Diabetes Care, Vol 20, Issue 9 1370-1375, Copyright © 1997 by American Diabetes Association

ARTICLES

Effects of a behavioral intervention on treatment adherence and stress management in adolescents with IDDM

FJ Mendez and M Belendez
Department of Personality, Psychological Assessment and Treatment, University of Murcia, Spain. xmendezc@fcu.um.es

OBJECTIVE: To evaluate the effects of a behavioral program to increase treatment adherence and to improve stress management in adolescents with IDDM. RESEARCH DESIGN AND METHODS: A quasi-experimental pretest-posttest design with a nonequivalent control group was used. Eighteen subjects were assigned to the experimental group, which received the program, while nineteen subjects made up the control group, which received routine medical care. During the 12 intervention sessions with diabetic adolescents, different procedures were applied: instruction, blood glucose discrimination training, role-playing, relaxation exercises, self-instructions, problem-solving strategies, and homework, among others. RESULTS: The results show significant changes in the experimental group in variables related to diabetes information (patients and their parents), adherence, daily hassles, uneasiness and likelihood of response in social interactions, skills and frequency of glycemic analyses, blood glucose estimate errors, and negative family support (parents). The program had no effect on either dietary and physical exercise or glycemic control. The improvements, which were maintained at a follow-up carried out 13 months after finishing the program, were: patients' information about physiopathology (P = 0.000), diet (P = 0.000), physical exercise (P = 0.048), glucose testing (P = 0.030), and insulin (P = 0.000), barriers to adherence frequency (P = 0.000), severity of daily hassles (P = 0.006), and degree of uneasiness in social interaction (P = 0.000). CONCLUSIONS: This research introduces the novelty of integrating several behavioral procedures within a wide-ranging package that affects aspects implied in diabetes control such as treatment adherence and stress management. The testing of similar programs on samples of subjects with glycemic control difficulties would be useful.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S. Kahana, D. Drotar, and T. Frazier Meta-Analysis of Psychological Interventions to Promote Adherence to Treatment in Pediatric Chronic Health Conditions J. Pediatr. Psychol., July 1, 2008; 33(6): 590 - 611. [Abstract] [Full Text] [PDF]

				P. S. Odegard and K. Capoccia Medication Taking and Diabetes: A Systematic Review of the Literature The Diabetes Educator, November 1, 2007; 33(6): 1014 - 1029. [Abstract] [Full Text] [PDF]

				E. B. Fisher, C. T. Thorpe, B. M. DeVellis, and R. F. DeVellis Healthy Coping, Negative Emotions, and Diabetes Management: A Systematic Review and Appraisal The Diabetes Educator, November 1, 2007; 33(6): 1080 - 1103. [Abstract] [Full Text] [PDF]

				T. R. Nansel, R. J. Iannotti, B. G. Simons-Morton, C. Cox, L. P. Plotnick, L. M. Clark, and L. Zeitzoff Diabetes Personal Trainer Outcomes: Short-term and 1-year outcomes of a diabetes personal trainer intervention among youth with type 1 diabetes Diabetes Care, October 1, 2007; 30(10): 2471 - 2477. [Abstract] [Full Text] [PDF]

				F. J. Cameron, E. A. Northam, G. R. Ambler, and D. Daneman Routine Psychological Screening in Youth With Type 1 Diabetes and Their Parents: A notion whose time has come? Diabetes Care, October 1, 2007; 30(10): 2716 - 2724. [Full Text] [PDF]

				T. Wysocki Behavioral Assessment and Intervention in Pediatric Diabetes Behav Modif, January 1, 2006; 30(1): 72 - 92. [Abstract] [PDF]

				D. A. Ellis, M. A. Frey, S. Naar-King, T. Templin, P. B. Cunningham, and N. Cakan The Effects of Multisystemic Therapy on Diabetes Stress Among Adolescents With Chronically Poorly Controlled Type 1 Diabetes: Findings From a Randomized, Controlled Trial Pediatrics, December 1, 2005; 116(6): e826 - e832. [Abstract] [Full Text] [PDF]

				C. Lloyd, J. Smith, and K. Weinger Stress and Diabetes: A Review of the Links Diabetes Spectr, April 1, 2005; 18(2): 121 - 127. [Abstract] [Full Text] [PDF]

				N. van der Ven Psychosocial Group Interventions in Diabetes Care Diabetes Spectr, April 1, 2003; 16(2): 88 - 95. [Abstract] [Full Text] [PDF]

				D. A. Murphy, M. Sarr, S. J. Durako, A.-B. Moscicki, C. M. Wilson, L. R. Muenz, and for the Adolescent Medicine HIV/AIDS Research Netw Barriers to HAART Adherence Among Human Immunodeficiency Virus-Infected Adolescents Arch Pediatr Adolesc Med, March 1, 2003; 157(3): 249 - 255. [Abstract] [Full Text] [PDF]

				A. M. Delamater, A. M. Jacobson, B. Anderson, D. Cox, L. Fisher, P. Lustman, R. Rubin, and T. Wysocki Psychosocial Therapies in Diabetes: Report of the Psychosocial Therapies Working Group Diabetes Care, July 1, 2001; 24(7): 1286 - 1292. [Abstract] [Full Text] [PDF]

				K. B. Johnson, R. D. Ravert, and A. Everton Hopkins Teen Central: Assessment of an Internet-Based Support System for Children With Cystic Fibrosis Pediatrics, February 1, 2001; 107(2): 24e - 24. [Abstract] [Full Text]

				R. E. Glasgow, D. J. Toobert, and C. D. Gillette Psychosocial Barriers to Diabetes Self-Management and Quality of Life Diabetes Spectr, January 1, 2001; 14(1): 33 - 41. [Abstract] [Full Text] [PDF]

				M. Orey, S. Kanner, and K. O. Lacey Characteristics of the Learner: Children and Adolescents The Diabetes Educator, November 1, 1999; 25(6_suppl): 25 - 33. [Abstract] [PDF]