Psychological Aspects Of Diabetes Care: Effecting Behavioral Change In Patients
Psychological aspects of diabetes care: Effecting behavioral change in patients Boon-How Chew , Sazlina Shariff-Ghazali , and Aaron Fernandez Boon-How Chew, Sazlina Shariff-Ghazali, Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia Aaron Fernandez, Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia Author contributions: Chew BH, Shariff-Ghazali S and Fernandez A contributed to this paper. Correspondence to: Boon-How Chew, MD, Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia. [email protected] Telephone: +60-3-89472520 Fax: +60-3-89472328 Received 2014 Aug 27; Revised 2014 Nov 5; Accepted 2014 Nov 17. Copyright 2014 Baishideng Publishing Group Inc. All rights reserved. This article has been cited by other articles in PMC. Patients with diabetes mellitus (DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors. Without patients adherence to the effective therapies, there would be persistent sub-optimal control of diseases, increase diabetes-related complications, causing deterioration in quality of life, resulting in increased healthcare utilization and burden on healthcare systems. However, provision of psychosocial support is generally inadequate due to its challenging nature of needs and demands on the healthcare systems. This review article examines patients psychological aspects in general, elaborates in particular about emotion effects on health, and emotion in relation to other psycholo Continue reading >>
Diabetes And Psychological Care
People with diabetes experience disproportionately high rates of mental health problems such as depression, anxiety and eating disorders. All people with diabetes should have access to psychological treatment and support to reduce psychological distress and improve self-management. Use the following resources and tools to improve psychological care for people with diabetes. This reportpresents the 3DFD service at Kings College Hospital NHS Foundation Trust, a UK first model of care that integrates diabetes, psychological and social interventions for people with complex psychological needs. London's care pathway for diabetes: commissioning recommendations for psychological support, London Mental Health Strategic Clinical Network website (September 2014) This guidance provides recommendations to support commissioners to deliver accessible and effective psychological support for diabetes care pathways. It also provides a directory of good practice case studies from across England.This guidance provides recommendations to support commissioners to deliver accessible and effective psychological support for diabetes care pathways. It also provides a directory of good practice case studies from across England. Investing in emotional and psychological wellbeing for people with long-term conditions, NHS Confederation website (April 2012) This report provides service design and productivity improvement guidance for commissioners, clinicians and managers in primary care, secondary care and mental health. The guide also presents nine case studies where local areas have improved access to psychological support for people with diabetes.This report provides service design and productivity improvement guidance for commissioners, clinicians and managers in primary care, secondary care a Continue reading >>
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T1dm Through The Life Span: Ada Position Statement
Psychosocial: Assessment and Treatment of Psychosocial Issues Assessment and appropriate management of psychosocial issues are important throughout the life span of individuals with type 1 diabetes. In pediatrics, health care providers should assess the individual child and the child's family for their ability to function and behave appropriately regarding safe and responsible diabetes care. For adults, the individual is the focus of care. However, family involvement should be strongly encouraged when appropriate. Depression screening and discussion about psychosocial issues are important components of the diabetes visit. Special attention should be paid to diabetes-related distress, fear of hypoglycemia (and hyperglycemia), eating disorders, insulin omission, subclinical depression, and clinical depression. These factors are significantly associated with poor diabetes self-management, a lower quality of life, and higher rates of diabetes complications. As individuals age, health care providers should evaluate issues related to self-care capacity, mobility, and autonomy. Such factors are to be promptly addressed, as they make the management of type 1 diabetes ever more problematic. Make age-appropriate screenings for psychosocial issues a component of most diabetes visits. Any concerns should be pursued through treatment that may include referral to a mental health specialist. (E) Ensure that there is developmentally appropriate parent/family involvement in the management of the child's/adolescent's diabetes care tasks, avoiding a premature transfer of sole responsibility for diabetes management to the developing child/teenager. (B) Directly ask about diabetes-related family conflict and stress and negotiate an acceptable resolution with the child/adolescent and parent Continue reading >>
Assessment Of Psychosocial Variables By Parents Of Youth With Type 1 Diabetes Mellitus
on behalf of the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG) Malerbi et al.; licensee BioMed Central Ltd.2012 To evaluate the impact of type 1 diabetes (T1D) on family functioning and child-rearing practices from parents point of view, to assess parents health-related quality of life and to explore the relations between psychosocial variables and diabetes care outcomes in youth with diabetes. This research was part of the cross-sectional multicenter Brazilian Type 1 Diabetes Study, conducted between December 2008 and December 2010 in 28 public clinics of 20 cities across four Brazilian geographical regions. Psychosocial questions were addressed to 1,079 parents of patients with T1D through an interview (89.3% mothers, 52.5% Caucasians, 38.6 7.6 years old). Overall, 72.5% of the families were from low or very low socioeconomic levels. Parents were also submitted to health-related quality of life instruments (EQ-5D+EQ-VAS). Clinical data from the last medical appointment were collected by a physician using standardized chart review forms. The demographic, educational and socioeconomic profiles were also obtained and HbA1c levels registered. Discomfort and anxiety/depression were the main complaints in EQ-5D, and were significantly more frequent in mothers (37.3% and 53.4%, respectively) than in fathers (25.7% and 32.7%, respectively). The mother was the only parent involved in diabetes care in 50.5% of the cases. The majority of parents (78.5%) mentioned changes in family functioning after the diagnosis, although they neither treated their diabetic children differently from the others (76.3%), nor set prohibitions (69.1%) due to diabetes. The majority was worried about diabetes complications (96.4%) and felt overwhelmed by diabetes care (62.8%). Parents report of Continue reading >>
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Psychological Assessment And Management In Diabetes
Psychological assessment and management in diabetes Bharti Kalra ( Department of Gynaecology, Bharti Hospital, Karnal, India. ) Sanjay Kalra ( Department of Endocrinology, Bharti Hospital, Karnal, India. ) Yatan Pal Singh Balhara ( Department of Psychiatry, National Drug Dependence Treatment Centre (NDDTC), AIIMS, New Delhi, India. ) Though the importance of psychological factors in the natural history, and the management of diabetes, cannot be overstated, these factors are sometimes not discussed adequately in current literature. Lack of trained manpower, time, and other resources, tends to detract diabetes care professionals from paying attention to this field. This review discusses simple, practical ways of psychological assessment and psychological management, in a manner relevant not only to Pakistan, but to other resource challenged settings as well. The paper underscores the fact that improvements in our understanding of psychological aspects of diabetes should be considered worthy of inclusion in the column: recent advances in endocrinology. Keywords: Psychosocial, Diabetes, South Asia, Cognitive behavioural therapy, Motivational interviewing. The IDF clinical guidelines task force clearly states that "psychosocial factors are relevant to nearly all aspects of diabetes management." Particularly important is the recognition that signs of cognitive, emotional, behavioural and social problems, which may be complicating self-care, be considered a part of minimal care required for diabetes patients, even in resource challenged settings.1 The ISPAD Consensus Guidelines, 2000, goes a step further, stating that "psychosocial factors are the most important influences affecting the care and management of diabetes."2 Despite the strong emphasis in international guidelines Continue reading >>
Psychological Aspects Related To Diabetes Mellitus
Psychological Aspects Related to Diabetes Mellitus 1Department of Psychiatry, Government Medical College and Hospital-32, Chandigarh 160030, India 2Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India 3Barbara Davis Center for Diabetes, School of Medicine, University of Colorado Denver, Aurora, CO 80045, USA 4Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India Received 30 July 2015; Accepted 17 August 2015 Copyright 2016 Nitin Gupta et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The prevalence of diabetes has shown an exponential worldwide rise in recent years [ 1 ]. Poor glycemic control results in long-term micro/macrovascular complications, and thus most diabetes organizations recommended good glycemic control (defined as A1c less than 7%) to prevent these complications. However, management of diabetes requires lifelong daily adherence to dietary and exercise plans, frequent blood glucose monitoring, and adherence to medications. This results in higher risk for reduced physical, emotional, and social well-being (in terms of quality of life) among people with diabetes. Over the decades, there has been a burgeoning research interest in the psychological aspects related to diabetes. Numerous evidences suggest the important role of psychosocial factors in diabetes self-management. Psychosocial problems can result in nonadherence to medications, poor quality of life, and lack of interest in managing disease resulting in poor glycemic control and long-term complications. In this regard Continue reading >>
Psychosocial Interventions For The Diabetic Patient
Psychosocial interventions for the diabetic patient Diabetes Research Group, Wrexham Academic Unit, Bangor University, Wrexham, UK Correspondence: John N Harvey, Gladstone Centre, Maelor Hospital, Wrexham LL13 7TD, UK, Email [email protected] Author information Copyright and License information Disclaimer Copyright 2015 Harvey. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution Non Commercial (unported, v3.0) License The full terms of the License are available at . Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. This article has been cited by other articles in PMC. Diabetes usually requires substantial life-long self-management by the patient. Psychological factors and the patients health beliefs are important determinants of self-care behavior. Education has a modest influence on generating better self-care, but psychologically based interventions are clearly more effective. This review gives an overview of these interventions with some discussion of their basis in psychological theory. Some labels such as cognitive behavioral therapy and family therapy include a wide range of approaches. Randomized trials have generally produced improvement in measures of psychological well-being, but improved glycemic control has been more elusive. The influence on behavior can be very dependent on the individual therapist. Only a few trials have managed to sustain improvement in glycosylated hemoglobin beyond a year. Not all patients are prepared to engage and accept these forms of therapeutic intervention. We are still some way from moving psychological management from the trial situation into the diabetic clinic. Keyword Continue reading >>
Ada Issues Guidelines For Psychosocial Care In Diabetes
ADA Issues Guidelines for Psychosocial Care in Diabetes The ADA's guidelines address the most common psychological factors The American Diabetes Association (ADA) released its first position statement that includes detailed guidelines for psychosocial assessments and care based on factors including age, type of diabetes, and family support system. The specific recommendations are available in "Psychosocial Care for People with Diabetes: A Position Statement of the America Diabetes Association" which will be published inDiabetes Care. The ADA's guidelines address the most common psychological factors affecting patients with type 1 and type 2 diabetes, including diabetes distress, depression, anxiety and eating disorders. It emphasizes that diabetes management is more successful when lifestyle and emotional status are integrated into diabetes care. FDA Approves Soliqua 100/33 for Type 2 Diabetes The position statement was based on diabetes research and recommendations combined with expertise of the study authors. Alicia McAuliffe-Fogarty, PhD, clinical health psychologist and vice president of the lifestyle management team at the ADA added, "People with diabetes have a greater risk of depression and anxiety, and while medical providers are trained to help people manage the medical aspects of their disease, they are not always taught to understand the impact that psychosocial factors have on people living with diabetes. Every person's needs are different, so individualized, patient-focused care that includes a mental health component should be a part of a comprehensive diabetes care plan for every person with diabetes." Clinicians are encouraged to assess the patient's emotional health and life circumstances during the first visit, and to perform necessary evaluations the Continue reading >>
The Assessment Of Diabetes-related Cognitive And Social Factors: The Multidimensional Diabetes Questionnaire
, Volume 20, Issue3 , pp 291312 | Cite as The Assessment of Diabetes-Related Cognitive and Social Factors: The Multidimensional Diabetes Questionnaire The purpose of this study was to examine the psychometric properties of the recently developed Multidimensional Diabetes Questionnaire (MDQ). The MDQ which is theoretically linked to a social learning perspective of diabetes, was designed to provide a comprehensive assessment of diabetes-related cognitive and social factors. It includes 41 items grouped into three sections: (1) perceptions related to diabetes and related social support, (2) positive and misguided reinforcing behaviors related to self-care activities, and (3) self-efficacy and outcome expectancies. Confirmatory factor analyses, conducted on a sample of 249 patients with non-insulin-dependant diabetes mellitus, supported the construct validity of the MDQ. Adequate internal consistency and significant demographic, psychological, behavioral, and disease-related correlates were found. The MDQ may prove valuable in understanding individual differences in adjustment to diabetes. diabetes mellitusassessmentconfirmatory factor analysispsychosocial adjustment This is a preview of subscription content, log in to check access Unable to display preview. Download preview PDF. Anderson, L. A. (1990). Health-care communication and selected psychosocial correlates of adherence in diabetes management. Diabetes Care 13(2): 6676. Google Scholar Anderson, B. J., and Coyne, J. C. (1993). Miscarried helping in the families of children and adolescents with chronic diseases. In Johnson, J. H., and Johnson, S. B. (eds.), Advances in Child Health Psychology, University of Florida Press, Gainesville, pp. 167177. Google Scholar Ary, D. V., Toobert, D. J., Wilson, W., and Glasgow, R. Continue reading >>
Psychosocial Assessment Of Artificial Pancreas (ap): Commentary And Review Of Existing Measures And Their Applicability In Ap Research
N2 - Aim: This study aimed to systematically review the evidence base for the use of existing psychological and psychosocial measures suitable for use in artificial pancreas (AP) research. Materials and Methods: This systematic review of published literature, gray literature, previous systematic reviews, and qualitative and economic studies was conducted using terms and abbreviations synonymous with diabetes, AP, and quality of life (QoL). Results: Two hundred ninety-two abstracts were identified that reported psychosocial assessment of diabetes-related technologies. Of these, nine met the inclusion criteria and were included. Only four of 103 ongoing trials evaluated psychosocial aspects as an outcome in the trial. Of these, treatment satisfaction, acceptance and use intention of AP, fear of hypoglycemia episodes, satisfaction with AP, and an unspecified QoL measure were used. Conclusions: A better understanding of the psychosocial side of AP systems and the extent to which human factors play a role in the uptake and efficient use of these systems will ultimately lead to the most benefit for people with diabetes. AB - Aim: This study aimed to systematically review the evidence base for the use of existing psychological and psychosocial measures suitable for use in artificial pancreas (AP) research. Materials and Methods: This systematic review of published literature, gray literature, previous systematic reviews, and qualitative and economic studies was conducted using terms and abbreviations synonymous with diabetes, AP, and quality of life (QoL). Results: Two hundred ninety-two abstracts were identified that reported psychosocial assessment of diabetes-related technologies. Of these, nine met the inclusion criteria and were included. Only four of 103 ongoing trials Continue reading >>
Assessing Psychosocial Variables: A Tool For Diabetes Educators.
1. Diabetes Educ. 2006 Jan-Feb;32(1):51-8. Assessing psychosocial variables: a tool for diabetes educators. (1)University of Massachusetts Lowell, 14 Innisfree Drive, Haverhill, MA 01832, USA. The purpose of this article is to share an educational strategy or tool that isrelevant for use in patient and professional diabetes education. The tool offers an opportunity for diabetes educators to screen for psychosocial variables suchas depression or emotional distress. A systematic review of the literature wasconducted to identify psychological variables that have an impact on individuals living with diabetes and their ability to self-manage their disease. Theliterature revealed that both depression and emotional distress related todiabetes was experienced by individuals with diabetes along with thoseindividuals who were unable to self-management their disease. The Accu-CheckInterview is a computer software program that may assist diabetes educators toprovide diabetes education. Use of the Accu-Check Interview software program has been implemented at various sites including the Joslin Clinic (Boston, Mass),Baystate Medical Center (Springfield, Mass), and Emerson Hospital (Concord,Mass). The Diabetes Self Care Profile is a Web-based version of the Accu-CheckInterview and can be accessed as a demonstration in English and Spanish. Thesetools allow diabetes educators to screen for psychosocial variables and addressissues with individuals while using a motivational interviewing approach. Continue reading >>
Nice Evidence Search | Psychosocial Assessment Tools
The operation that you have selected will move away from the current results page, your download options will not persist. Please click "Confirm" if you are happy to lose these search results. - Publisher:American Diabetes Association Objective:"Patients with diabetes suffer high rates of mental health problems, and this combination is associated with poor outcomes. Although effective treatments exist for both diabetes and... - Publisher:American Diabetes Association Pan A, Keum N, Okereke OI, Sun Q, et al. (2012) Bidirectional association between depression and metabolic syndrome: A systematic review and meta-analysis of epidemiological studies. Diabetes Care... - Publisher:American Diabetes Association van Bastelaar KMP, Pouwer F, Cuijpers P et al. (2011) Web-based depression treatment for type 1 and type 2 diabetic patients: a randomized controlled trial. Diabetes Care 34: 3205The link will... - Publisher:American Diabetes Association Full reference:Alberti G, Zimmet P, Shaw J, Bloomgarden Z, Kaufman F, Silink M, et al. Type 2 diabetes in the young: the evolving epidemic: the international diabetes federation consensus... - Publisher:American Diabetes Association Ell K, Katon W, Xie B et al. (2010) Collaborative care management of major depression among low-income, predominatly Hispanic subjects with diabetes: a randomized controlled trial. Diabetes Care... Continue reading >>
Diabetes Mellitus - Psychosocial Issues In Diabetes
Diabetes mellitus - Psychosocial issues in diabetes Globally the incidence of diabetes is likely to exceed 250 million people by 2025 that is a measure of the scale of the problem this condition is likely to present in the future. It is evidence of how diabetes will be one of the foremost public health challenges facing the world in the decades ahead. Accordingly diabetes belongs at the top of the healthcare agenda but it has yet to be afforded that position. Throughout 2006, this Continuing Education module will deal with the causes and complications of diabetes mellitus, and the management of type 1 and type 2 in the various patient groups. This month Jennifer Clarke and Rita Forde outline the psychosocial implications of living with diabetes. Next month we will begin a focus on the complications of the condition and how they can be prevented. This will include footcare, and microvascular and macrovascular complications. The implications of a diagnosis of diabetes on the person and their family are immense. Many experience various emotions such as shock, anxiety, depression or guilt. Living with diabetes provides a daily challenge, as its management requires frequent and continuous effort from the person living with the condition.1 This incorporates such factors as home blood glucose monitoring, meal and exercise planning, and adherence medications. People living with diabetes need to be provided with information, reassurance and support in relation to all aspects of their condition. It is essential to assess the individuals ability to cope with and manage their diabetes effectively. This assessment involves careful observation, probing questions and attention to their feelings, thoughts and expectations. Health education involves more than just providing information Continue reading >>
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The Ada Issues Guidelines For Psychosocial Care In Diabetes
The ADA Issues Guidelines for Psychosocial Care in Diabetes The ADA released detailed guidelines for psychosocial assessments and care based on factors including age, type of diabetes, and family support system. The American Diabetes Association (ADA) released its first position statement that includes detailed guidelines for psychosocial assessments and care based on factors including age, type of diabetes, and family support system. The specific recommendations are available in "Psychosocial Care for People with Diabetes: A Position Statement of the America Diabetes Association" which will be published inDiabetes Care. The ADA's guidelines address the most common psychological factors affecting patients with type 1 and type 2 diabetes, including diabetes distress, depression, anxiety and eating disorders . It emphasizes that diabetes management is more successful when lifestyle and emotional status are integrated into diabetes care. The position statement was based on diabetes research and recommendations combined with expertise of the study authors. Alicia McAuliffe-Fogarty, PhD, clinical health psychologist and vice president of the lifestyle management team at the ADA added, "People with diabetes have a greater risk of depression and anxiety , and while medical providers are trained to help people manage the medical aspects of their disease, they are not always taught to understand the impact that psychosocial factors have on people living with diabetes. Every person's needs are different, so individualized, patient-focused care that includes a mental health component should be a part of a comprehensive diabetes care plan for every person with diabetes." Cognitive Ability and Brain Gray Matter in Adolescents With Type 2 Diabetes Clinicians are encouraged to assess Continue reading >>
Ada Releases Guidelines For Psychosocial Care For Diabetes Patients
ADA releases guidelines for psychosocial care for diabetes patients ADA releases guidelines for psychosocial care for diabetes patients The position statement provides recommendations for psychosocial assessment and care of individuals with diabetes. The American Diabetes Association has released a position statement to provide diabetes care providers with guidelines for psychosocial assessment and care of patients with diabetes . The position statement focuses on the most common psychosocial factors, including environmental, social, behavioral, and emotional factors, that affect individuals with diabetes. The researchers note that providers should consider the context of the person with diabetes when practicing psychosocial care. The recommendations are based on common clinical models, expert consensus, and tested interventions that take into account available resources, practice patterns, and practitioner burden. A summary of the guidelines is as follows: General considerations in psychosocial care Psychosocial care should be provided to all individuals with diabetes, with the goals of optimizing health outcomes and health-related quality of life.Grade A Providers should assess symptoms of diabetes distress, depression, anxiety, and disordered eating and of cognitive capacities using patient-appropriate standardized tools at the initial visit, at periodic intervals, and when there is a change in disease, treatment, or life circumstance. Grade B Monitor patient performance of self-management behaviors and psychosocial factors that could affect the patient's self-management. Grade E Consider the assessment of life circumstances that affect physical and psychological health outcomes and their incorporation into intervention strategies. Grade E Providers should address p Continue reading >>
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