Monitoring and discussing health-related quality of life in adolescents with type 1 diabetes improve psychosocial well-being - A randomized controlled trial

被引:172
作者
De Wit, Marrtje [1 ,2 ]
De Waal, Henriette A. Delemarre-Van [3 ,4 ]
Bokma, Jan Alle [5 ]
Haasnoot, Krijn [6 ]
Houdijk, Mieke C. [7 ]
Gemke, Reinoud J. [3 ]
Snoek, Frank J. [1 ,2 ]
机构
[1] Vrije Univ Amsterdam, Med Ctr, Dept Med Psychol, Amsterdam, Netherlands
[2] Vrije Univ Amsterdam, Med Ctr, EMGC Inst, Amsterdam, Netherlands
[3] Vrije Univ Amsterdam, Med Ctr, Dept Pediat, Amsterdam, Netherlands
[4] Vrije Univ Amsterdam, Med Ctr, Inst Clin Expt Neurosci, Amsterdam, Netherlands
[5] Spaarne Ziekenhuis, Dept Pediat, Hoofddorp, Netherlands
[6] Med Ctr, Dept Pediat, Alkmaar, Netherlands
[7] Juliana Kinderziekenhuis, Dept Pediat, The Hague, Netherlands
关键词
D O I
10.2337/dc08-0394
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE- To test the effects Of monitoring and discussing of health-related quality of life (HRQoL) in adolescents with type 1 diabetes in a Multicenter randomized controlled trial. RESEARCH DESIGN AND METHODS - Four centers were randomly assigned to the HRQoL intervention (46 adolescents) or control (45 adolescents) group, with three regular Visits scheduled Within 12 months in both groups. In the HRQoL intervention group, HRQoL of adolescents was assessed using the Pediatric Quality of Life Inventory, and outcomes were discussed face-to-face during the consultation. The control group received care as usual. Mean differences between the groups at 12 months in physical and psychosocial well-being (Child Health Questionnaire [CFQ]-CF87/PF50, Diabetes-Specific Faintly Conflict Scale, and Center for Epidemiological Studies Scale for Depression), satisfaction with care (Patients' Evaluation Of the Quality of Diabetes Care), and A I C were determined, controlling for baseline scores. RESULTS - Mean scores on the CHQ subscales of psychosocial health (P < 0.001), behavior (P < 0.001), Mental health (P < 0.001), and faintly activities (P < 0.001) improved in the HRQoL intervention group, except for adolescents With the highest A I C values. Adolescents in the HRQoL intervention group reported higher self-esteem (CHQ) at follow-up (P = 0.016), regardless of AlC, and were more satisfied with care (P = 0.009) than control subjects. No significant differences between the two groups over time were observed in AlC levels. CONCLUSIONS - Periodic monitoring and discussion of HRQoL in adolescents with diabetes is appreciated and has positive effects on their psychosocial well-being, except for those in poorest control.
引用
收藏
页码:1521 / 1526
页数:6
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