Effects of a Mindfulness Intervention Delivered within Diabetes Education on Diabetes-related Outcomes in Military Veterans

糖尿病教育中的正念干预对退伍军人糖尿病相关结果的影响

• 批准号: 10179480
• 负责人: MONICA DINARDO
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10179480
• 关键词: Adherence; Affect; Attention; Awareness; Behavior; Behavioral; Blindness; Blood Glucose; Cardiovascular Diseases; Caring; Chronic; Complementary and alternative medicine; Coping Skills; Data; Diabetes Mellitus; Discipline of Nursing; Disease Management; Distress; Education; Educational Curriculum; Educational Intervention; Family; Fostering; Frequencies; Fright; Glycosylated hemoglobin A; Health; Healthcare; Hour; Hypoglycemia; Impairment; Individual; Informal Social Control; Interpersonal Relations; Intervention; Investigation; Kidney Failure; Laboratories; Lead; Learning; Life Style Modification; Lower Extremity; Measures; Medication Management; Metabolic; Metabolic Control; Methods; Military Personnel; Mind; Mind-Body Intervention; Mindfulness Training; Modeling; Morbidity - disease rate; Nurse Practitioners; Nurses; Nursing Research; Outcome; Participant; Patient Self-Report; Problem Solving; Questionnaires; Randomized; Randomized Controlled Trials; Regimen; Request for Proposals; Research; Research Personnel; Risk; Risk Reduction; Sampling; Self Care; Self Efficacy; Strategic Planning; Stress; Telephone Interviews; Testing; Time; Training; Training Programs; Training and Education; Veterans; blood glucose regulation; coping; design; diabetes control; diabetes education; diabetes educator; diabetes self-management; disorder prevention; education research; emotional distress; evidence base; experience; experimental group; glycemic control; health administration; improved; innovation; intervention effect; limb amputation; mindfulness; mindfulness intervention; mortality; patient oriented; post intervention; primary outcome; programs; psychological distress; satisfaction; secondary outcome; skills; stress management; stress reactivity; stress reduction; theories; treatment as usual

 DESCRIPTION (provided by applicant): Twenty-five percent of military Veterans who receive care through the Veterans Health Administration (VHA) have diabetes, making support for diabetes self-management a priority. However, diabetes-related distress resulting from daily self-care tasks affects up to 40% of people with diabetes, placing them at risk for impaired diabetes self-management, decreased metabolic control, and higher morbidity and mortality. Emerging research suggests that mindfulness, a mind-body therapy studied in a variety of chronic health conditions over the past 30-years, helps to reduce emotional distress and may improve diabetes outcomes. The objectives of this study are to examine the effects of a program of mindfulness training and practice, provided as part of diabetes education, which we call Mind-STRIDE (Mindful Stress Reduction in Diabetes Education), on psycho- behavioral and glycemic outcomes including: 1) mindfulness, 2) diabetes-related distress, 3) diabetes self- efficacy, 4) diabetes self-management, and 5) glycemic control. We will also explore Veterans' satisfaction and experiences with mindfulness training and practice. To achieve these objectives, we will conduct a mixed- methods randomized controlled trial of 126 Veterans randomly assigned to either the experimental condition that receives routine diabetes education plus Mind-STRIDE, or to usual care that receives diabetes education alone. Quantitative outcomes will be measured by subjective questionnaires except for hemoglobin A1c, which will be assessed through standard laboratory methods. Data will be collected at baseline, 12-weeks, and 24- weeks, and will be analyzed by mixed-effects modeling. Qualitative telephone interviews will be conducted at 15-weeks in a subset of participants from the experimental group, and will be analyzed using modified Grounded Theory methods. Quantitative and qualitative findings will be compared and interpreted using Convergent Parallel Design. By examining the acceptance and effects of mind-body interventions like Mind- STRIDE among Veterans who have chronic health conditions such as diabetes, the VA will benefit from new evidence-based, patient-centered approaches that support self-care.

 描述（由申请人提供）： 通过退伍军人卫生管理局（VHA）接受护理的军事退伍军人中有25％的退伍军人患有糖尿病，因此优先考虑糖尿病自我管理。但是，每日自我保健任务引起的糖尿病相关困扰会影响多达40％的糖尿病患者，使他们面临糖尿病自我管理受损，代谢控制降低以及更高的发病率和死亡率的风险。新兴的研究表明，正念是过去30年来在各种慢性健康状况下研究的思维疗法，有助于减少情绪困扰，并可能改善糖尿病结果。这项研究的目的是研究作为糖尿病教育的一部分，我们称之为思维障碍（糖尿病教育的正念压力），对心理行为和血糖的结果的影响，包括：1）正念，2）与糖尿病相关的糖尿病，3）糖尿病，3）糖尿病，糖尿病，糖症，糖尿病及其糖尿病。我们还将在正念培训和实践中探索退伍军人的满意度和经验。为了实现这些目标，我们将对126名退伍军人的随机对照试验进行随机分配给接受常规糖尿病教育的实验疾病，或者单独接受糖尿病教育的常规护理。除血红蛋白A1C外，定量结果将通过主观问卷进行测量，该问卷将通过标准实验室方法进行评估。数据将在基线，12周和24周内收集，并将通过混合效应建模进行分析。定性电话访谈将在实验组的一部分参与者的15周中进行，并将使用修改的接地理论方法进行分析。使用收敛并行设计比较定量和定性发现。通过检查具有慢性健康状况（例如糖尿病）的退伍军人中思维迈进的心理干预措施的接受和影响，VA将受益于支持自我保健的新的基于循证的，以患者为中心的方法。