial interventions in diabetes: a conceptual review. Diabetes Care 30, 2433-2440

Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland, United States
Diabetes care (Impact Factor: 8.42). 11/2007; 30(10):2433-40. DOI: 10.2337/dc07-1222
Source: PubMed

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    • "Previous research has suggested that motivational problems are probably one of the most important reasons for poor diabetes management (Ruderfelt & Axelsson 2004, Peyrot & Rubin 2007). As diabetes is a lifelong disease and involves consultations with healthcare practitioners, several researchers have indicated that support from these practitioners is critical for effective diabetes management (Lorig 2001, Thorne & Paterson 2001, Macdonald et al. 2008) and may influence an individual's motivation to self-manage their disease (Williams et al. 2005, Tang et al. 2008). "

    Full-text · Article · Aug 2014 · European Diabetes Nursing
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    • "There is evidence, however, that low adherence rates are problematic among type 2 diabetes patients [3] [4]. As suggested in a previous review, strategies to foster behavioural change can be implemented by physicians during diabetes care visits [5]. Cognitive behavioural therapy (CBT) has also been recommended in chronic diseases to improve selfmanagement [6–8], but the treatment is time-consuming and requires specific psychological training. "
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    ABSTRACT: Diabetes perceptions, acceptance and treatment motivation are changeable factors of adherence. This study aimed to test the effects of brief psychological interventions based on diabetes threat and mastery perceptions in terms of adherence, acceptance and motivation. Physicians may find such interventions useful during a 15-minute consultation with diabetes patients. This randomized controlled study included 80 patients with type 2 diabetes, recruited from the hospital diabetes department, who were randomly assigned to four intervention groups based on autobiographical recall. Those in the two intervention groups were asked to recall diabetic events based on mastery and threat perceptions, respectively, whereas those in the two control groups recalled non-diabetic events based on positive and negative emotions, respectively. Following this, all participants completed validated self-questionnaires assessing diabetes perceptions, acceptance, treatment motivation and adherence. Patients in the threat group reported less adherence (P<0.01) and less avoidance (P<0.05), and perceived diabetes as less threatening (P<0.05) than those in the mastery group. Similar results were obtained when the threat group was compared with its matched negative-emotion control group (P<0.05, P<0.05 and P=0.087, respectively). Patients in the mastery group reported feeling a stronger sense of mastery (P<0.05) than those in their positive-emotion control group and greater treatment acceptance than those in the threat group (P<0.01). Contrary to conventional medical belief, discussing threatening personal events with patients can yield positive results. Health professionals should take threat and mastery perceptions of diabetes into account during regular consultations with a view to improving treatment acceptance and adherence. With this brief intervention of type 2 diabetes patients, it was also more effective to alleviate their emotional difficulties than to enhance their perception of mastery.
    Full-text · Article · Oct 2013 · Diabetes & Metabolism
    • "The psychological burden on the individual patient caused by the disease must also be recognized. Diabetes care providers such as nurses and physicians must deal with patients' everyday problems in managing diabetes, and some patients may need to seek help from psychosocial specialists[17]. Some earlier research have shown a high prevalence of depression in persons with T2D and an association between depression and poor self-management, poor metabolic control, and diabetic complications181920. "
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    ABSTRACT: The present study protocol is designed to cover the Norwegian part of the European Union Collaborative Project-REgioNs of Europe WorkINg together for HEALTH (RENEWING HEALTH). Self-management support is an important element of care for persons with type 2 diabetes (T2D) for achieving metabolic control and positive lifestyle changes. Telemedicine (TM) with or without health counseling may become an important technological aid for self-management and may provide a user-centered model of care. In spite of many earlier studies on TM, there remains a lack of consensus in research findings about the effect of TM interventions. The aim of RENEWING HEALTH is to validate and evaluate innovative TM tools on a large scale through a common evaluation, making it easier for decision makers to choose the most efficient and cost-effective technological interventions. The Norwegian pilot study evaluates whether the introduction of a mobile phone with a diabetes diary application together with health counseling intervention produces benefits in terms of the desired outcomes, as reflected in the hemoglobin A1c level, health-related quality of life, behavior change, and cost-effectiveness. The present study has a mixed-method design comprising a three-armed prospective randomized controlled trial and qualitative interviews with study data collected at three time points: baseline, after 4 months, and after 1 year. The patients' registrations on the application are recorded continuously and are sent securely to a server. The inclusion of patients started in March 2011, and 100% of the planned sample size is included (N=151). Of all the participants, 26/151 patients (17.2%) are lost to follow-up by now, and 11/151 patients (7.3%) are still in the trial. Results of the study protocol will be presented in 2014. The key goals of this trial are to investigate the effect of an electronic diabetes diary app with and without health counseling, and to determine whether health counseling is important to the continued use of the application and the patients' health competence and acceptability. Research within this area is needed because few studies have investigated the effectiveness of apps used in long-term interventions with this degree of self-management. Clinicaltrials.gov NCT01315756; http://clinicaltrials.gov/ct2/show/NCT01315756 (Archived by WebCite at http://www.webcitation/6BTyuRMpH).
    No preview · Article · Aug 2013
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