A Psychoeducational Intervention for Women with Diabetes

针对女性糖尿病患者的心理教育干预

• 批准号: 7099303
• 负责人: SUE M PENCKOFER
• 金额: $ 12.79万
• 依托单位: LOYOLA UNIVERSITY CHICAGO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-01 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7099303
• 关键词: angers; anxiety; clinical research; depression; health; quality of life; self care

DESCRIPTION (provided by applicant): While cardiac mortality for men with diabetes has declined (13.1%), there has been a 23% increase in age-adjusted cardiac mortality for women with diabetes. This poor outcome, occurring in a time of significant advances in the management of heart disease, suggests the need to consider directing treatment at other risk factors. Depression is an independent risk factor for cardiovascular disease About 25% of persons with diabetes have depression, and the rate of depression in women with diabetes is doubled that of men with diabetes. Women with diabetes exhibit worse diabetes self-care, glycemic control, and poorer quality of life than men with diabetes, outcomes that are exacerbated by depression. Anxiety and anger commonly accompany depressive symptoms, appear to impose similar risks for poor medical outcomes, and occur more often in women with diabetes than men with diabetes. Most diabetes education programs may briefly address dysphoric symptoms; however, their primary emphasis is not on the assessment and management of these symptoms. The Study of Women's Emotions and Evaluation of a Psychoeducational (SWEEP) Program will test the effectiveness and feasibility of an eight week psychoeducational intervention on: (1) dysphoric symptoms (depressive symptoms, anxiety, and anger), (2) glycemic control (HbA1c), (3) health-related quality of life (functional status, life satisfaction, and diabetes-related distress), and (4) diabetes self-management (self care behaviors and self-efficacy) at three and 6 months follow-up. Fifty women with type 2 diabetes who are receiving usual medical care (UMC) for diabetes and have significant depressive symptoms, will be randomized to receive a cognitive behavioral psychoeducational intervention delivered in a group format (n=25) or no additional treatment (n=25). A mixed model analysis of variance will be used to test the study hypothesis that the group receiving UMC plus the psychoeducational intervention will have significantly better outcomes than the group that receives UMC alone. The findings should demonstrate the feasibility and health related benefits of psychoeducational treatment in diabetes care for women living with type 2 diabetes. In addition to this research, the application describes a training plan that will enhance the applicant's knowledge and skills in (1) assessment and treatment of depression and other dysphoric mood states (2) cognitive behavioral psychoeducational interventions in women with diabetes and (3) clinical trials methodology. Public Information: The SWEEP program, targeted at improving negative emotions such as depression, anxiety and anger, will be tested to see if it improves blood sugar control, self-management of diabetes, and quality of life in women with type 2 diabetes. If proven to be successful, it could become an important adjunct to current diabetes care.

描述（由申请人提供）：虽然男性糖尿病患者的心源性死亡率下降（13.1%），但女性糖尿病患者的年龄调整心源性死亡率增加了23%。在心脏病管理取得重大进展的时期，这种不良结局表明需要考虑针对其他风险因素进行治疗。抑郁症是心血管疾病的独立危险因素约25%的糖尿病患者患有抑郁症，女性糖尿病患者的抑郁症发病率是男性糖尿病患者的两倍。与男性糖尿病患者相比，女性糖尿病患者表现出更差的糖尿病自我护理，血糖控制和更差的生活质量，抑郁症会加剧这些结果。焦虑和愤怒通常伴随抑郁症状，似乎对不良医疗结果产生类似的风险，并且女性糖尿病患者比男性糖尿病患者更常见。大多数糖尿病教育计划可能会简要地解决烦躁症状;然而，他们的主要重点不是这些症状的评估和管理。妇女情绪研究和心理教育方案评价将测试为期八周的心理教育干预的有效性和可行性，涉及：（1）烦躁症状（抑郁症状、焦虑和愤怒），（2）血糖控制（HbA 1c），（3）健康相关生活质量（4）糖尿病自我管理（自我护理行为和自我效能）。50名正在接受糖尿病常规医疗护理（UMC）并有显著抑郁症状的2型糖尿病女性患者将随机接受认知行为心理教育干预（n=25）或不接受额外治疗（n=25）。将使用混合模型方差分析来检验研究假设，即接受UMC加心理教育干预的组将比单独接受UMC的组具有显著更好的结果。研究结果应证明的可行性和健康相关的好处，心理教育治疗糖尿病护理的妇女生活与2型糖尿病。除了这项研究之外，该申请还描述了一项培训计划，该计划将提高申请人在以下方面的知识和技能：（1）抑郁症和其他烦躁情绪状态的评估和治疗（2）糖尿病女性的认知行为心理教育干预和（3）临床试验方法。公共信息：SWEEP计划旨在改善抑郁、焦虑和愤怒等负面情绪，将进行测试，以确定它是否能改善2型糖尿病女性的血糖控制、糖尿病自我管理和生活质量。如果被证明是成功的，它可能成为目前糖尿病护理的重要辅助手段。