Mindfulness: a novel approach for the management of diabetes-related distress

正念：管理糖尿病相关困扰的新方法

• 批准号: 7916336
• 负责人: Laura A Young
• 金额: $ 0.81万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7916336
• 关键词: Adult; Attention; Awareness; Behavior Therapy; Behavioral; Blood Pressure; Caring; Chronic; Chronic Disease; Complex; Control Groups; Coping Skills; Data; Development; Diabetes Mellitus; Disease; Disease Management; Distress; Emotional; Emotions; Endocrinology; Epidemic; Epidemiology; Esthesia; Etiology; Face; Feeling; Fellowship; Fostering; Functional disorder; Future; Glucose; Goals; Guilt; Hand; Health Personnel; Health education; Hypotension; Inflammation; Instruction; Integrative Medicine; Interruption; Intervention; Lead; Life; Life Style; Living Wills; Measures; Mediating; Mediator of activation protein; Medical; Meditation; Mentors; Metabolic; Metabolic Control; Metabolism; Mind-Body Intervention; Modeling; Morbidity - disease rate; Neurosecretory Systems; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Patients; Physicians; Physiological; Play; Prevention; Principal Investigator; Quality of life; Randomized Clinical Trials; Reporting; Research; Role; Scientist; Self Care; Self Management; Stress; Structure; Sympathetic Nervous System; Teaching Method; Techniques; Testing; Thinking; Training; Up-Regulation; adverse outcome; base; biological adaptation to stress; blood pressure regulation; career; career development; design; diabetes management; efficacy testing; emotional distress; experience; falls; fighting; flexibility; glucose metabolism; hypothalamic-pituitary-adrenal axis; improved; mindfulness; mindfulness meditation; mindfulness-based stress reduction; mortality; novel; novel strategies; planetary Atmosphere; post intervention; programs; psychologic; psychological distress; psychological outcomes; public health relevance; self reliance; stem; stressor; tool

DESCRIPTION (provided by applicant): Forty percent of adults with type 2 diabetes (T2DM) report disease-related psychological distress. The cultivation of mindfulness through Mindfulness Based Stress Reduction (MBSR) has been shown to improve emotional distress in a variety of chronic diseases; however, this promising mind body therapy has not been rigorously tested in patients with T2DM. During this mentored career development proposal, Dr. Young will enhance her prior training in epidemiology and endocrinology by pursuing a practical, hands-on research experience. She will develop an expertise In the utilization of mind-body therapies in research through active participation in seminars, academic retreats and completion of a two-year Integrative medicine fellowship. The overarching hypothesis guiding this proposal is that modulation of the stress reaction through training in mindfulness meditation will lead to Improvements In physiologic and psychological outcomes in patients with T2DM. Dr Young Is proposing a randomized, clinical trial evaluating the Impact of the standard 8-week MBSR program, compared to a health education control, on glucose metabolism, blood pressure, diabetes- related distress and quality of life in adults with T2DM who have moderate to severe levels of diabetes- related emotional distress. Additionally, she will investigate the role of neuroendocrine dysfunction, systemic inflammation and diabetes self-care practices as mediators in the relationship between increased stress, adverse glucose metabolism and elevated blood pressure. The combination of an outstanding mentoring team, highly supportive research atmosphere, inter-disciplinary training, thoughtfully designed training strategy and novel research plan provides an optimal setting for Dr. Young to pursue her long-term career goal of becoming a successful, independent, physician-scientist examining the utility of mind-body therapies as adjunctive treatments to current medical care in patients with diabetes and obesity. PUBLIC HEALTH RELEVANCE: Given its potential to foster the development of self-reliance, improved coping skills and healthier lifestyles, mindfulness meditation may be beneficial for patients with T2DM who are unable to manage the stress that accompanies living with this disease. If proven to be safe and efficacious, health care providers will have an important tool at their disposal in the fight to decrease morbidity and mortality in patients with T2DM.

描述（由申请人提供）：40% 的 2 型糖尿病 (T2DM) 成人患者报告有与疾病相关的心理困扰。通过基于正念的减压（MBSR）培养正念已被证明可以改善多种慢性疾病引起的情绪困扰；然而，这种有前景的身心疗法尚未在 T2DM 患者中经过严格测试。在这项受指导的职业发展建议中，杨博士将通过追求实用的实践研究经验来加强她之前在流行病学和内分泌学方面的培训。她将通过积极参与研讨会、学术静修和完成两年的综合医学奖学金，发展在研究中运用身心疗法的专业知识。指导该提议的总体假设是，通过正念冥想训练调节压力反应将改善 T2DM 患者的生理和心理结果。 Young 博士提议开展一项随机临床试验，评估标准 8 周 MBSR 计划与健康教育对照相比，对患有中度 2 型糖尿病的成年人的葡萄糖代谢、血压、糖尿病相关痛苦和生活质量的影响。严重程度的糖尿病相关情绪困扰。此外，她还将研究神经内分泌功能障碍、全身炎症和糖尿病自我护理实践在压力增加、葡萄糖代谢不良和血压升高之间关系中的调节作用。优秀的指导团队、高度支持的研究氛围、跨学科培训、精心设计的培训策略和新颖的研究计划相结合，为杨博士追求成为一名成功、独立的医生的长期职业目标提供了最佳环境-科学家正在研究身心疗法作为糖尿病和肥胖患者当前医疗护理的辅助疗法的效用。 公共健康相关性：鉴于正念冥想有可能促进自力更生、提高应对技能和更健康的生活方式，因此对于无法应对这种疾病带来的压力的 T2DM 患者可能有益。如果被证明是安全有效的，医疗保健提供者将拥有一个重要的工具来降低 T2DM 患者的发病率和死亡率。