Psychological Models To Help Understand Selfmanagement

The psychological literature has investigated in considerable detail the beliefs that predict a person's intention to engage in a health-enhancing behaviour. These models can help guide the clinician in terms of the most relevant topics to explore. The Health Belief Model (Figure 5.3), proposed by Becker65, argues that people acquire beliefs about perceived disease severity, susceptibility and the perceived benefits over barriers for change these combine to increase the 'likelihood of taking...

Cognitivebehavioural Therapy

A clinical model that is used in psychotherapy to modify cognitions (the way a person interprets events), was developed by A.T. Beck, the founder of cognitive-behavioural therapy. This model can be helpful in understanding and modifying the beliefs of people with diabetes. Cognitive therapy, originally developed to treat depression45 and anxiety46, has been successfully applied to a wide array of psychological problems, ranging from personality disorders to eating disorders and substance...

References

Pregnancy and diabetes. In Alberti KGMM, Krall L (eds) Diabetes Annual 1. Amsterdam Elsevier 1985 238-45 2. Greene MF. Congenital malformations. In Hare JW (ed) Diabetes Complicating Pregnancy the Joslin Clinic Method. New York Alan R Liss, 1989 147-61 3. Leslie RDG, John PN, Pyke DA, White JM. Haemoglobin A1 in diabetic pregnancy. Lancet 1978 ii 292-93 4. Miller E, Hare JW, Cloherty JP et al. Elevated maternal haemoglobin Ale in early pregnancy and major eongenital...

Bgatrecent Studies

The above studies demonstrate clearly the efficacy of BGAT and also suggest that certain patients may be especially likely to benefit from the intervention, i.e. those patients who have more difficulty recognizing BG symptoms and other cues. To further enhance the efficacy of BGAT for this patient population, the next version BGAT-II made two significant changes a the addition of three chapters devoted exclusively to external cues insulin, food and physical activity and b more structured...

Coping Skills Training As An Element Of Comprehensive Group Diabetes Psychoeducation

An intervention based on the diabetes-specific coping skills training model I have just described has also been incorporated into the comprehensive 5 day 37 hour outpatient education programme offered by the Johns Hopkins Diabetes Center at the Johns Hopkins Hospital in Baltimore. Over 3000 participants have completed this programme since its inception in 1984. The programme is taught by a multidisciplinary team of health care providers, including mental health professionals who offer...

Info

Some stress-responsive individuals with type 1 diabetes ' ' . Recent studies suggest that psychotherapy and pharmacotherapy may relieve emotional distress in people with diabetes who suffer from depression and anxiety disorder, just as these treatments relieve symptoms in those who do not have diabetes54'65'69. Finally, we find some evidence for the effectiveness of comprehensive approaches to treating acute medical crises and eating disorders in young people with diabetes84-86'89. These...

Relaxation Training Can Improve Glucose Tolerance And Reduce Longterm Hyperglycaemia

A variety of studies over the past two decades support the notion that improving stress management or coping skills can improve self-care, metabolic outcomes and quality of life. For example, several studies of people with type 2 diabetes generally report improved glucose tolerance and reduced long-term hyperglycaemia following biofeedback-assisted relaxation training BART - 0. Evidence for the effectiveness of BART in people with type 1 diabetes is less conclusive. While several studies11,12...

Psychosocial Development And Diabetes In The Schoolaged Child

The primary developmental tasks of the child during the elementary school years include making a smooth adjustment from the home to the school setting forming close friendships with children of the same sex obtaining approval from this peer group developing new intellectual, athletic and artistic skills and evaluating him herself positively when comparing his her abilities to those of the peer group12'13. Psychological development in school-aged children is assessed primarily with respect to...

Introduction

Diabetes pregnancy has long been associated with a high risk of fetal malformations, spontaneous abortions, stillbirths, macrosomia and neonatal mortality and morbidity1'2. It was not until the introduction of glycated haemoglobin assays in the late 1970s that it became clear that the increased risk of major congenital abnormality in diabetic women was to a large extent determined by poor glycaemic control in early pregnancy3. Since then, several studies have demonstrated that near-normal...

Implications And Future Directions

Given the solid body of empirical evidence that BGAT is effective, the next important question from a clinical perspective is what types of patients should be considered for this intervention The specific effects demonstrated in studies of BGAT suggest that several patient groups are most likely to benefit, which are shown in Table 7.6. For example, BGAT improves detection of low BG, reduces the frequency of severe hypoglycaemia, and may preserve the integrity of hormonal counter-regulation...

Staff Attitudes

Poor levels of compliance can be difficult for staff, given both the pressure of meeting targets set by national and international bodies19 and the relentless reminder of risk from complications demonstrated in patients with whom staff may have had long and established relationships. This can result in negative and detrimental attitudes towards 'non-compliant' patients, which can have a deleterious effect on rapport, patients' self-esteem and motivation. Staff could be in danger of assuming...

The Transtheoretical Model Of Behaviour Change

Model Trans Theoretical Change

Prochaska and DiClemente54 investigated the process of change in an observational study that followed smokers who were attempting to stop independently. They observed that individuals went through a number of discernible stages in the change process, which led to the Transtheoretical Model of Change Figure 5.2 . Six stages of readiness were described precontemplation, contemplation, determination, action, maintenance and relapse. Each stage represents an amalgamation of attitudes, intentions...

Obstacles To Metabolic Control Of Children And Adolescents With Insulin Dependent Diabetes Mellitus

Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993 329 97786 2. Diabetes Control and Complications Trial Research Group. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus Diabetes Control and Complications Trial. J...

Psychotherapy In Diabetes Mellitus Thesis.com

The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993 329 14 977-86 2. Ruggiero L, Glasgow RE, Dryfoos JM, Rossi JS, Prochaska JO, Orleans CT, Prokhorov AV, Rossi SR, Greene GW, Reed GR, Kelly K, Chobanian L, Johnson S. Diabetes self-management. Self-reported recommendations and patterns in a large population. Diabet Care 1997 2o 4 568-76 3. Lazarus RS, Folkman...