BackgroundDepression is twice as common in people with diabetes, and this comorbidity worsens the course of both pathologies. In clinical practice guidelines, screening and treatment of depression in patients with diabetes are highly recommended. However, depression is still both underrecognized and undertreated. To find ways to enhance their reach, psychological treatments have taken advantage of benefits of internet and technological devices as delivery formats, providing interventions that require considerably less (or even no) interaction time with therapists. Web-based treatments hold promise for effective interventions at low cost with positive results.ObjectiveThe objectives of this review were to describe Web-based interventions for depression in individuals with diabetes and to discuss these studies’ procedures and findings in light of evidence from a wider range of interventions for depression and diabetes.MethodsA comprehensive literature search was conducted in PsycINFO and MEDLINE electronic databases. Studies were included when they met the following selection criteria: the study was available in a peer-reviewed journal mainly publishing studies written in either English or Spanish; the studied sample comprised individuals with diabetes; the intervention targeted depression symptomatology; the intervention was accessible via the internet; and the intervention was accessible via the internet with little or no clinician support.ResultsOverall, 5 research studies were identified in the review. All studies were randomized controlled trials, and most used a wait list as a control; 4 studies reported treatment dropout, rates of which varied from 13% to 42%. Studies supported the notion that the Web-based format is a suitable psychology service delivery option for diabetic individuals with depression (effect size range for completers 0.7-0.89). Interventions varied in their characteristics but most were clinical-assisted, had a cognitive behavioral therapy approach, used diabetes-specific topics, had a weekly modular display, used homework assignments, and had some adherence management strategy. These characteristics are consistent with the intervention features associated with positive results in the literature.ConclusionsThe analyzed studies’ findings and procedures are discussed in light of evidence drawn from a wider range of reviews on Web-based interventions for depression and diabetes. Consistent with previous research on depression treatment, Web-based interventions for depression among individuals with diabetes have shown positive results. Future research should contribute new evidence as to why these interventions are effective, for whom, and which particular aspects can increase patients’ adherence.

Objetivo: conocer la experiencia de personas con diabetes mellitus o hipertensión, pertenecientes a un programa de telemonitoreo. Método: diseño cualitativo a través de grupos focales a usuarios del Servicio de Salud Pública en Santiago de Chile. Participaron 46 personas distribuidas en 10 grupos. Resultados: estos se orientan a los beneficios percibidos de participar en el programa: promoción de rutinas de cuidado de la salud, aprendizaje sobre el manejo de su enfermedad, empoderamiento frente a los servicios de urgencia, apoyo percibido por parte del equipo de salud del servicio de telemonitoreo, integración de la familia a los cuidados de la salud, comodidad y accesibilidad; y posibles barreras percibidas para ingresar o permanecer en el programa. Conclusión: este es el primer estudio en Chile sobre la experiencia de pacientes con enfermedades crónicas pertenecientes a un programa de telemonitoreo. Los resultados dan cuenta de la aceptación y utilidad del programa en el seguimiento de sus enfermedades y son un aporte fundamental para el perfeccionamiento y desarrollo de estos programas.

Background

RESUMEN INTRODUCCIÓN:La adaptación a la enfermedad crónica es un proceso complejo que se ve influenciado por aspectos psicosociales. Considerando la corta duración las consultas médicas, sería beneficioso contar con instrumentos que evalúen estos aspectos de manera rápida y simple, permitiendo identificar posibles focos de intervención. OBJETIVO: El objetivo de este estudio fue analizar las propiedades psicométricas de un cuestionario que evalúa afrontamiento de la enfermedad crónica, apoyo social y conducta alimentaria en personas con diabetes y/o hipertensión. METODO: Para la construcción del cuestionario se generó un conjunto de ítems, tanto creados por los autores como obtenidos a través de una revisión de cuestionarios existentes, de los cuales se seleccionaron 25. Participaron 216 individuos con diabetes y/o hipertensión, que ingresaban a un programa de monitoreo a distancia de su patología. Se realizaron análisis paralelo para el número de factores, análisis factorial de ejes principales, de confiabilidad y de regresión lineal múltiple y logística con datos informados por los pacientes (por ejemplo: HbA1c) y observables a través del programa de telemonitoreo (datos bioquímicos de glicemia y/o presión arterial y adherencia al programa). RESULTADOS: Se extrajeron 5 factores que se denominaron: afrontamiento activo, evitativo y de resignación pasiva, sobrealimentación y apoyo social. Los factores presentaron una fiabilidad de .54 a .91. Las estrategias de afrontamiento se asociaron a adherencia a los tratamientos y gravedad de la patología. CONCLUSIONES: Los resultados sugieren que el cuestionario posee propiedades psicométricas aceptables, permitiendo pesquisar aspectos psicosociales que influyen en el manejo y pronóstico de la patología. PALABRAS CLAVE: Diabetes, hipertensión, cuestionario, aspectos psicológicos, afrontamiento. ABSTRACT INTRODUCTION:Adapting to chronic disease is a complex process influenced by psychosocial factors. Considering the rather limited time of medical consultations, it would be beneficial to have instruments that evaluate these psychosocial factors quickly and easily, allowing the identification of potential focuses of intervention. OBJECTIVE: To analyze the psychometric properties of a questionnaire that assesses coping with chronic illness, social support and eating behavior in people with diabetes and/or hypertension. METHODS: The questionnaire is composed of a set of 25 items generated by both the authors and existing questionnaires. The subjects for this study are 216 diabetes and/or hypertension patients, who joined a remote monitoring program for these pathologies. The analysis considered parallel analyzes for the number of factors, factorial analysis (principal axis), reliability and multiple linear or logistic regression with data reported by the patients (for example, HbA1c) as well as and observable data obtained with a telemonitoring program (biochemical glycemia data and/or blood pressure and adherence to the program). RESULTS: Five factors were identified: active, ...