Does low well-being modify the effects of PRISMA (Dutch DESMOND), a structured self-management-education program for people with type 2 diabetes?

作者：van Vugt Michael^*; de Wita Maartje; Bader Suzanne; Snoek Frank J

来源：Primary Care Diabetes, 2016, 10(2): 103-110.

DOI：10.1016/j.pcd.2015.06.008

• Well-being
• Self-management
• Education
• Type 2 diabetes mellitus

Aims: Diabetes self-management education improves behavioural and clinical outcomes in type 2 diabetes patients, however little is known about the modifying effects of wellbeing. This is relevant given high prevalence of depression and distress among diabetes patients. We aimed to test whether low well-being modifies the effects of the PRISMA self management education program (Dutch DESMOND).
Methods: 297 primary care type 2 diabetes patients participated in the PRISMA observational study with a pre-post measurement design. Patients were grouped in low (n = 63) and normal well-being (n = 234). Low well-being was defined as either low mood (WHO-5 < 50) and/or high diabetes-distress (PAID-5 > 8). Outcome measures were: diabetes self-efficacy (CIDS), illness perception (IPQ) and diabetes self-care activities (SDSCA).
Results: Improvements were found in illness perception (b = 1.586, p < 0.001), general diet (b = 1.508, p = 0.001), foot care (b = 0.678, p = 0.037), weekly average diet (b = 1.140, p = 0.001), creating action plan (b = 0.405, p = 0.007). Well-being interaction effects were found for general diet (p = 0.009), weekly average diet (p = 0.022), and creating an action plan (p = 0.002).
Conclusions: PRISMA self-management education seems as effective for people with normal well-being as for people with low well-being. Further research should examine whether addressing mood and diabetes-distress as part of self-management education could reduce attrition and maintain or improve well-being among participants.

• 出版日期2016-4