Toward effective interventions to reduce diabetes distress among adults with type 1 diabetes: Enhancing Emotion regulation and cognitive skills

PATIENT EDUCATION AND COUNSELING

卷:102

Article

Fisher, Lawrence¹  Hessler, Danielle¹  Polonsky, William²  Strycker, Lisa³  Bowyer, Vicky¹  Masharani, Umesh⁴ 

[1] Univ Calif San Francisco, Dept Family & Community Med, San Francisco, CA 94143 USA

[2] Univ Calif San Diego, Dept Psychiat, Behav Diabet Inst, San Diego, CA 92103 USA

[3] Oregon Res Inst, Eugene, OR 97403 USA

[4] Univ Calif San Francisco, Dept Med, San Francisco, CA USA

关键词: Diabetes;    Diabetes distress;    Emotion regulation;    Cognition;   

DOI  :  10.1016/j.pec.2019.03.021

来源: Elsevier

【 摘 要 】

Objective: We tested three models to determine how improvements in emotion regulation (ER) and cognitive skills (CS) as a result of intervention operate to affect reductions in diabetes distress DD. Methods: Change data were drawn from the baseline and 9-month T1-REDEEM trial. Adults with type 1 diabetes were recruited from several U.S. states and Toronto, Canada. A primary and two alternative structural equation models were tested to explore the directionality of effect: primary model - changes in ER and CS drive changes in DD; reverse model - changes in DD drive changes in ER and CS; and bidirectional model - changes in ER, CS and DD occur together with no directionality. Results: All three models displayed a good fit to the data. The primary model indicated 7 significant directional pathways: improvements in ER and CS operate together to drive reductions in DD. The reverse model only indicated that reductions in DD affected changes in one CS variable; and the bidirectional model indicated only that these results were bidirectional. Reductions in all tested domains of DD occurred together. Conclusions: Improvements in ER and CS drive reductions in DD. Practice implications: Interventions to reduce high DD should focus on improving ER and CS. (C) 2019 Elsevier B.V. All rights reserved.

【 授权许可】

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