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Root AL, Crossley NP, Heck JL, McCage S, Proulx J, Jones EJ. Effects of Mindfulness-Based Interventions on Cardiometabolic-Related Adverse Pregnancy Outcomes: A Systematic Review. J Cardiovasc Nurs 2024; 39:335-346. [PMID: 37878581 DOI: 10.1097/jcn.0000000000001054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
BACKGROUND Growing evidence suggests maternal stress contributes to the development of adverse pregnancy outcomes that are associated with cardiovascular and cardiometabolic risk in birthing persons. Mindfulness-based interventions may positively affect psychological stress in pregnancy and, in turn, reduce stress. However, few study authors have examined the effects of mindfulness-based interventions on adverse pregnancy outcomes that heighten cardiovascular risk. OBJECTIVE The aim of this study was to appraise available literature examining the effects of mindfulness-based interventions delivered during pregnancy on adverse pregnancy outcomes associated with future cardiovascular and cardiometabolic disease risk. METHODS In this systematic review, multiple electronic databases were searched using major keywords, including "mindfulness-based intervention," "pregnancy," "preterm delivery," "gestational diabetes," "small for gestational age," "preeclampsia," and "hypertension in pregnancy" during February 2023. RESULTS Six studies using mindfulness-based interventions during pregnancy were included. The review indicated that these interventions were largely effective at reducing prenatal stress; however, the overall effects of interventions were mixed concerning their impact on pregnancy complications. Study authors examining the effects on gestational diabetes-related outcomes reported significant improvements in blood glucose levels, hemoglobin A 1c , and oral glucose tolerance. Outcomes were mixed or inconclusive related to the effects of interventions on the incidence of preterm birth, birth of a small-for-gestational-age newborn, and preeclampsia. CONCLUSIONS Mitigating cardiovascular and cardiometabolic risk-associated adverse pregnancy outcomes through mindfulness-based approaches may represent an emerging field of study. The few studies and limited, mixed findings synthesized in this review indicate that high-validity studies are warranted to examine the effects of mindfulness-based interventions on pregnancy complications that contribute to cardiovascular-related maternal morbidity and suboptimal life course health for diverse birthing persons.
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Deo PS, Barber TM, Gotts C, Villarreal M, Randeva H, Brown S, Bath J, O'Hare P, Chaggar S, Hanson P. A pilot study to assess the feasibility and uptake of MindDEC, a mindfulness-based self-management course for type 2 diabetes. Complement Ther Med 2024; 83:103059. [PMID: 38821377 DOI: 10.1016/j.ctim.2024.103059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/07/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVE The study aimed to investigate the feasibility of a remote mindfulness based self-management intervention for individuals with type 2 diabetes. It is important to further our understanding of how to improve self-management to improve health outcomes and low levels of uptake to self-management courses. METHOD 29 participants with type 2 diabetes were recruited from the University Hospital Coventry and Warwickshire NHS trust. Three groups of participants engaged with a remote mindfulness based self-management intervention, which were delivered sequentially. After each intervention was complete, patient feedback was retrieved and implemented into the following intervention. The quantitative analysis comprised of descriptive statistics, independent sample t-test, paired sample t-test and multiple regression analysis. A qualitative analysis was also conducted through reflexive thematic analysis (RTA) to understand participant's perspective on the intervention. RESULTS There was a total of 17 who attended the course (59 %) and a total drop out of 12 participants over the three courses (41 %). The qualitative findings reported three main themes: (1) Eating to manage my emotions rather than my diabetes (2) Implementing mindfulness has helped me manage my emotions (3) Medication rather than self-management behaviours control my diabetes. The focus group feedback included participants' appreciation of the community aspect of the intervention and their perception that the current course was more interactive compared to previous interventions. In addition, participants highlighted the importance of offering the course at an earlier stage of diagnosis to provide further support at the beginning of their diabetes journey. No significant findings were reported for the independent sample t-test, paired sample t-test and multiple regression analysis. CONCLUSION The qualitative findings suggested that the course was beneficial, especially in demonstrating how mindfulness could aid self-management for individuals living with type 2 diabetes. Further funding and trials are warranted to improve the quality of technology used and to assess impact on diabetes control and mental health.
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Affiliation(s)
- P S Deo
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; University of the West of England, Bristol BS16 1QY, UK
| | - T M Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - C Gotts
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - M Villarreal
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - H Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK; Aston University, Birmingham B4 7ET, UK
| | - S Brown
- University of the West of England, Bristol BS16 1QY, UK
| | - J Bath
- University of the West of England, Bristol BS16 1QY, UK
| | - P O'Hare
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - S Chaggar
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - P Hanson
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
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Leung LYL, Tam HL, Leung ISH, Chan ASW, Yin Y, Zhang X, Mao A, Cheong PL. Perceived Well-Being among Adults with Diabetes and Hypertension: A National Study. Healthcare (Basel) 2024; 12:844. [PMID: 38667606 PMCID: PMC11049827 DOI: 10.3390/healthcare12080844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/27/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Perceived health and distresses are associated with the practice of lifestyle modifications, which increases the risk of diabetes and hypertension-related complications. This study aimed to define the characteristics and distribution of perceived health and distresses across the states between people with diabetes and hypertension. Data were derived from a national survey of US adults aged ≥18 years who were interviewed via phone call. Perceived health and distresses were assessed through corresponding questions. An amount of 333,316 respondents (43,911 with diabetes and 130,960 with hypertension) were included in the analysis; 61.8% of people with diabetes and 74.5% of people with hypertension reported having good or better health, while residents in the Southwest region perceived poor health statuses and more distresses. Education level (diabetes: odds ratio [OR] = 0.47-0.79, hypertension: OR = 0.42-0.76), employment status level (diabetes: OR = 1.40-2.22, hypertension: OR = 1.56-2.49), and household income (diabetes: OR = 0.22-0.65, hypertension: OR = 0.15-0.78) were significant factors associated with poorly perceived health among people with diabetes and hypertension, and the use of technology and strategies for policymakers are suggested to improve the perceived health status in this regard.
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Affiliation(s)
- Leona Yuen-Ling Leung
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong SAR, China;
| | - Hon-Lon Tam
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Isaac Sze-Him Leung
- Department of Statistics, The Chinese University of Hong Kong, Hong Kong SAR, China;
| | - Alex Siu-Wing Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University of Hong Kong, Hong Kong SAR, China;
| | - Yueheng Yin
- School of Nursing, Nanjing Medical University, Nanjing 210029, China;
| | - Xiubin Zhang
- School of Public Health, National Heart and Lung Institute, Imperial College London, London W12 7RQ, UK;
| | - Aimei Mao
- Department of Education, Kiang Wu Nursing College of Macau, Macau SAR, China; (A.M.); (P.-L.C.)
| | - Pak-Leng Cheong
- Department of Education, Kiang Wu Nursing College of Macau, Macau SAR, China; (A.M.); (P.-L.C.)
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Balsom AA, Klest B, Sander B, Gordon JL. Acceptance and commitment therapy adapted for women with infertility: a pilot study of the Infertility ACTion program. Reprod Health 2024; 21:43. [PMID: 38576027 PMCID: PMC10996141 DOI: 10.1186/s12978-024-01766-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 03/02/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Approximately one in six couples are currently infertile, defined as unable to achieve pregnancy despite 12 or more months of active attempts to conceive. Experiencing infertility has been disproportionately associated with an array of psychological difficulties, particularly in women. However, currently available psychological interventions have had minimal benefits for distress, anxiety, or depression related to infertility. METHODS A one-arm pilot study was conducted to test the acceptability of a newly created acceptance and commitment therapy-based self-guided program-Infertility ACTion. Twenty women, located in Canada, completed the program and completed measures assessing expectancy of improvement, treatment credibility, participant satisfaction, treatment completion and retention, psychological flexibility, fertility quality of life, depression, and anxiety. Participants were also asked to provide feedback on how the researchers could improve the intervention. Paired sample t-tests were conducted to compare pre- and post-intervention outcomes. RESULTS Sixteen out of 20 participants completed the entire intervention. Reported treatment expectancy, credibility and satisfaction were favorable. Eighty-one percent of participants reported that they would recommend the program to a friend and 88% thought the program was worth their time. Medium increases in psychological flexibility and fertility quality of life were observed. Improvements in anxious and depressive symptoms were in the small to medium range but were not significant. Participants had several recommendations for program improvement. CONCLUSIONS This acceptance and commitment therapy-based self-guided program proved to be an acceptable treatment for infertility-related distress. Participant feedback will be used to adjust the current intervention in preparation for a more rigorous randomized-controlled trial testing this program.
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Affiliation(s)
- Ashley A Balsom
- Department of Psychology, University of Regina, Regina, SK, Canada
| | - Bridget Klest
- Department of Psychology, University of Regina, Regina, SK, Canada
| | - Bethany Sander
- Department of Psychology, University of Regina, Regina, SK, Canada
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Tschirhart H, Landeen J, Yost J, Nerenberg KA, Sherifali D. Perceptions of diabetes distress during pregnancy in women with type 1 and type 2 diabetes: a qualitative interpretive description study. BMC Pregnancy Childbirth 2024; 24:232. [PMID: 38570742 PMCID: PMC10988880 DOI: 10.1186/s12884-024-06370-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/25/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Diabetes distress is commonly seen in adults with pre-existing diabetes and is associated with worsened glycemic management and self-management practices. While a majority of women report increased stress during pregnancy, it is unknown how women with type 1 or type 2 diabetes experience diabetes distress during this unique and transitional time. PURPOSE This study aimed to understand the experiences and perceptions of diabetes distress in women with pre-existing diabetes during pregnancy. METHODS A qualitative study using an interpretive description approach was conducted. In-depth, one to one interviewing was used to capture rich descriptions of the pregnancy experience. Nested, stratified, and theoretical sampling was used to recruit 18 participants with type 1 and type 2 diabetes from the quantitative strand of this mixed methods study. Constant comparative analysis was used to inductively analyze the data and develop themes. FINDINGS Four themes, each with several subthemes, emerged under the main finding of "Diabetes Distress": 1) Worry for Baby's Health - "What's this going to do to the baby?"' 2) Feeling Overwhelmed with Diabetes Management-"It just seemed unattainable"; 3) Living with Diabetes - "There's no way out" and 4) Cycle of Diabetes Distress. CONCLUSIONS The findings from this study identify the sources and experiences of diabetes distress during pregnancy in women with pre-existing diabetes. Diabetes distress often presents as cyclical and multifaceted during pregnancy, with elements of fear for the unborn baby, difficulties with diabetes management, and having negative lived experiences of diabetes. Further work is needed to develop appropriate screening tools for pregnancy and interventions to mitigate diabetes distress. Diabetes educators are well-positioned provide emotional support and person-centred self-management education to individuals with diabetes.
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Affiliation(s)
- Holly Tschirhart
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
| | - Janet Landeen
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jennifer Yost
- M. Louise Fitzpatrick College of Nursing, Villanova University, Pennsylvania, USA
| | - Kara A Nerenberg
- Departments of Medicine, Obstetrics & Gynecology, and Community Health Sciences, University of Calgary, Calgary, Canada
| | - Diana Sherifali
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
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Rodrigues DAC, Marcadenti A, Machado RHV, Bersch-Ferreira AC, Gherardi-Donato ECS, Quinhoneiro D, Almeida JCD, Souza VS, Souza SRD, Busnello FM, Ferreira DC, Bressan J, Figueiredo MOAD, Reis NM, Consoli MLD, Ferreira LG. Mindful eating questionnaire: Validation and reliability in Brazilian adults with type 2 diabetes mellitus. Appetite 2024; 195:107228. [PMID: 38278444 DOI: 10.1016/j.appet.2024.107228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 01/09/2024] [Accepted: 01/17/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVE The objective was to evaluate the psychometric properties of the Mindful Eating Questionnaire (MEQ) in Brazilian subjects with type 2 diabetes mellitus (T2DM) and validate a Brazilian version of the MEQ for adults with T2DM (MEQ-DM). METHODOLOGY Baseline data from the multicentre Nutritional Strategy for Glycaemic Control in Patients with Type 2 Diabetes Mellitus (NUGLIC) trial were used. Construct validity was assessed using exploratory factor analysis (EFA). The root mean square error of approximation (RMSEA), comparative fit index (CFI) and Tucker‒Lewis index (TLI) fit indices indicated the adequacy of the model. The reliability of the questionnaire was evaluated considering the different factor loadings. Criterion validity was tested by correlating the MEQ-DM with sociodemographic variables, body mass index (BMI) and physical activity levels. RESULTS A total of 370 participants were included, who were mostly female (60.8 %) and had a median age of 61 (54-67) years. The EFA results supported the two-factor structure of the 25-item MEQ-DM: disinhibition and awareness. The results of the fit indices (RMSEA = 0.04; CFI = 0.95 and TLI = 0.94) and composite reliability (disinhibition = 0.84 and awareness = 0.81) were consistent. The criterion validity analysis indicated a significant association between MEQ-DM scores and age, sex, civil status, education level, BMI and physical activity (p < 0.05). CONCLUSION When explored with Brazilian adults with T2DM, the MEQ-DM presented a factorial model with two dimensions: disinhibition and awareness. This model must be confirmed in future studies with Brazilians with T2DM.
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Affiliation(s)
| | - Aline Marcadenti
- Hcor Research Institute, Hcor, São Paulo, Brazil; Graduate Program in Health Sciences (Cardiology), Instituto de Cardiologia/Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, Brazil.
| | | | - Angela C Bersch-Ferreira
- Hcor Teaching Institute, Hcor, São Paulo, Brazil; PROADI-SUS Office, Real e Benemérita Associação Portuguesa de Beneficência, São Paulo, Brazil.
| | | | - Driele Quinhoneiro
- Ribeirão Preto College of Nursing, Universidade de São Paulo, Ribeirão Preto, Brazil.
| | - Jussara Carnevale de Almeida
- Department of Nutrition, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | | | | | - Fernanda Michielin Busnello
- Graduate Program in Nutrition Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
| | - Daniela Corrêa Ferreira
- Department of Nutrition, Universidade Federal de Juiz de Fora, Governador Valadares, Minas Gerais, Brazil.
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil.
| | | | - Nídia Marinho Reis
- Department of Nutrition, Universidade Federal de Lavras - Lavras, Minas Gerais, Brazil.
| | | | - Lívia Garcia Ferreira
- Department of Nutrition, Universidade Federal de Lavras - Lavras, Minas Gerais, Brazil.
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Michot AP, Evans TL, Vasudevan MM, Bradford A, Hundt NE, Christie IC, True G, Kunik ME. The case for screening for diabetes distress, depression, and anxiety. J Health Psychol 2024:13591053241241841. [PMID: 38557312 DOI: 10.1177/13591053241241841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Our goal was to determine the prevalence of anxiety and depression in a sample of U.S. military veterans with type 2 diabetes and elevated diabetes distress (DD). Cross-sectional analyses were conducted. The association between DD and anxiety and depression was assessed with logistic regression. Almost 80% of persons with elevated DD had clinically significant anxiety or depression symptoms. The odds of depression and anxiety increased with DD severity. Given the large overlap of depression and anxiety with elevated DD, we recommend providers screen for all three conditions and, if positive, connect to resources for diabetes self-management and/or clinical treatment.
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Affiliation(s)
| | - Tracy L Evans
- Michael E. DeBakey Veterans Affairs Medical Center, USA
- Baylor College of Medicine, USA
- UTHealth School of Public Health, USA
| | - Madhuri M Vasudevan
- Michael E. DeBakey Veterans Affairs Medical Center, USA
- Baylor College of Medicine, USA
| | - Andrea Bradford
- Michael E. DeBakey Veterans Affairs Medical Center, USA
- Baylor College of Medicine, USA
| | - Natalie E Hundt
- Michael E. DeBakey Veterans Affairs Medical Center, USA
- Baylor College of Medicine, USA
| | - Israel C Christie
- Michael E. DeBakey Veterans Affairs Medical Center, USA
- Baylor College of Medicine, USA
| | - Gala True
- Southeast Louisiana Veterans Health Care System, USA
- Louisiana State University Health Sciences Center, USA
| | - Mark E Kunik
- Michael E. DeBakey Veterans Affairs Medical Center, USA
- Baylor College of Medicine, USA
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Jiang S, Pan X, Li H, Su Y. Global trends and developments in mindfulness interventions for diabetes: a bibliometric study. Diabetol Metab Syndr 2024; 16:43. [PMID: 38360701 PMCID: PMC10870632 DOI: 10.1186/s13098-024-01288-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/08/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Diabetes is a metabolic disorder posing a global threat to health. Many scholars are dedicated to developing non-pharmacological therapies, and mindfulness intervention is among the potentially effective approaches. Due to the rapid increase in relevant research in recent years, along with the diverse focus and interventions used in studies, it has become challenging for practitioners to quickly comprehend the key features of this field and the directions worth paying attention to. Bibliometric analysis, in response, can help scholars understand this field and identify points of interest. METHODS Publications related to mindfulness intervention in diabetes from the establishment of the Web of Science Core Collection (WOSCC) to September 2023 were searched. We employed four bibliometric techniques: General Analysis of Publications, Collaborative Network Analysis, Co-citation Analysis, and Keyword Analysis. The CiteSpace 6.1.R was used to analyze the literature with the strongest citation bursts, while VOSviewer 1.6.13 was used to provide visualizations of publicly available data by analyzing co-citations or co-authorship affiliations. RESULTS We found a total of 387 articles. The results indicate that research on this topic has been steadily increasing over time. The United States is the top producer of relevant publications, with Tilburg University being the institution that publishes the most articles. The journal "Mindfulness" has the highest publication count. In the collaborative network analysis, the United States emerged as the main hub for global cooperation in this research field, contributing 182 articles with a total of 5872 citations. The journal "Diabetes Care" was frequently cited and played a central role. The keyword analysis revealed that researchers have shown a strong interest in how mindfulness interventions affect the mental health of diabetic individuals. Additionally, there is a focus on studying elderly diabetic groups and exploring how mindfulness interventions impact metabolic diseases. These areas are currently the main research priorities. CONCLUSION Our findings demonstrate the current trend and hotspots in mindfulness intervention and offer some directions for future research.
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Affiliation(s)
- Sijia Jiang
- College of Physical Education, Chongqing University of Posts and Telecommunications, Chongqing, China
| | - Xiaoli Pan
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing, China
| | - Hansen Li
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing, China
| | - Yuqin Su
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing, China.
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Rees K, Takeda A, Court R, Kudrna L, Hartley L, Ernst E. Meditation for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev 2024; 2:CD013358. [PMID: 38358047 PMCID: PMC10867897 DOI: 10.1002/14651858.cd013358.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
BACKGROUND Interventions incorporating meditation to address stress, anxiety, and depression, and improve self-management, are becoming popular for many health conditions. Stress is a risk factor for cardiovascular disease (CVD) and clusters with other modifiable behavioural risk factors, such as smoking. Meditation may therefore be a useful CVD prevention strategy. OBJECTIVES To determine the effectiveness of meditation, primarily mindfulness-based interventions (MBIs) and transcendental meditation (TM), for the primary and secondary prevention of CVD. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, three other databases, and two trials registers on 14 November 2021, together with reference checking, citation searching, and contact with study authors to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) of 12 weeks or more in adults at high risk of CVD and those with established CVD. We explored four comparisons: MBIs versus active comparators (alternative interventions); MBIs versus non-active comparators (no intervention, wait list, usual care); TM versus active comparators; TM versus non-active comparators. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were CVD clinical events (e.g. cardiovascular mortality), blood pressure, measures of psychological distress and well-being, and adverse events. Secondary outcomes included other CVD risk factors (e.g. blood lipid levels), quality of life, and coping abilities. We used GRADE to assess the certainty of evidence. MAIN RESULTS We included 81 RCTs (6971 participants), with most studies at unclear risk of bias. MBIs versus active comparators (29 RCTs, 2883 participants) Systolic (SBP) and diastolic (DBP) blood pressure were reported in six trials (388 participants) where heterogeneity was considerable (SBP: MD -6.08 mmHg, 95% CI -12.79 to 0.63, I2 = 88%; DBP: MD -5.18 mmHg, 95% CI -10.65 to 0.29, I2 = 91%; both outcomes based on low-certainty evidence). There was little or no effect of MBIs on anxiety (SMD -0.06 units, 95% CI -0.25 to 0.13; I2 = 0%; 9 trials, 438 participants; moderate-certainty evidence), or depression (SMD 0.08 units, 95% CI -0.08 to 0.24; I2 = 0%; 11 trials, 595 participants; moderate-certainty evidence). Perceived stress was reduced with MBIs (SMD -0.24 units, 95% CI -0.45 to -0.03; I2 = 0%; P = 0.03; 6 trials, 357 participants; moderate-certainty evidence). There was little to no effect on well-being (SMD -0.18 units, 95% CI -0.67 to 0.32; 1 trial, 63 participants; low-certainty evidence). There was little to no effect on smoking cessation (RR 1.45, 95% CI 0.78 to 2.68; I2 = 79%; 6 trials, 1087 participants; low-certainty evidence). None of the trials reported CVD clinical events or adverse events. MBIs versus non-active comparators (38 RCTs, 2905 participants) Clinical events were reported in one trial (110 participants), providing very low-certainty evidence (RR 0.94, 95% CI 0.37 to 2.42). SBP and DBP were reduced in nine trials (379 participants) but heterogeneity was substantial (SBP: MD -6.62 mmHg, 95% CI -13.15 to -0.1, I2 = 87%; DBP: MD -3.35 mmHg, 95% CI -5.86 to -0.85, I2 = 61%; both outcomes based on low-certainty evidence). There was low-certainty evidence of reductions in anxiety (SMD -0.78 units, 95% CI -1.09 to -0.41; I2 = 61%; 9 trials, 533 participants; low-certainty evidence), depression (SMD -0.66 units, 95% CI -0.91 to -0.41; I2 = 67%; 15 trials, 912 participants; low-certainty evidence) and perceived stress (SMD -0.59 units, 95% CI -0.89 to -0.29; I2 = 70%; 11 trials, 708 participants; low-certainty evidence) but heterogeneity was substantial. Well-being increased (SMD 0.5 units, 95% CI 0.09 to 0.91; I2 = 47%; 2 trials, 198 participants; moderate-certainty evidence). There was little to no effect on smoking cessation (RR 1.36, 95% CI 0.86 to 2.13; I2 = 0%; 2 trials, 453 participants; low-certainty evidence). One small study (18 participants) reported two adverse events in the MBI group, which were not regarded as serious by the study investigators (RR 5.0, 95% CI 0.27 to 91.52; low-certainty evidence). No subgroup effects were seen for SBP, DBP, anxiety, depression, or perceived stress by primary and secondary prevention. TM versus active comparators (8 RCTs, 830 participants) Clinical events were reported in one trial (201 participants) based on low-certainty evidence (RR 0.91, 95% CI 0.56 to 1.49). SBP was reduced (MD -2.33 mmHg, 95% CI -3.99 to -0.68; I2 = 2%; 8 trials, 774 participants; moderate-certainty evidence), with an uncertain effect on DBP (MD -1.15 mmHg, 95% CI -2.85 to 0.55; I2 = 53%; low-certainty evidence). There was little or no effect on anxiety (SMD 0.06 units, 95% CI -0.22 to 0.33; I2 = 0%; 3 trials, 200 participants; low-certainty evidence), depression (SMD -0.12 units, 95% CI -0.31 to 0.07; I2 = 0%; 5 trials, 421 participants; moderate-certainty evidence), or perceived stress (SMD 0.04 units, 95% CI -0.49 to 0.57; I2 = 70%; 3 trials, 194 participants; very low-certainty evidence). None of the trials reported adverse events or smoking rates. No subgroup effects were seen for SBP or DBP by primary and secondary prevention. TM versus non-active comparators (2 RCTs, 186 participants) Two trials (139 participants) reported blood pressure, where reductions were seen in SBP (MD -6.34 mmHg, 95% CI -9.86 to -2.81; I2 = 0%; low-certainty evidence) and DBP (MD -5.13 mmHg, 95% CI -9.07 to -1.19; I2 = 18%; very low-certainty evidence). One trial (112 participants) reported anxiety and depression and found reductions in both (anxiety SMD -0.71 units, 95% CI -1.09 to -0.32; depression SMD -0.48 units, 95% CI -0.86 to -0.11; low-certainty evidence). None of the trials reported CVD clinical events, adverse events, or smoking rates. AUTHORS' CONCLUSIONS Despite the large number of studies included in the review, heterogeneity was substantial for many of the outcomes, which reduced the certainty of our findings. We attempted to address this by presenting four main comparisons of MBIs or TM versus active or inactive comparators, and by subgroup analyses according to primary or secondary prevention, where there were sufficient studies. The majority of studies were small and there was unclear risk of bias for most domains. Overall, we found very little information on the effects of meditation on CVD clinical endpoints, and limited information on blood pressure and psychological outcomes, for people at risk of or with established CVD. This is a very active area of research as shown by the large number of ongoing studies, with some having been completed at the time of writing this review. The status of all ongoing studies will be formally assessed and incorporated in further updates.
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Affiliation(s)
- Karen Rees
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Rachel Court
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Laura Kudrna
- Institute of Applied Health, University of Birmingham, Birmingham, UK
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Lehmann G, Ziebell P, Schmitt A, Kulzer B, Hermanns N, Ehrmann D. Explaining improvement in diabetes distress: a longitudinal analysis of the predictive relevance of resilience and acceptance in people with type 1 diabetes. Acta Diabetol 2024; 61:151-159. [PMID: 37747554 PMCID: PMC10866794 DOI: 10.1007/s00592-023-02180-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/03/2023] [Indexed: 09/26/2023]
Abstract
AIMS To analyze if midterm improvement in diabetes distress can be explained by resilience, diabetes acceptance, and patient characteristics. METHODS N = 179 adults with type 1 diabetes were enrolled during their stay at a tertiary diabetes center (monocentric enrolment) and followed up over three months in a prospective, observational study ('DIA-LINK1'). Improvement in diabetes distress was assessed as reduction in the Problem Areas in Diabetes Scale score from baseline to follow-up. Resilience (Resilience Scale-13), acceptance (Diabetes Acceptance Scale), and patient characteristics were analyzed as predictors of improvement in diabetes distress using hierarchical multiple regression. RESULTS Greater reductions in diabetes distress were significantly explained by lower diabetes acceptance at baseline (β = -0.34, p < 0.01), while resilience, diabetes complications, and other person-related variables were not significantly related to changes in diabetes distress (all p > 0.05). When change in diabetes acceptance from baseline to follow-up was added to the model, improved diabetes distress was explained by increasing diabetes acceptance (β = 0.41, p < 0.01) and a shorter duration of diabetes (β = -0.18, p = 0.03), while baseline diabetes acceptance was no longer significantly associated (β = -0.14, p > 0.05). CONCLUSIONS Diabetes acceptance is inversely related to diabetes distress, and increasing acceptance explained greater improvement in diabetes distress. These findings suggest that increasing diabetes acceptance may facilitate the reduction of diabetes distress. Treatment approaches targeting acceptance might be useful for the mental healthcare of people with type 1 diabetes and clinically elevated diabetes distress.
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Affiliation(s)
- Gina Lehmann
- Institute of Psychology, Julius-Maximilians-University of Würzburg, Würzburg, Germany
| | - Philipp Ziebell
- Institute of Psychology, Julius-Maximilians-University of Würzburg, Würzburg, Germany
| | - Andreas Schmitt
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Johann-Hammer-Str. 24, 97980, Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Bernhard Kulzer
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Johann-Hammer-Str. 24, 97980, Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Department for Psychology, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Norbert Hermanns
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Johann-Hammer-Str. 24, 97980, Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Department for Psychology, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Dominic Ehrmann
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Johann-Hammer-Str. 24, 97980, Bad Mergentheim, Germany.
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.
- Department for Psychology, Otto-Friedrich-University of Bamberg, Bamberg, Germany.
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11
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ElSayed NA, Aleppo G, Bannuru RR, Beverly EA, Bruemmer D, Collins BS, Darville A, Ekhlaspour L, Hassanein M, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S77-S110. [PMID: 38078584 PMCID: PMC10725816 DOI: 10.2337/dc24-s005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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12
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Kunik ME, Evans TL, Christie IC, True G, Bradford A, Vasudevan MM, Hundt NE. The impact of veteran support and resources for diabetes (iNSPiRED) on diabetes distress: Results from a randomized, parallel-group trial. Gen Hosp Psychiatry 2023; 85:55-62. [PMID: 37806018 DOI: 10.1016/j.genhosppsych.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE The primary objective of this research was to assess the impact of a novel, peer-directed intervention (iNSPiRED) on diabetes distress (DD) among veterans with type 2 diabetes and DD. Secondary objectives were to assess iNSPiRED's impact on anxiety, depression, and diabetes self-management behaviors. METHOD A single-blinded, randomized, parallel-group trial was conducted. Participants (n = 218) were recruited through a Veterans Affairs medical center and community agencies in a major metropolitan area from September 2019 through January 2022. Certified mental health peer specialists delivered iNSPiRED, a three-month goal-setting and resource navigation intervention. Outcomes were assessed at baseline, postintervention, and month six. Multilevel random-intercept linear regression models with treatment x time interaction terms were used to assess treatment effects. RESULTS Frequency of following a healthy eating plan was higher for iNSPiRED vs usual care at month three relative to baseline (B = 0.58; p = 0.03) after adjusting for race and socioeconomic status. No other treatment effects differed significantly from zero (ps ≥ 0.05). CONCLUSION Peer-directed interventions have the potential to deliver low-cost, highly scalable care. However, based on the largely negative findings of the current study, it is likely that more intense, multimodal interventions are needed to address DD.
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Affiliation(s)
- Mark E Kunik
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, M ichael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA.
| | - Tracy L Evans
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, M ichael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; UTHealth School of Public Health, 1200 Pressler St, 77030 Houston, TX, USA.
| | - Israel C Christie
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, M ichael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
| | - Gala True
- South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA; Southeast Louisiana Veterans Health Care System, 2400 Canal St, New Orleans, LA 70119, USA; Louisiana State University Health Sciences Center, 433 Bolivar St, New Orleans, LA 70112, USA.
| | - Andrea Bradford
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, M ichael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
| | - Madhuri M Vasudevan
- Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA.
| | - Natalie E Hundt
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, M ichael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA.
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13
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Fawson S, Moon Z, Novogrudsky K, Moxham F, Forster K, Tribe I, Moss-Morris R, Johnson C, Hughes LD. Acceptance and commitment therapy processes and their association with distress in cancer: a systematic review and meta-analysis. Health Psychol Rev 2023:1-22. [PMID: 37746724 DOI: 10.1080/17437199.2023.2261518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/15/2023] [Indexed: 09/26/2023]
Abstract
Around 42% of individuals with cancer experience distress. Acceptance and commitment therapy (ACT) can reduce distress, but effects are small, and mechanisms unclear. This review aimed to identify associations between ACT processes and distress in cancer. Search terms included cancer, ACT processes, self-compassion, and distress. Six online databases and grey literature were searched until March 2022. Of 6555 papers screened, 108 studies were included with 17,195 participants. Five meta-analyses of 77 studies were conducted. Random effects meta-analyses of correlations revealed higher scores on flexible processes (acceptance, present moment awareness, self-compassion) were associated with lower distress (rpooled = -0.24, -0.39, -0.48, respectively); whilst higher scores on inflexible processes (experiential avoidance, cognitive fusion) were associated with higher distress (rpooled = 0.58, 0.57, respectively). Meta-analyses displayed moderate-to-high heterogeneity with most studies assessed as low risk of bias. Meta-regressions revealed no significant moderators (stage, time since diagnosis, gender and age). This review provides a theoretically aligned evidence base for associations between ACT processes and distress in cancer, supporting elements of ACT theory and providing targeted directions for intervention development. Due to limited evidence, future research should focus on self-as-context, values and committed action and conduct mediation analysis in controlled trials of ACT processes on distress in cancer.
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Affiliation(s)
- Sophie Fawson
- Psychology Department, King's College London, London, UK
- NIHR Maudsley Biomedical Research Centre, London, UK
| | - Zoe Moon
- Psychology Department, King's College London, London, UK
- School of Pharmacy, University College London, London, UK
| | | | - Faye Moxham
- Psychology Department, King's College London, London, UK
| | - Katie Forster
- Psychology Department, King's College London, London, UK
| | - Insun Tribe
- Psychology Department, King's College London, London, UK
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Hamasaki H. The Effects of Mindfulness on Glycemic Control in People with Diabetes: An Overview of Systematic Reviews and Meta-Analyses. MEDICINES (BASEL, SWITZERLAND) 2023; 10:53. [PMID: 37755243 PMCID: PMC10534311 DOI: 10.3390/medicines10090053] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/20/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023]
Abstract
Background: Previous research has demonstrated the effectiveness of mindfulness interventions in improving glycemic control. By enhancing attention control, emotion regulation, and self-awareness, mindfulness shows promise in managing the lifestyle factors associated with cardiovascular disease risk. However, the impact of mindfulness on glycemic control in people with diabetes remains unclear. This overview aims to summarize the current evidence of the impact of mindfulness interventions on glycemic control in people with diabetes and propose suggestions for future research. Methods: The author searched electronic databases (PubMed/MEDLINE, Embase, and Cochrane Library) to identify relevant systematic reviews and meta-analyses. The current evidence regarding the effects of mindfulness on glycemic control in people with diabetes was summarized. Results: This review evaluated a total of five systematic reviews and meta-analyses of randomized controlled trials (RCTs). Mindfulness interventions show potential for improving glycemic control as measured by hemoglobin A1c (HbA1c) levels, as well as reducing stress, depression, and anxiety in people with diabetes. Four out of five systematic reviews and meta-analyses reported a significant reduction in HbA1c levels by approximately 0.3%. However, the available studies lacked adequate description of key characteristics of study subjects, such as body mass index, medication, and disease conditions, which are essential for assessing the impact of mindfulness on glycemic control. Moreover, there was significant heterogeneity in the intervention methods employed across the included RCTs. Conclusions: Mindfulness interventions are effective in improving glycemic control in people with type 2 diabetes. However, the overall quality of the reviewed studies raises uncertainty regarding the effectiveness of mindfulness as a treatment for people with diabetes. Further research is necessary to elucidate the biological effects of mindfulness on physiological, neurological, and endocrinological functions in humans.
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15
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Persson DR, Zhukouskaya K, Wegener AMK, Jørgensen LK, Bardram JE, Bækgaard P. Exploring Patient Needs and Designing Concepts for Digitally Supported Health Solutions in Managing Type 2 Diabetes: Cocreation Study. JMIR Form Res 2023; 7:e49738. [PMID: 37624633 PMCID: PMC10492168 DOI: 10.2196/49738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Self-management of the progressive disease type 2 diabetes mellitus (T2DM) becomes part of the daily life of patients starting from the time of diagnosis. However, despite the availability of technical innovations, the uptake of digital solutions remains low. One reason that has been reported is that digital solutions often focus purely on clinical factors that may not align with the patient's perspective. OBJECTIVE The aim of this study was to develop digital solutions that address the needs of patients with T2DM, designed from the user's perspective. The goal was to address the patients' expressed real-world needs by having the users themselves choose the scope and format of the solutions. METHODS Using participatory methods, we conducted 3 cocreation workshops in collaboration with the Danish Diabetes Association, with 20 persons with T2DM and 11 stakeholders across workshops: user experience designers, researchers, and diabetes experts including a diabetes nurse. The overall structure of the 3 workshops was aligned with the 4 phases of the double diamond: initially discovering and mapping out key experienced issues, followed by a workshop on thematic mapping and definition of key concepts, and succeeded by an exploration and development of 2 prototypes. Subsequently, high-fidelity interactive prototypes were refined as part of the delivery phase, in which 7 formative usability tests were conducted. RESULTS The workshops mapped experiential topics over time from prediagnosis to the current state, resulting in a detailed exploration and understanding of 6 themes related to and based on the experiences of patients with T2DM: diabetes care, diabetes knowledge, glucose monitoring, diet, physical activity, and social aspects of diabetes. Two prototypes were developed by the participants to address some of their expressed needs over time related to the 6 themes: an activity-based continuous glucose monitoring app and a web-based guide to diabetes. Both prototypes emphasize periods of structured self-measurements of blood glucose to support evolving needs for self-exploration through distinct phases of learning, active use, and supporting use. Periods of low or intermittent use may thus not reflect a failure of design in a traditional sense but rather be a sign of evolving needs over time. CONCLUSIONS Our results indicate that the needs of patients with T2DM differ between individuals and change over time. As a result, the suggested digitally supported empowering health prototypes can be personalized to support self-exploration, individual preference in long-term management, and changing needs over time. Despite individuals experiencing different journeys with diabetes, users perceive the self-measurement of blood glucose as a universally useful tool to empower everyday decision-making.
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Affiliation(s)
- Dan Roland Persson
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Katiarina Zhukouskaya
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kgs. Lyngby, Denmark
| | | | | | - Jakob Eyvind Bardram
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Per Bækgaard
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kgs. Lyngby, Denmark
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16
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Robinson DJ, Hanson K, Jain AB, Kichler JC, Mehta G, Melamed OC, Vallis M, Bajaj HS, Barnes T, Gilbert J, Honshorst K, Houlden R, Kim J, Lewis J, MacDonald B, MacKay D, Mansell K, Rabi D, Sherifali D, Senior P. Diabetes and Mental Health. Can J Diabetes 2023; 47:308-344. [PMID: 37321702 DOI: 10.1016/j.jcjd.2023.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
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17
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ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Leon J, Lyons SK, Perry ML, Prahalad P, Pratley RE, Seley JJ, Stanton RC, Young-Hyman D, Gabbay RA, on behalf of the American Diabetes Association. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2023. Diabetes Care 2023; 46:S68-S96. [PMID: 36507648 PMCID: PMC9810478 DOI: 10.2337/dc23-s005] [Citation(s) in RCA: 112] [Impact Index Per Article: 112.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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18
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Du Y, Baumert J, Paprott R, Färber F, Nübel J, Hermanns N, Heidemann C, Scheidt-Nave C. Diabetes-related distress and associated factors among adults with diabetes in Germany: Results of the nationwide study "Disease knowledge and information needs - Diabetes mellitus 2017". J Psychosom Res 2023; 164:111073. [PMID: 36370499 DOI: 10.1016/j.jpsychores.2022.111073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 09/30/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Diabetes-related distress (DRD) can affect diabetes management adversely. In lack of population-based data, the frequency and determinants of DRD among adults with diabetes in Germany remain controversial. METHODS This study included 1367 adults with diabetes who participated in a nationwide health telephone survey conducted among German adults aged 18 years and older in 2017. The short form of the Problem Areas in Diabetes (PAID-5) scale was used to assess DRD. The associations of high DRD (PAID-5 sum score ≥ 8) with socio-demographics, diabetes-related risk factors, diabetes clinical characteristics as well as quality of self-care and chronic illness care assessed by patients were tested in multivariable logistic regression models. RESULTS The overall DRD prevalence was 15.1% (95% confidence intervals, 95% CIs, 12.5-18.0%) with no significant difference between men (14.7%, 95% CIs 11.2-19.1%) and women (15.4%, 11.9-19.8%). In multivariable analyses, DRD was significantly associated with younger age (odds ratio 0.96, 95% CIs 0.94-0.98, per year), immigration background (2.26, 1.16-4.42), current smoking (2.06, 1.14-3.70), insulin use (2.57, 1.45-4.56), and the presence of diabetes-specific complications (1.80, 1.10-2.94) or depressive symptoms (5.34, 3.24-8.81). Among those with depressive symptoms (18,4% of the study population), 38.3% also had DRD, which accounted for 7.0% (95% CIs 5.3-9.3%) of the study population. CONCLUSION DRD is a common health problem among adults with diabetes in Germany, and highly correlates with depressive symptoms, current smoking, immigration background, and insulin use. Addressing DRD needs to become an integrative part of ambulatory diabetes care.
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Affiliation(s)
- Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Jens Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Rebecca Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Francesca Färber
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Julia Nübel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Norbert Hermanns
- Research Institute of the Diabetes-Academy Bad Mergentheim (FIDAM), Bad Mergentheim, Baden-Württemberg, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Jenkinson E, Knoop I, Hudson JL, Moss‐Morris R, Hackett RA. The effectiveness of cognitive behavioural therapy and third-wave cognitive behavioural interventions on diabetes-related distress: A systematic review and meta-analysis. Diabet Med 2022; 39:e14948. [PMID: 36031793 PMCID: PMC9826380 DOI: 10.1111/dme.14948] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/25/2022] [Indexed: 01/11/2023]
Abstract
AIM Diabetes-related distress is common in diabetes and has implications for well-being. Cognitive behavioural therapy (CBT) and third-wave CBT hold promise as treatments for diabetes-related distress, although previous findings are inconclusive. We aimed to conduct a systematic review with meta-analysis to understand the efficacy of these interventions in treating diabetes-related distress, while also assessing the associative benefits of these interventions on depression, anxiety and glycaemic control. We also aimed to conduct a narrative synthesis, and subgroup analyses to identify intervention components most useful in treating diabetes-related distress. METHOD We searched seven electronic databases from inception to April 2021. Data extraction was independently performed by two reviewers. Methodological quality was assessed. The protocol was registered with the Prospective Register Of Systematic Reviews (PROSPERO): CRD42021240628. RESULTS We included 22 randomised controlled trials investigating the efficacy of CBT and third-wave CBT interventions on diabetes-related distress. CBT for diabetes-related distress significantly reduced distress (SMD = -0.278, p = 0.010) and depression (SMD = -0.604, p = 0.016). Third-wave CBT for diabetes-related distress significantly reduced anxiety (SMD = -0.451, p = 0.034). No significant effect of either intervention on glycated haemoglobin was observed. CBT interventions that included a digital component, were delivered by a psychological practitioner, and included behavioural activation bolstered the effects on diabetes-related distress. CONCLUSIONS CBT aiming to target diabetes-related distress is beneficial for distress and depression. Third-wave CBT for diabetes-related distress is beneficial for anxiety. More work is needed to optimise interventions to improve both mental and physical health outcomes in people with diabetes.
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Affiliation(s)
- Emma Jenkinson
- Health Psychology Section, Department of PsychologyInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Iris Knoop
- Health Psychology Section, Department of PsychologyInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Joanna L. Hudson
- Health Psychology Section, Department of PsychologyInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Rona Moss‐Morris
- Health Psychology Section, Department of PsychologyInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Ruth A. Hackett
- Health Psychology Section, Department of PsychologyInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
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Bendig E, Schmitt A, Wittenberg A, Kulzer B, Hermanns N, Moshagen M, Baumeister H. ACTonDiabetes: study protocol of a pragmatic randomised controlled trial for the evaluation of an acceptance and commitment-based internet-based and mobile-based intervention for adults living with type 1 or type 2 diabetes. BMJ Open 2022; 12:e059336. [PMID: 36109030 PMCID: PMC9478835 DOI: 10.1136/bmjopen-2021-059336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 07/27/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Living with diabetes can be burdensome and lead to serious emotional distress and impaired mental health. Acceptance and commitment therapy (ACT) can support people facing the challenges of living with diabetes. This trial aims to evaluate the effectiveness and cost-effectiveness of the internet-based and mobile-based intervention (IMI) 'ACTonDiabetes' in reducing diabetes distress against enhanced treatment as usual (TAU+) following specialised diabetes care. METHODS AND ANALYSIS A two-armed pragmatic randomised controlled trial will be conducted to evaluate the guided IMI ACTonDiabetes against TAU+. A total of 210 adults with type 1 or type 2 diabetes and elevated diabetes distress (Problem Areas in Diabetes ≥40) will be recruited at a specialised diabetes centre. The intervention begins 2-4 weeks after hospital discharge and takes about 7-10 weeks to complete. Assessments are performed at baseline and 5 and 10 weeks as well as 6 and 12 months after randomisation. The primary outcome is diabetes distress at a 10-week follow-up (T2). Secondary outcomes are depression (Patient Health Questionnaire-8), psychological well-being (WHO-5), quality of life (Assessment of Quality of Life-8 Dimension), Diabetes-related Self-Management Questionnaire, diabetes acceptance (Acceptance and Action Diabetes Questionnaire) and negative treatment effects (Inventory for the Assessment of Negative Effects of Psychotherapy). All statistical analyses will be performed based on the intention-to-treat principle with additional per-protocol analyses. Changes in outcomes will be evaluated using the general linear model. A health-economic evaluation will be conducted from a societal perspective. Reasons for drop-out will be systematically investigated. ETHICS AND DISSEMINATION This clinical trial has been approved by the State Medical Chamber of Baden-Württemberg (file no. B-F-2019-010). Trial results will be submitted for publication in a peer-reviewed journal and presented at conferences. TRIAL REGISTRATION NUMBER DRKS00016738.
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Affiliation(s)
- Eileen Bendig
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Andreas Schmitt
- Research Institute of the Diabetes Academy Mergentheim, Diabetes Center Mergentheim, Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
| | - Amelie Wittenberg
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Bernhard Kulzer
- Research Institute of the Diabetes Academy Mergentheim, Diabetes Center Mergentheim, Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
| | - Norbert Hermanns
- Research Institute of the Diabetes Academy Mergentheim, Diabetes Center Mergentheim, Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
| | - Morten Moshagen
- Department of Research Methods, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
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21
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Alho I, Lappalainen P, Muotka J, Lappalainen R. Acceptance and commitment therapy group intervention for adolescents with type 1 diabetes: A randomized controlled trial. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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22
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Zhang YY, Li W, Sheng Y. The Chinese version of the revised Diabetes Distress Scale for adults with type 2 diabetes: Translation and validation study. Int J Nurs Sci 2022; 9:243-251. [PMID: 35509697 PMCID: PMC9052264 DOI: 10.1016/j.ijnss.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aimed to translate the revised 17-item Diabetes Distress Scale (DDS17, 2017) into mandarin (simplified) Chinese and validate the Chinese version of DDS17 (C-DDS17, 2021) among adult patients with type 2 diabetes in China. Methods A scale translation and cross-sectional validation study was conducted. The DDS17 was translated into mandarin (simplified) Chinese through a five-step process: authorization, forward translation, synthesis, back translation, and amendment. During this session, 59 patients assessed the understandability and readability of the translated scale. From June 7 to September 4, 2021, a cross-sectional study that adhered to the COSMIN checklist was conducted with 400 individuals with type 2 diabetes from three Class A tertiary comprehensive hospitals in Beijing, China. The content, construct, convergent, discriminant validity, and reliability (Cronbach’s α coefficient and item-total correlation coefficients) of the C-DDS17 were evaluated. This study was a part of a project registered in the Chinese Clinical Trial Registry (no. ChiCTR2100047071). Results Among the participants, 33.3% (133/400) of them experienced moderate to high diabetes distress. The content validity indices of the C-DDS17 equaled 1.00. The scale yielded a four-factor structure. The average variances extracted were 0.42–0.57, which was lower than squared correlations. Cronbach’s α coefficient was 0.88 for the overall scale and ranged from 0.76 to 0.81 for sub-scales. Corrected item-total correlation coefficients ranged from 0.42 to 0.61. The eighth item (“Feeling that I am often failing with my diabetes routine”) was better fit to physician distress than regimen distress but had little influence on the validation results. Conclusions The C-DDS17 is a reliable and valid instrument for assessing diabetes distress in patients with type 2 diabetes. It is a promising instrument for early identification and management of diabetes distress in clinical practice and trials.
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Affiliation(s)
- Yu-Yun Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Li
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
| | - Yu Sheng
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Corresponding author.
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23
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Ho KHM, Mak AKP, Chung RWM, Leung DYL, Chiang VCL, Cheung DSK. Implications of COVID-19 on the Loneliness of Older Adults in Residential Care Homes. QUALITATIVE HEALTH RESEARCH 2022; 32:279-290. [PMID: 34855529 DOI: 10.1177/10497323211050910] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
With little understandings on the loneliness of older adults in residential care homes structured by social contact restrictions, the provision of person-centered care was jeopardized during the pandemic. This study employed hermeneutic phenomenology to explore the lived experiences of loneliness of this population during a 5-month period of the COVID-19 pandemic. We conducted unstructured face-to-face interviews with 15 older adults living in seven residential care homes. Thematic analysis was guided by Van Manen's approach. The essence of loneliness was uncovered as "A deprived sense of self-significance in a familiar world contributes to older adult's disconnection with prior commitments." A sub-theme "From collapse to dissolution of self-understanding" revealed how COVID-19 structured their loneliness. Another sub-theme, "Restoring meanings by establishing connections with entities" illustrated the ways to mitigate loneliness during the pandemic. Activities fostering alternative self-interpretation are important to protect older adults against loneliness.
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Affiliation(s)
- Ken H M Ho
- Nethersole School of Nursing, Faculty of Medicine, 71024The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Agnes K P Mak
- School of Nursing, 261919Tung Wah College, Kowloon, Hong Kong
| | | | - Doris Y L Leung
- School of Nursing, 26680The Hong Kong Polytechnic University, Hong Kong
| | - Vico C L Chiang
- School of Nursing, 26680The Hong Kong Polytechnic University, Hong Kong
| | - Daphne S K Cheung
- School of Nursing, 26680The Hong Kong Polytechnic University, Hong Kong
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24
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Xia T, Lopes S, Chen L, Roth R, Zinzow H, Jones K, Zhang L, Shi L, Jindal M. A Feasibility Study on Low-dose Mindfulness-based Stress Reduction Intervention Among Prediabetes and Diabetes Patients. Complement Ther Med 2022; 65:102810. [DOI: 10.1016/j.ctim.2022.102810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/30/2021] [Accepted: 01/25/2022] [Indexed: 11/03/2022] Open
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25
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Zhang H, Zhang Q, Luo D, Cai X, Li R, Zhang Y, Lu Y, Liu J, Gu J, Li M. The effect of family-based intervention for adults with diabetes on HbA1c and other health-related outcomes: Systematic review and meta-analysis. J Clin Nurs 2021; 31:1488-1501. [PMID: 34888968 DOI: 10.1111/jocn.16082] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/11/2021] [Accepted: 10/03/2021] [Indexed: 01/17/2023]
Abstract
AIMS AND OBJECTIVES To evaluate the effectiveness of family-based intervention for adults with diabetes on glycosylated haemoglobin and other health-related outcomes. BACKGROUND The impact of family-based intervention on adults with diabetes has been evaluated in various studies, but there is uncertainty about their effect on health-related outcomes for adults with diabetes. DESIGN A systematic review and meta-analysis of randomised controlled trials. METHODS A review was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Six relevant databases were searched from inception to 5 March 2021. Heterogeneity between studies was quantified by using Higgins' I2 test. Sensibility and subgroup analyses were used to explore potential heterogeneity. RESULTS The review included 23 studies (3,114 participants). Family-based intervention had a significant effect on improving glycosylated haemoglobin levels, body mass index, blood pressure, fasting glucose, diabetes self-care, diabetes self-efficacy, diabetes distress and positive family support. Non-significant results were obtained for blood lipid, body weight, depression and negative family support. In particular, subgroup analyses indicated that family-based intervention in Asian regions was more effective in improving glycosylated haemoglobin levels than in other areas. CONCLUSION Family-based intervention may improve diabetes control, diabetes self-care, psychological well-being and positive family support in adults with diabetes and is especially effective in Asian regions. Given the limitations in current studies, further studies are recommended to combine family theory with family-based intervention, and to examine the effectiveness of such intervention for family members. RELEVANCE TO CLINICAL PRACTICE This review and meta-analysis provides evidence that family-based intervention can improve positive family support, which has a good effect on diabetes control and psychological well-being in adults with diabetes, and it is especially effective in Asian regions. Findings suggested that unreinforced participation by family members and integrating flexible strategies into family-based intervention may be equally effective.
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Affiliation(s)
- Huijing Zhang
- School of Nursing, Peking University, Beijing, China
| | - Qi Zhang
- School of Nursing, Peking University, Beijing, China
| | - Dan Luo
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xue Cai
- Nursing Department, ZhongDa Hospital Southeast University, Nanjing, China
| | - Ruxue Li
- School of Nursing, Peking University, Beijing, China
| | - Yating Zhang
- School of Nursing, Peking University, Beijing, China
| | - Yanhui Lu
- School of Nursing, Peking University, Beijing, China
| | - Jiajia Liu
- School of Nursing, Peking University, Beijing, China
| | - Jiaxin Gu
- School of Nursing, Peking University, Beijing, China
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, China
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Chong YY, Chien WT, Cheng HY, Lamnisos D, Ļubenko J, Presti G, Squatrito V, Constantinou M, Nicolaou C, Papacostas S, Aydin G, Ruiz FJ, Garcia-Martin MB, Obando-Posada DP, Segura-Vargas MA, Vasiliou VS, McHugh L, Höfer S, Baban A, Neto DD, da Silva AN, Monestès JL, Alvarez-Galvez J, Blarrina MP, Montesinos F, Salas SV, Őri D, Kleszcz B, Lappalainen R, Ivanović I, Gosar D, Dionne F, Merwin RM, Gloster AT, Karekla M, Kassianos AP. Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4143. [PMID: 33919888 PMCID: PMC8070933 DOI: 10.3390/ijerph18084143] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/05/2021] [Accepted: 04/08/2021] [Indexed: 12/16/2022]
Abstract
This study aimed to compare the mediation of psychological flexibility, prosociality and coping in the impacts of illness perceptions toward COVID-19 on mental health among seven regions. Convenience sampled online survey was conducted between April and June 2020 from 9130 citizens in 21 countries. Illness perceptions toward COVID-19, psychological flexibility, prosociality, coping and mental health, socio-demographics, lockdown-related variables and COVID-19 status were assessed. Results showed that psychological flexibility was the only significant mediator in the relationship between illness perceptions toward COVID-19 and mental health across all regions (all ps = 0.001-0.021). Seeking social support was the significant mediator across subgroups (all ps range = <0.001-0.005) except from the Hong Kong sample (p = 0.06) and the North and South American sample (p = 0.53). No mediation was found for problem-solving (except from the Northern European sample, p = 0.009). Prosociality was the significant mediator in the Hong Kong sample (p = 0.016) and the Eastern European sample (p = 0.008). These findings indicate that fostering psychological flexibility may help to mitigate the adverse mental impacts of COVID-19 across regions. Roles of seeking social support, problem-solving and prosociality vary across regions.
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Affiliation(s)
- Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (W.T.C.); (H.Y.C.)
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (W.T.C.); (H.Y.C.)
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (W.T.C.); (H.Y.C.)
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, 1516 Nicosia, Cyprus;
| | - Jeļena Ļubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiņš University, LV-1007 Riga, Latvia;
| | - Giovambattista Presti
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (G.P.); (V.S.)
| | - Valeria Squatrito
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (G.P.); (V.S.)
| | - Marios Constantinou
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, 2417 Nicosia, Cyprus;
| | - Christiana Nicolaou
- Department of Nursing, Cyprus University of Technology, 3036 Limassol, Cyprus;
| | | | - Gökçen Aydin
- Department of Psychological Counseling and Guidance, Faculty of Education, Hasan Kalyoncu University, Gaziantep 27010, Turkey;
| | - Francisco J. Ruiz
- Department of Psychology, Fundación Universitaria Konrad Lorenz, Bogotà 110231, Colombia; (F.J.R.); (M.A.S.-V.)
| | - Maria B. Garcia-Martin
- Faculty of Psychology, University of La Sabana, Chía 53753, Colombia; (M.B.G.-M.); (D.P.O.-P.)
| | - Diana P. Obando-Posada
- Faculty of Psychology, University of La Sabana, Chía 53753, Colombia; (M.B.G.-M.); (D.P.O.-P.)
| | - Miguel A. Segura-Vargas
- Department of Psychology, Fundación Universitaria Konrad Lorenz, Bogotà 110231, Colombia; (F.J.R.); (M.A.S.-V.)
| | - Vasilis S. Vasiliou
- School of Applied Psychology, University College Cork, T12 YN60 Cork, Ireland;
| | - Louise McHugh
- School of Psychology, University College Dublin, D04 V1W8 Dublin, Ireland;
| | - Stefan Höfer
- Department of Medical Psychology, Innsbruck Medical University, 6020 Innsbruck, Austria;
| | - Adriana Baban
- Department of Psychology, Babeş-Bolyai University (UBB), 400095 Cluj-Napoca, Romania;
| | - David Dias Neto
- ISPA—Instituto Universitário, APPsyCI—Applied Psychology Research Center Capabilities & Inclusion, 1149-041 Lisbon, Portugal;
| | - Ana Nunes da Silva
- Faculdade de Psicologia, Alameda da Universidade, Universidade de Lisboa, 1649-013 Lisbon, Portugal;
| | | | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, 11003 Cadiz, Spain;
| | | | | | | | - Dorottya Őri
- Heim Pal National Pediatric Institute, Department of Mental Health, 1089 Budapest, Hungary;
| | - Bartosz Kleszcz
- Bartosz Kleszcz Psychotherapy and Training, ul. Aleja Zwycięstwa 31/8, 41-200 Sosnowiec, Poland;
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, FI-40014 Jyväskylä, Finland;
| | - Iva Ivanović
- Clinic for Psychiatry, Clinical Center of Montenegro, 81110 Podgorica, Montenegro;
| | - David Gosar
- Department of Child, Adolescent and Developmental Neurology, University Children’s Hospital, University Medical Center, 1000 Ljubljana, Slovenia;
| | - Frederick Dionne
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada;
| | - Rhonda M. Merwin
- Department of Psychiatry and Behavioral Science, Duke University, Durham, NC 27708, USA;
| | - Andrew T. Gloster
- Division of Clinical Psychology and Intervention Science, University of Basel, 4001 Basel, Switzerland;
| | - Maria Karekla
- Department of Psychology, University of Cyprus, 1678 Nicosia, Cyprus; (M.K.); (A.P.K.)
| | - Angelos P. Kassianos
- Department of Psychology, University of Cyprus, 1678 Nicosia, Cyprus; (M.K.); (A.P.K.)
- Department of Applied Health Research, University College London, London WC1E 6BT, UK
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Rajaeiramsheh F, Rezaie Z, Davoudi M, Ahmadi SM, Qorbani-Vanajemi M. Psychometric properties of the Persian versions of acceptance and action diabetes questionnaire (AADQ) and the diabetes acceptance and action scale (DAAS), in Iranian youth with type 1 diabetes. J Diabetes Metab Disord 2021; 20:655-663. [PMID: 34178858 DOI: 10.1007/s40200-021-00796-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/06/2021] [Indexed: 11/26/2022]
Abstract
Background Psychological flexibility has considerable effects on medical and psychosocial outcomes in youth with type 1 diabetes mellitus (T1DM). This study aimed to evaluate the psychometric properties of the Persian versions of the Acceptance and Action Diabetes Questionnaire (AADQ) and the Diabetes Acceptance and Action Scale for children and adolescents (DAAS), the measures of diabetes-specific psychological flexibility. Methods 196 youth with T1DM completed the DAAS, AADQ (youth-report), Child and Adolescent Mindfulness Measure (CAMM), Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA), and the Avoidance and Fusion Questionnaire for Youths (AFQ-Y8). Also, their parents completed AADQ (parent-report). Data analyzed by SPSS V.26 and LISREL 8.8. Results The mean and standard deviation of participants' age was 14.7 ± 2.08.The internal consistency due to Cronbach's alpha method was 0.87, 0.8, 0.84, and 0.83 for DAAS total scores, avoidance, values impairment, and fusion, respectively. The internal consistency of AADQ (both parent-report and youth report) was above 0.8. Test-retest reliability (from 45 participants) with a one-week interval was assessed by the interclass correlation coefficient (ICC). The DAAS, AADQ-parent report, and AADQ-youth report's reliability coefficients were 0.93, 0.82, and 0.92, respectively. The AADQ (both forms) and DAAS evidence good content validity based on correlations with other measures. Confirmatory factor analysis (CFA) and Exploratory Factor Analysis (EFA) showed DAAS has the three-factor model, which strongly a suitable model is fitting. EFA also verified the AADQ model fitting. Conclusions In general, these results support the psychometric properties of the Persian versions of DAAS and AADQ among the Iranian youth patients with T1DM. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-021-00796-1.
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Affiliation(s)
- Fereshteh Rajaeiramsheh
- Department of clinical psychology, Faculty of behavioral science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Zeinab Rezaie
- Department of clinical psychology, School of Medical, Kashan University of Medical Sciences (KAUMS), Kashan, Iran
| | - Mohammadreza Davoudi
- Department of clinical psychology, Faculty of behavioral science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Majid Ahmadi
- Department of Internal Medicine, School of Medical, Yasouj University of Medical Sciences (YUMS), Yasouj, Iran
| | - Milad Qorbani-Vanajemi
- Department of counseling, Faculty of behavioral science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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