Self-management is an important part of diabetes treatment, but the promotion of self-care activities is still a challenge. In this study, we explored how living with diabetes in everyday life was experienced following a self-management intervention program based on motivational interviewing. We conducted seven focus group interviews, each comprising 3 to 5 participants diagnosed with type 1 or type 2 diabetes. Data analysis based on a phenomenological method revealed three main themes concerning diabetes self-management: becoming a self-regulating practitioner, managing the rules of self-management, and creating a supportive social network. Narrative analysis revealed a divergence in patients' self-perceived competence in handling diabetes. The study findings indicate that people with diabetes have specific needs for support in the daily responsibility of managing diet, exercise, medication, and blood glucose monitoring. A meaningful treatment from the patient's perspective would appear to be one aimed at overcoming problems the patient experiences in self-management of diabetes.
Aims/hypothesis The aim of this study was to measure the efficacy of motivational interviewing (MI) compared with usual care on changes in glycaemic control and competence of diabetes self-management in patients with diabetes mellitus.Methods Patients were eligible if they had type 1 or 2 diabetes mellitus, were over 18 years of age and had participated in a 4 day group education programme offered at a diabetes clinic at a university hospital in Denmark. Exclusion criteria included pregnancy, severe debilitating disease and cognitive deficit. Out of 469 patients who attended the group education programme, 349 patients were randomised to either a usual care control group or an intervention group, which received up to five individual counselling sessions in 1 year based on MI, in addition to usual care. A randomised parallel design was used and openlabel allocation was done by random permuted blocks, with allocation concealment by sequentially numbered, sealed, opaque envelopes. The primary outcome was glycated haemoglobin (HbA 1c ). Analysis regarding measurements of glycated haemoglobin (HbA 1c ) and competence of selfmanagement (using the Problem Areas in Diabetes Scale [PAID] and Perceived Competence for Diabetes Scale [PCDS]) was based on 298 participants followed for a 24 month period. Data were collected at the Department of Endocrinology at Odense University Hospital. Our hypotheses were that MI could: (1) reduce HbA 1c levels; (2) increase self-efficacy; and (3) increase diabetes self-care, compared with usual care. Results Out of the 176 included in the control group and 173 in the intervention group, 153 and 145 were analysed in the groups, respectively. When using the baseline value as covariate there were no significant differences in change score between the two study groups with regard to mean level of HbA 1c (0.131, p=0.221), PAID scores (−1.793, p=0.191) or PCDS scores (0.017, p=0.903) at the 24 month follow-up, using a mixed effects regression model. TheElectronic supplementary material The online version of this article
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