Randomized trial of behavioral family systems therapy for diabetes - Maintenance of effects on diabetes outcomes in adolescents
Randomized trial of behavioral family systems therapy for diabetes - Maintenance of effects on diabetes outcomes in adolescents
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DOI：
10.2337/dc06-1613
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发表时间：
2007-03-01
期刊：
影响因子：
16.2
通讯作者：
White, Neil H.
中科院分区：
文献类型：
--
作者：
Wysocki, Tim;Harris, Michael A.;White, Neil H.
目的-研究表明，家庭沟通和解决冲突是至关重要的1型糖尿病的青少年有效管理刺激了兴趣，评估针对这些过程的心理治疗。以前的试验表明，行为家庭系统疗法（BFST）改善了父母与青少年的关系，但没有治疗依从性或血糖控制。这项研究评估了一种修订后的干预措施，糖尿病BFST（BFST-D），修改后的干预措施对糖尿病相关的家庭冲突，治疗依从性和代谢控制产生了更大的影响，研究设计和方法--将104个1型糖尿病控制不佳的青少年家庭随机分为两组，一组继续接受标准治疗（SC），或通过12次多家庭教育支持（ES）组或12次BFST-D超过6个月来增加该方案。相关措施收集在基线和随访评估在6，12，和18 months.RESULTS - BFST-D是显着上级SC和ES在A1 C的影响，而对治疗依从性和家庭冲突的影响是模棱两可的。A1 C的改善似乎是由治疗依从性的改善介导的。在每次随访时，与SC组和ES组相比，BFST-D青少年在治疗依从性方面实现中度或更大改善（> 0.5 SD）的百分比显著更高。治疗依从性的变化与A1 C的变化在每个follow-up.CONCLUSIONS显着相关-这些结果支持BFST-D在改善A1 C的疗效，但需要进一步的研究，以确定这种效果的机制，并实现成本效益传播的干预。
OBJECTIVE - Studies showing that family communication and conflict resolution are critical to effective management of type 1 diabetes in adolescents have stimulated interest in evaluating psychological treatments targeting these processes. Previous trials have shown that Behavioral Family Systems Therapy (BFST) improved parent-adolescent relationships but not treatment adherence or glycemic control. This study evaluates a revised intervention, BFST for Diabetes (BFST-D), modified to achieve greater impact on diabetes-related family conflict, treatment adherence, and metabolic control,RESEARCH DESIGN AND METHODS - A sample of 104 families of adolescents with inadequate control of type 1 diabetes was randomized to either remain in standard care (SC) or to augmentation of that regimen by 12 sessions of either a multifamily educational support (ES) group or 12 sessions of BFST-D over 6 months. Pertinent measures were collected at baseline and at follow-up evaluations at 6, 12, and 18 months.RESULTS - BFST-D was significantly superior to both SC and ES in effects on A1C, while effects on treatment adherence and family conflict were equivocal. Improvement in A1C appeared to be mediated by improvement in treatment adherence. A significantly higher percentage of BFST-D youth achieved moderate or greater improvement (> 0.5 SD) in treatment adherence compared with the SC group at each follow-up and the ES group at 6 and 18 months. Change in treatment adherence correlated significantly with change in A1C at each follow-up.CONCLUSIONS - These results support the efficacy of BFST-D in improving A1C, but further research is needed to identify the mechanisms of this effect and to achieve cost-effective dissemination of the intervention.