Coping skills training for youth with diabetes mellitus has long-lasting effects on metabolic control and quality of life
Coping skills training for youth with diabetes mellitus has long-lasting effects on metabolic control and quality of life
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DOI：
10.1067/mpd.2000.106568
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发表时间：
2000-07-01
影响因子：
5.1
通讯作者：
Tamborlane, WV
中科院分区：
文献类型：
--
作者：
Grey, M;Boland, EA;Tamborlane, WV
目的：确定在实施强化治疗方案的青年中，行为干预联合强化糖尿病管理（IDM）对代谢控制和生活质量的初步影响是否可以持续1年以上。（43名女性，95%为白色）12至20岁（平均值= 14.2 +/- 1.9;持续时间，8.7 +/- 3.9）选择开始IDM的患者被随机分配到两组之一：有或没有应对技能培训，包括G小组会议和每月的后续行动，以帮助青年在糖尿病管理的背景下科普他们的生活;技能包括解决社会问题，认知行为修正和解决冲突。在干预前和干预后3个月、6个月和12个月，使用糖尿病自我效能量表、儿童抑郁量表、应对胰岛素依赖型糖尿病的问题和糖尿病生活质量：青年量表收集数据。每月收集两组患者的临床资料（糖化血红蛋白水平、身高、体重、不良反应）。CST受试者的糖化血红蛋白较低（P =.001），糖尿病（P =.002）和医疗（P =.04）自我效能较好，糖尿病对他们的生活质量的影响较小（P =.005），比1年后单独接受IDM的年轻人。在男性中，CST并没有影响IDM低血糖，糖尿病酮症酸中毒和体重增加的不良后果，但CST降低体重增加（P =.05）和低血糖的发生率在女性（P =.03）。结论：除了行为干预IDM在青春期的结果在改善代谢控制和生活质量超过1年。
Objective: To determine whether initial effects on metabolic control and quality of life associated with a behavioral intervention combined with intensive diabetes management (IDM) can be sustained over 1 year in youth implementing intensive therapy regimens.Study design: Seventy-seven patients (43 females, 95% white) 12 to 20 years (mean = 14.2 +/- 1.9; duration, 8.7 +/- 3.9) electing to initiate IDM were randomly assigned to one of two groups: with or without coping skills training (CST), which consists of G small group sessions and monthly follow-up to help youth cope with their lives in the context of diabetes management; skills included social problem solving, cognitive behavior modification, and conflict resolution. Data were collected before the intervention and at 3, 6, and 12 months after the intervention LSI using the Self-Efficacy for Diabetes Scale, Children's Depression Inventory, Issues in Coping with IDDM, and the Diabetes Quality of Life: Youth scales. Clinical data (glycosylated hemoglobin level, height, weight, adverse effects) were collected monthly.Results: The CST and IDM groups were comparable at baseline. CST subjects had lower glycosylated hemoglobin (P =.001) and better diabetes (P =.002) and medical (P =.04) self-efficacy, and less impact of diabetes on their quality of life (P =.005) than youth receiving IDM alone after 1 year. In males, CST did not affect adverse outcomes of IDM hypoglycemia, diabetic ketoacidosis, and weight gain, but CST decreased the incidence of weight gain (P =.05) and hypoglycemia in females (P =.03).Conclusions: The addition of behavioral intervention to IDM in adolescence results in improved metabolic control and quality of life over 1 year.