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Change in self-rated general health is associated with perceived illness burden: a 1-year follow up of patients newly diagnosed with type 2 diabetes.

https://arctichealth.org/en/permalink/ahliterature267908
Source
BMC Public Health. 2015;15:439
Publication Type
Article
Date
2015
Author
Anni Brit Sternhagen Nielsen
Per Jensen
Dorte Gannik
Susanne Reventlow
Hanne Hollnagel
Niels de Fine Olivarius
Source
BMC Public Health. 2015;15:439
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - etiology
Cost of Illness
Denmark
Diabetes Mellitus, Type 2 - complications - diagnosis - psychology - therapy
Diagnostic Self Evaluation
Female
Follow-Up Studies
Health Behavior
Health status
Humans
Life Style
Male
Middle Aged
Self Report
Abstract
Diabetic patients' lifestyle adaptations to improve glycaemic control are not always followed by improvements in self-rated general health (SRH). The perceived impact of diabetes on patients' daily lives may influence changes in their SRH. This paper examines the association of illness severity, treatment, behavioural, and coping-related factors with changes in SRH from diagnosis of type 2 diabetes until one year later, in a population-based sample of 599 patients aged 40 years or over who were treated in general practice.
Change in SRH was estimated by a cumulative probit model with the inclusion of covariates related to SRH (e.g. illness severity at diagnosis, behaviour, treatment, and the perceived impact of diabetes on patients' daily lives one year later).
At diagnosis, 11.6% of patients reported very good, 35.1% good, 44.6% fair and 8.5% poor SRH. Physical inactivity, many diabetes-related symptoms, and cardiovascular disease were related to lower SRH ratings. On average SRH improved by 0.46 (95% CI: 0.37; 0.55) during the first year after diagnosis without inclusion of covariates. Mental and practical illness burden was the only factor associated with change in SRH, independent of patients' diabetes severity and medical treatment (p = 0.03, multivariate analysis). Compared to otherwise similar patients without illness burden, increase in SRH was marginally smaller among patients who expressed minor illness burden, but much smaller among patients with more pronounced illness burden.
Much as one would expect, many patients increased their SRH during the first year after diabetes diagnosis. This increase in SRH was not associated with indicators of illness severity or factors reflecting socio-demographic circumstances, but patients experiencing illness burden had a smaller increase than those who reported no illness burden. We suggest that during the diabetes consultation, general practitioners explore further how patients manage their illness burden. We further suggest that diabetes guidelines extend their current focus on clinical and social aspects of diabetes to include questions on patient's perceived illness burden and SRH.
Notes
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PubMed ID
25924731 View in PubMed
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Effect on motivation, perceived competence, and activation after participation in the ''Ready to Act'' programme for people with screen-detected dysglycaemia: a 1-year randomised controlled trial, Addition-DK.

https://arctichealth.org/en/permalink/ahliterature135966
Source
Scand J Public Health. 2011 May;39(3):262-71
Publication Type
Article
Date
May-2011
Author
Helle Terkildsen Maindal
Annelli Sandbæk
Marit Kirkevold
Torsten Lauritzen
Author Affiliation
Section for General Medical Practice, School of Public Health, Aarhus University, Aarhus, Denmark. htm@alm.au.dk
Source
Scand J Public Health. 2011 May;39(3):262-71
Date
May-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood Glucose - analysis
Cardiovascular Diseases - prevention & control
Denmark
Diabetes Mellitus, Type 2 - complications - diagnosis - psychology - therapy
Female
Glucose Intolerance - complications - diagnosis - psychology - therapy
Health Behavior
Health promotion
Humans
Male
Mass Screening
Middle Aged
Patient Education as Topic
Patient Participation
Program Evaluation
Questionnaires
Risk factors
Self Care
Abstract
To investigate the reach of the ''Ready to Act'' programme and the 1-year effects on psychological determinants of healthy behaviour: motivation, perceived competence, and activation level.
A total of 509 adults with dysglycaemia were recruited from general practioners (GPs) in the intensive arm of the Danish Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION) study, a type 2 diabetes screening programme. The participants were randomised to the ''Ready to Act'' programme added on top of GP care (n = 322) or to GP care (n = 187). The core components of the programme were motivation, action experience, informed decision-making, and social involvement conducted in two one-to-one sessions and eight group-meetings (18 hours). The reach of the programme was measured by the proportion of people who signed up. Outcomes were changes in treatment motivation (Treatment Self-Regulation Questionnaire, TSRQ), perceived competence (Perceived Competence Scale, PCS), and activation in chronic care (Patient Activation Measure, PAM). Effect size was the difference between 1-year changes in the randomisation groups analysed by intention-to-treat.
A total of 142 (44%) of 322 signed up and 123 (87%) of these completed. At 1 year, the difference in autonomous motivation for behavioural treatment (TSRQ) between the randomisation groups was 1.0 (95% CI 0.1 to 2.0), and the difference in perceived competence changes in healthy diet (PCS-d) was 1.5 (95% CI 0.2 to 2.7). No differences were observed for activation (PAM) between the groups. Subgroup analysis revealed men to benefit more from the intervention than women.
The programme is a promising health-promoting component in prevention and care for people with screen-detected dysglycaemia, as it attracted four of 10 people and had effects on motivation and perceived competence.
PubMed ID
21427147 View in PubMed
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