Two for one? Effects of a couples intervention on partners of persons with Type 2 diabetes: a randomized controlled trial
Two for one? Effects of a couples intervention on partners of persons with Type 2 diabetes: a randomized controlled trial
复制标题
DOI：
10.1111/dme.13871
复制
发表时间：
2019-04-01
影响因子：
3.5
通讯作者：
Weinstock, R. S.
中科院分区：
文献类型：
--
作者：
Trief, P. M.;Fisher, L.;Weinstock, R. S.
目的比较参加电话夫妇行为干预以改善2型糖尿病患者的血糖控制的合作伙伴的结果与参加个人干预或教育的未治疗合作伙伴的结果;探索“涟漪效应”，即在未治疗合作伙伴中看到的积极行为变化。方法糖尿病支持项目是一项三臂随机电话干预试验，比较了夫妇电话（CC）、个人电话（IC）和糖尿病教育电话（DE）的结果。夫妇包括一方患有2型糖尿病，HbA（1c）≥ 58 mmol/mol（7.5%）。所有兵种都接受了自我管理教育（两次电话）。CC和IC武器参加了10个额外的行为改变电话。合作中心包括合作伙伴，强调合作伙伴的沟通、协作和支持。在4、8和12个月时进行设盲评估。伴侣的结局是心理社会（糖尿病困扰，关系满意度，抑郁症状），医疗（BMI，血压）和行为（脂肪摄入量，活动）。结果268例性伴平均年龄55.8岁，64.6%为女性，29.9%为少数民族。CC（与IC和DE相比）伴侣在糖尿病困扰方面有更大的减少，婚姻满意度（4个月和8个月）有更大的增加，舒张压也有一些改善。在其他结局方面，两组之间没有一致的差异。没有证据表明饮食或活动行为对未经治疗的伴侣产生涟漪反应，即比较IC组和DE组的伴侣。结论：夫妻合作干预显著改善了伴侣糖尿病困扰和关系满意度。对行为或医疗伴侣的结果没有一致的影响，也没有证据表明饮食或活动行为的涟漪反应，这表明应该直接针对伴侣来实现这些变化。（临床试验注册编号：NCT 01017523）
Aims To compare the outcomes of partners who participated in a telephone couples behavioural intervention to improve glycaemic control in persons with Type 2 diabetes with those of untreated partners of participants in an individual intervention or education; to explore 'ripple effects', i.e. positive behaviour changes seen in untreated partners. Methods The Diabetes Support Project was a three-arm randomized telephone intervention trial comparing outcomes of couples calls (CC), individual calls (IC) and diabetes education calls (DE). Couples included one partner with Type 2 diabetes and HbA(1c) >= 58 mmol/mol (7.5%). All arms received self-management education (two calls). CC and IC arms participated in 10 additional behaviour change calls. CC included partners, emphasizing partner communication, collaboration and support. Blinded assessments were performed at 4, 8 and 12 months. Partner outcomes were psychosocial (diabetes distress, relationship satisfaction, depressive symptoms), medical (BMI, blood pressure) and behavioural (fat intake, activity). Results Partners' (N = 268) mean age was 55.8 years, 64.6% were female and 29.9% were from minority ethnic groups. CC (vs. IC and DE) partners had greater reductions in diabetes distress, greater increases in marital satisfaction (4 and 8 months), and some improvements in diastolic BP. There were no consistent differences among arms in other outcomes. There was no evidence of a dietary or activity behaviour ripple effect on untreated partners, i.e. comparing partners in the IC and DE arms. Conclusions A collaborative couples intervention resulted in significant improvements in partner diabetes distress and relationship satisfaction. There were no consistent effects on behavioural or medical partner outcomes, and no evidence of diet or activity behaviour ripple effects, suggesting that partners should be targeted directly to achieve these changes. (Clinical Trial Registry No: NCT01017523)