A Psychoeducational Intervention for Women with Diabetes

虽然男性糖尿病患者的心源性死亡率下降了（13.1%），但年龄增加了23%， 女性糖尿病患者的校正心脏病死亡率这种糟糕的结果，发生在一个重要的时间， 心脏病管理的进步，表明需要考虑将治疗方向指向其他疾病， 危险因素抑郁症是心血管疾病的独立危险因素 糖尿病患者有抑郁症，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。 糖尿病女性糖尿病患者的糖尿病自我护理、血糖控制和生活质量较差 比糖尿病患者更严重，抑郁症会加剧这种结果。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， 女性糖尿病患者比男性糖尿病患者更常见。大多数糖尿病教育项目可能会短暂地 解决焦虑症状;然而，他们的主要重点不是评估和管理 这些症状。女性情绪研究与心理教育评估（SWEEP） 计划将测试八周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）健康- 相关的生活质量（功能状态、生活满意度和糖尿病相关的痛苦），和（4）糖尿病自我- 3个月和6个月随访时的管理（自我护理行为和自我效能）。50个女人 2型糖尿病患者正在接受糖尿病常规医疗护理（UMC），并患有严重抑郁症 症状，将随机接受认知行为心理教育干预， 分组形式（n = 25）或无额外治疗（n = 25）。将使用混合模型方差分析， 测试研究假设，接受UMC加心理教育干预的小组将有 结果明显优于单独接受UMC的组。调查结果应证明 糖尿病妇女护理中心理教育治疗的可行性和健康相关益处 2型糖尿病除了这项研究，应用程序还描述了一个培训计划，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的评估和治疗 陈述（2）糖尿病妇女的认知行为心理教育干预和（3）临床试验 方法论 公共信息：SWEEP计划旨在改善抑郁等负面情绪， 焦虑和愤怒，将进行测试，看看它是否能改善血糖控制，糖尿病的自我管理， 2型糖尿病患者的生活质量如果被证明是成功的，它可能成为一个重要的辅助工具， 到目前的糖尿病护理。

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 effectivenessand 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 womenwith 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.