Problem-solving therapy for adults with diabetic retinopathy and diabetesspecific distress: a pilot randomized controlled trial
AuthorRees, G; O'Hare, F; Saeed, M; Sudholz, B; Sturrock, BA; Xie, J; Speight, J; Lamoureux, EL
Source TitleBMJ Open Diabetes Research and Care
PublisherBMJ PUBLISHING GROUP
AffiliationMelbourne School of Population and Global Health
Ophthalmology (Eye & Ear Hospital)
Document TypeJournal Article
CitationsRees, G., O'Hare, F., Saeed, M., Sudholz, B., Sturrock, B. A., Xie, J., Speight, J. & Lamoureux, E. L. (2017). Problem-solving therapy for adults with diabetic retinopathy and diabetesspecific distress: a pilot randomized controlled trial. BMJ OPEN DIABETES RESEARCH & CARE, 5 (1), https://doi.org/10.1136/bmjdrc-2016-000307.
Access StatusOpen Access
ARC Grant codeARC/LP0884108
OBJECTIVE: To provide preliminary evidence for the impact of problem-solving therapy for diabetes (PST-D) in adults with diabetic retinopathy (DR) and diabetes distress. RESEARCH DESIGN AND METHODS: In a pilot randomized controlled trial, 40 participants with DR and diabetes distress were allocated to the PST-D or control groups. Diabetes distress (DDS), depressive symptoms (PHQ-9), self-care activities (SDSCA), and HbA1c were assessed at baseline, and 3 and 6-month follow-ups. RESULTS: At the 6-month follow-up, the PST-D group showed significant improvements relative to the control group, in 'regimen-related distress' (PST-D: -1.3±1.4; control: -0.4±1.1), depressive symptoms (PST-D: -4.3±6.1; control: -0.3±4.6), and HbA1c (PST-D: -1.2%±1.01; control: 0.2%±1.2%) (all p<0.05). In multiple regression analysis, adjusting for baseline values and sociodemographic factors, PST-D was associated with significant improvement in 'regimen-related distress', depressive symptoms, and HbA1c at the 6-month follow-up (p<0.05). CONCLUSIONS: PST-D is a promising intervention for improving psychological outcomes and glycemic control. A fully powered study is required to confirm these findings and examine mechanisms of change in HbA1c. TRIAL REGISTRATION NUMBER: ACTRN12616001010482; results.
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