Dataset Information

The effect of guided self-determination on self-management in persons with type 1 diabetes mellitus and HbA_1c ?64 mmol/mol: a group-based randomised controlled trial.

ABSTRACT:

Objectives

To determine whether the impact of guided self-determination (GSD) applied in group training (GSD-GT) in people with chronically elevated HbA_1c and type 1 diabetes mellitus (DM) was superior to 'care as usual' in improving HbA_1c and psychological functioning.

Setting

An outpatient clinic at a university hospital in Western Norway.

Participants

A total of 178 adults (all Caucasian) aged 18-55 (mean age 36.7±10.7, 62% women) with type 1 DM for at least 1 year and HbA_1c ?64 mmol/mol (8.0%) were randomly assigned to participate in either GSD-GT or a control group (CG). Exclusion criteria were severe comorbidity, major psychiatric disorder, cognitive deficiency/language barriers and pregnancy.

Intervention

Intervention group met seven times for 2 hours over 14 weeks to promote patient autonomy and intrinsic motivation using reflection sheets and advanced professional communication in accordance with the GSD methodology.

Primary and secondary outcome measures

The primary outcome was HbA_1c and secondary outcomes (all outcomes 9 months post intervention) were self-monitored blood glucose frequency, self-reported diabetes competence, autonomy support by healthcare providers (Health Care Climate Questionnaire), autonomous versus controlled diabetes motivation (Treatment Self-Regulation Questionnaire), diabetes distress (Problem Areas In Diabetes Scale (PAID) and Diabetes Distress Scale (DDS)), self-esteem (Rosenberg Self-Esteem Scale) and psychological well-being (World Health Organization five-item Well-Being Index scale).

Results

Among participants allocated to the GSD-GT (=90) 48 completed the study, whereas 83 completed in the CG (n=88). With 95% CIs GSD-GT did not have effect on HbA_1c (B -0.18, CI (-0.48, 0.12), p=0.234). GSD-GT improved autonomy-motivated behaviour (B 0.51, CI (0.25, 0.77), p<0.001), diabetes distress (PAID, B -6.96, CI (-11.40, -2.52), p=0.002), total DDS (B -5.15, CI (-9.34, -0.96), p=0.016), DDS emotional burden (B -7.19, CI (-13.20, -1.19), p=0.019) and self-esteem (B 1.43, CI (0.34, 2.52), p=0.011).

Conclusions

Results from this behavioural intervention must be interpreted cautiously because of recruitment and attrition problems. Medical outcomes did not improve. Psychological outcomes improved, especially reduced diabetes distress.

Trial registration number

Clinical Trials.gov NCT 01317459.

SUBMITTER: Mohn J

PROVIDER: S-EPMC5734217 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Publications

The effect of guided self-determination on self-management in persons with type 1 diabetes mellitus and HbA<sub>1c</sub> ≥64 mmol/mol: a group-based randomised controlled trial.

Mohn Jannike J Graue Marit M Assmus Jõrg J Zoffmann Vibeke V Thordarson Hrafnkell H Peyrot Mark M Rokne Berit B

BMJ open 20170703 6

<h4>Objectives</h4>To determine whether the impact of guided self-determination (GSD) applied in group training (GSD-GT) in people with chronically elevated HbA<sub>1c</sub> and type 1 diabetes mellitus (DM) was superior to 'care as usual' in improving HbA<sub>1c</sub> and psychological functioning.<h4>Setting</h4>An outpatient clinic at a university hospital in Western Norway.<h4>Participants</h4>A total of 178 adults (all Caucasian) aged 18-55 (mean age 36.7±10.7, 62% women) with type 1 DM for ...[more]

PMID: 28674125

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Dataset Information

The effect of guided self-determination on self-management in persons with type 1 diabetes mellitus and HbA_1c ?64 mmol/mol: a group-based randomised controlled trial.

Objectives

Setting

Participants

Intervention

Primary and secondary outcome measures

Results

Conclusions

Trial registration number

Publications

The effect of guided self-determination on self-management in persons with type 1 diabetes mellitus and HbA<sub>1c</sub> ≥64 mmol/mol: a group-based randomised controlled trial.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

The effect of guided self-determination on self-management in persons with type 1 diabetes mellitus and HbA1c ?64 mmol/mol: a group-based randomised controlled trial.

Objectives

Setting

Participants

Intervention

Primary and secondary outcome measures

Results

Conclusions

Trial registration number

Publications

The effect of guided self-determination on self-management in persons with type 1 diabetes mellitus and HbA<sub>1c</sub> ≥64 mmol/mol: a group-based randomised controlled trial.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

The effect of guided self-determination on self-management in persons with type 1 diabetes mellitus and HbA_1c ?64 mmol/mol: a group-based randomised controlled trial.