Diabetes rehabilitation: development and first results of a Multidisciplinary Intensive Education Program for patients with prolonged self-management difficulties.

For a number of diabetes patients regular care may be insufficient. A Multidisciplinary Intensive Education Program (MIEP), based on the empowerment approach, has been developed to help patients obtain their treatment goals (adequate self-management, glycemic control and quality of life). The aim of this pilot study is to determine the effects of MIEP and it's mechanisms of influence. MIEP consisted of 12 days group-sessions and individual counseling. At baseline and 3-months follow-up, blood-glucose (HbA1c), quality of life, health locus of control, distress, and knowledge were obtained (N = 51). Paired T-tests and regression analyses were conducted. HbA1c, and knowledge improved significantly, patients rated themselves healthier and were more internal and less powerful others oriented. Baseline scores explained effects in HbA1c, and quality of life. Locus of control significantly contributed in effects on quality of life. MIEP benefited patients with prolonged self-management difficulties, and this form of care seems to complement regular care.

[1]  I. Mühlhauser,et al.  Diabetes care and patient-oriented outcomes. , 1999, JAMA.

[2]  M. Funnell,et al.  Patient Empowerment: Results of a randomized controlled trial , 1995, Diabetes Care.

[3]  H. Bilo,et al.  Longitudinal study on glycaemic control and quality of life in patients with Type 2 diabetes mellitus referred for intensified control , 1999, Diabetic medicine : a journal of the British Diabetic Association.

[4]  T. Mandrup-Poulsen,et al.  Recent advances: Diabetes , 1998 .

[5]  C. van Weel,et al.  The impact of type 2 diabetes mellitus on daily functioning. , 1999, Family practice.

[6]  S. Norris,et al.  Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. , 2001, Diabetes care.

[7]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[8]  J. Turtle,et al.  Knowledge and attitude change as predictors of metabolic improvement in diabetes education. , 1990, Social science & medicine.

[9]  B. Hanestad Self-reported quality of life and the effect of different clinical and demographic characteristics in people with type 1 diabetes. , 1993, Diabetes research and clinical practice.

[10]  C. Hershey,et al.  Barriers to Control of Blood Glucose in Diabetes Mellitus , 2000, American journal of medical quality : the official journal of the American College of Medical Quality.

[11]  F J Snoek,et al.  Development of a Type 2 Diabetes Symptom Checklist: a Measure of Symptom Severity , 1994, Diabetic medicine : a journal of the British Diabetic Association.

[12]  R. Holman,et al.  Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. , 1998 .

[13]  D. Nerenz,et al.  Ongoing assessment of health status in patients with diabetes mellitus. , 1992, Medical care.

[14]  S. Genuth,et al.  The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. , 1993, The New England journal of medicine.

[15]  R. Holman,et al.  Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) , 1998, The Lancet.

[16]  J. Groothoff,et al.  Quality of life in patients with diabetic foot ulcers. , 2001, Disability and rehabilitation.

[17]  A. Jacobson The psychological care of patients with insulin-dependent diabetes mellitus. , 1996, The New England journal of medicine.

[18]  B. Klapp,et al.  The network of psychological variables in patients with diabetes and their importance for quality of life and metabolic control. , 2002, Diabetes care.

[19]  R. Rubin,et al.  Quality of life and diabetes , 1999, Diabetes/metabolism research and reviews.

[20]  David Handelsman,et al.  Development of the Diabetes Knowledge (DKN) Scales: Forms DKNA, DKNB, and DKNC , 1984, Diabetes Care.

[21]  I. Mühlhauser,et al.  Social status and the quality of care for adult people with Type I (insulin-dependent) diabetes mellitus – a population-based study , 1998, Diabetologia.

[22]  R. Rubin,et al.  Psychosocial Problems and Interventions in Diabetes: A review of the literature , 1992, Diabetes Care.

[23]  Kenneth A. Wallston,et al.  Development of the Multidimensional Health Locus of Control (MHLC) Scales , 1978, Health education monographs.

[24]  R. Rubin,et al.  Modeling The Effect of Diabetes Education on Glycemic Control , 1994, The Diabetes educator.

[25]  R. Glasgow,et al.  Evaluating Diabetes Education: Are we measuring the most important outcomes? , 1992, Diabetes Care.

[26]  R. Sanderman,et al.  Psychometric qualities of the rand 36-item health survey 1.0: A multidimensional measure of general health status , 1996, International journal of behavioral medicine.

[27]  M. Funnell,et al.  Theory is the Cart, Vision is the Horse: Reflections on Research in Diabetes Patient Education , 1999, The Diabetes educator.

[28]  Walter Devillé,et al.  Well-Being and Symptoms in Relation to Insulin Therapy in Type 2 Diabetes , 1998, Diabetes Care.

[29]  A. Aro,et al.  Health related quality of life among insulin-dependent diabetics: disease-related and psychosocial correlates. , 1997, Patient education and counseling.

[30]  J. Lyons,et al.  A biopsychosocial treatment approach to the management of diabetes mellitus. , 1991, General hospital psychiatry.

[31]  Frank J. Snoek,et al.  Psychology in Diabetes Care , 2005 .

[32]  M. Funnell,et al.  Empowerment: An Idea Whose Time Has Come in Diabetes Education , 1991, The Diabetes educator.

[33]  V. Coates,et al.  Knowledge and diabetes self-management. , 1996, Patient education and counseling.