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(申请人提供)：虽然男性糖尿病患者的心脏死亡率下降了(13.1%)，但女性糖尿病患者的年龄调整后心脏死亡率增加了23%。这一糟糕的结果发生在心脏病管理取得重大进展的时候，表明有必要考虑针对其他危险因素进行治疗。抑郁症是心血管疾病的独立危险因素约有25%的糖尿病患者患有抑郁症，女性糖尿病患者的抑郁率是男性糖尿病患者的两倍。与男性糖尿病患者相比，患有糖尿病的女性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，抑郁会加剧这些结果。焦虑和愤怒通常伴随着抑郁症状，似乎对糟糕的医疗结果施加了类似的风险，而且糖尿病女性比糖尿病男性更容易发生。大多数糖尿病教育项目可能会简单地解决烦躁不安的症状；然而，他们的主要重点并不是这些症状的评估和管理。女性情绪研究和心理教育评估(SCEEP)计划将在3个月和6个月的随访中测试为期8周的心理教育干预的有效性和可行性：(1)烦躁症状(抑郁症状、焦虑和愤怒)，(2)血糖控制(HbA1c)，(3)与健康相关的生活质量(功能状况、生活满意度和与糖尿病相关的痛苦)，(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)并有明显抑郁症状的2型糖尿病女性将被随机分成两组，一组接受认知行为心理教育干预(n=25)，另一组不接受额外治疗(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的组有显著更好的结果。这些发现应该证明心理教育治疗在糖尿病护理中对患有2型糖尿病的妇女的可行性和与健康相关的好处。除了这项研究之外，该申请还描述了一项培训计划，该计划将增强申请者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)糖尿病妇女的认知行为心理教育干预；以及(3)临床试验方法学。公共信息：这项旨在改善抑郁、焦虑和愤怒等负面情绪的SWEEP计划将进行测试，看看它是否能改善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治疗的重要辅助手段。