DIABETES & AGING INCREASED REGIMEN ADHERENCE IN ELDERLY

这个竞争性的更新项目将系统地开发和 评估心理社会干预计划以增加治疗方案 65岁或以上有型的人的依从性 II(非胰岛素依赖型)糖尿病。很少有心理社交活动 针对II型糖尿病的干预措施已经开发出来，我们 据我所知，没有一款是为老年人设计的。基于我们的 与养生法相关的社会学习因素的研究结果 II型糖尿病患者的依从性(例如，自我 效力、坚持的障碍、解决问题的技能)，我们有 最近开发了一个群体干预计划来修改这些 变量。 最初的发展阶段，包括与 我们目前研究的老年参与者，进一步的数据分析， 焦点小组和小规模试点工作将使我们能够调整我们的 目前的干预措施，以满足国家的需要和关切 老年人。特别是，我们将包括干预组件，以 解决抑郁症，这在患有抑郁症的老年人中很普遍 慢性病和个人疾病模式。由此产生的 然后将针对延迟治疗对干预进行评估 控制条件。以下各项中的多个衡量标准 将收集类别进行评估：坚持饮食 (卡路里摄入量、纤维和脂肪摄入量)和锻炼自我照顾 行为；过程/中介变量；以及次要结果 (例如，血糖控制、生活满意度)。 根据这项研究的结果，第二个结果研究将 将修订后的干预措施与 以教育为基础的糖尿病教育计划旨在 控制社交互动、治疗师联系和 提供的信息。这项研究将做出重大贡献 对心理社会干预的设计和理解 糖尿病方案，并对儿童健康保健产生影响 患有其他慢性病的老年人。

This competing renewal project will systematically develop and evaluate a psychosocial intervention program to increase regimen adherence among persons 65 years of age or older who have Type II (noninsulin-dependent) diabetes mellitus. Few psychosocial interventions have been developed for Type II diabetes and we know of none designed for older individuals. Based upon our findings concerning social learning factors related to regimen adherence among persons with Type II diabetes (e.g., self- efficacy, barriers to adherence, problem-solving skills), we have recently developed a group intervention program to modify these variables. An initial developmental phase consisting of interviews with elderly participants in our current research, further data analyses, focus groups, and small-scale pilot work will allow us to adapt our current intervention to meet the needs and concerns of the elderly. In particular, we will include intervention components to address depression, which is prevalent among the elderly with chronic illnesses, and personal models of illness. The resulting intervention will then be evaluated against a delayed treatment control condition. Multiple measures within each of the following categories will be collected to evaluate: adherence to dietary (caloric intake, fiber and fat consumption) and exercise self-care behaviors; process/mediating variables; and secondary outcomes (e.g., glycemic control, life satisfaction). Based upon the results of this study, a second outcome study will be conducted in which a revised intervention is compared to an educationally based diabetes education program designed to control for social interaction, therapist contact and amount of information presented. This research will contribute significantly to the design and understanding of psychosocial intervention programs for diabetes and have implications for the health care of the elderly with other chronic diseases.