Cognitive behavioural group training (CBGT) for patients with type 1 diabetes in persistent poor glycaemic control: who do we reach?

• Published in: Patient education and counseling Vol. 56; no. 3; pp. 313 - 322
• Main Authors: van der Ven, Nicole C.W., Lubach, Caroline H.C., Hogenelst, Marloes H.E., van Iperen, Ada, Tromp-Wever, Anita M.E., Vriend, Annelies, van der Ploeg, Henk M., Heine, Robert J., Snoek, Frank J.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.03.2005
• Subjects: Adaptation, Psychological; Adolescent; Adult; Behavioural intervention; Cognitive Therapy - organization & administration; Cost of Illness; Depression - diagnosis; Depression - etiology; Depression - prevention & control; Diabetes; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - metabolism; Diabetes Mellitus, Type 1 - prevention & control; Diabetes Mellitus, Type 1 - psychology; Female; Follow-Up Studies; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Motivation; Negativism; Netherlands; Nursing; Outpatient Clinics, Hospital; Patient Compliance - psychology; Psychotherapy, Group - organization & administration; Quality of Life; Reach; Self Care - psychology; Self Care - standards; Stress, Psychological - diagnosis; Stress, Psychological - etiology; Stress, Psychological - prevention & control; Netherlands; Reach; Behavioural intervention; Diabetes
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2004.03.005

Approximately a quarter of adults with type 1 diabetes do not succeed in achieving satisfactory glycaemic control, partly due to problems with the demanding self-management regimen. To improve glycaemic control, interventions with a cognitive behavioural approach, aimed at modifying dysfunctional beliefs, reducing negative emotions and enhancing self-care practices are a potentially successful tool. Little is known about the reach of such an approach. This article describes characteristics of participants in a randomized, controlled trial of cognitive behavioural group training for patients with type 1 diabetes in poor glycaemic control. Results show that outpatients from seven hospitals in the area of Amsterdam, selected on long-standing high HbA1c and volunteering to participate, report high levels of psychological distress and depressive symptoms. Furthermore, self-care behaviours were perceived as important, but burdensome. Diabetes-specific self-efficacy was relatively low. It is concluded that this selected group of adults with type 1 diabetes would potentially benefit from a cognitive-behavioural intervention in order to reduce negative emotions, enhance diabetes self-efficacy, self-care behaviour and glycaemic outcomes.