The purpose of this study is to investigate the impact of a 6-month Web-based intervention on the psychosocial well-being of older adults with diabetes.
Methods
This study was a randomized controlled trial (N = 62) comparing the effects of a 6-month Web-based intervention plus usual care with usual care alone among adults aged 60 years or older with diabetes. The outcomes included quality of life, depression, social support, and self-efficacy.
Results
The intervention group showed significant improvement, F(4.48) = 4.03 P = .007, when compared with the control group on measures of depression, quality of life, social support, and self-efficacy when controlling for all baseline outcome variables (age, gender, and number of years with diabetes).
Conclusions
These findings provide support for the conclusion that a Web-based intervention is effective in improving the psychosocial well-being of participants at a 6-month follow-up. Future research needs to investigate the long-term effectiveness of Web-based interventions for sustaining psychosocial well-being, including factors that may affect quality of life, such as diabetes-specific beliefs, attitudes, social support, and disease-specific coping skills.
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References
1.
Funnell MM, Merritt JHThe challenges of diabetes and older adults. Nurs Clin North Am. 1993;1:45-60.
2.
Peyrot M., Rubin RRLevels and risks of depression and anxiety symptomatology among diabetic adults . Diabetes Care. 1997;20:585-595.
3.
Odegard PS, Capoccia K.Medications taking and diabetes: a systematic review of the literature. Diabetes Educ. 2007;33: 1014-1029.
4.
Clark M.Diabetes self management education: a review of published studies. Prim Care Diabetes. 2008;3:113-120.
5.
Ciechanowski PS, Katon WJ, Russo JEDepression and diabetes: impact of depressive symptoms on adherence, function and costs. Arch Intern Med . 2000;160:3278-3285.
6.
Lustman PJ, Anderson RJ, Freeland KE, De Groot M., Carney R., Clouse REDepression and poor glycemic control: a meta-analytic review of the literature . Diabetes Care. 2000;23:934-942.
7.
Anderson RJ, Freeland KE, Clouse RE, Lustman PJThe prevalence of comorbid depression in adults with diabetes: a meta-analysis . Diabetes Care. 2001;24:1069-1078.
8.
Ciechanowski PS, Katon WJ, Russo JE, Hirsch IBThe relationship of depressive symptoms to symptom reporting, self-care and glucose control in diabetes. Gen Hosp Psychiatry. 2003;25: 246-252.
9.
Peyrot M., Rubin RR, Siminerio LMPhysician and nurse use of psychosocial strategies in diabetes care: results of the Cross-national Diabetes Attitudes, Wishes and Needs (DAWN) Study. Diabetes Care. 2006;29:1256-1262.
10.
Egede LE, Zheng D., Simpson K.Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2002;25:464-470.
11.
Rosenthal MJ , Fajardo M., Gilmore S., Morley JE, Nabiloff BDHospitalization and mortality of diabetes in older adults: a three-year prospective study. Diabetes Care. 1998;21:231-235.
12.
Egede LE, Zheng D., Simpson K.Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2000;25:464-470.
13.
Barrera M. Jr , Glasgow RE, McKay HG, Boles SM, Feil EGDo Internet-based support interventions change perceptions of social support? An experimental trial of approaches for supporting diabetes self-management. Am J Community Psychol. 2002;30: 637-654.
14.
Glasgow RE, Barrera M. Jr, McKay HG, Boles SMSocial support and health among participants in an internet-based diabetes support program: a multi-dimensional investigation. Cyberpsychol Behav. 1999;2:271-281.
15.
Eysenbach G. , Powell J., Englesakis M., Rizo C., Stern A.Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interactions . BMJ. 2004;328:1166.
16.
Powell J., McCarthy N., Eysenbach G.Cross-sectional survey of users of Internet depression communities. BMC Psychiatry. 2003;3:19.
17.
Griffiths F. , Lindenmeyer A., Powell J., Lowe P., Thorogood M.Why are health care interventions delivered over the internet? A systematic review of the published literature. J Med Internet Res. 2006;8:e10. http://www.pubmedcentral.nih.gov/articlerender.fcgi ?tool=pubmed&pubmedid=16867965. Accessed August 18, 2009.
18.
Nguyen, HQ, Donesky-Cuenco DA, Wolpin S., et al. Randomized controlled trial of an internet-based versus face-to-face dyspnea self-management program for patients with chronic obstructive pulmonary disease: pilot study. J Med Internet Res. 2008;10(2):e9. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubm ed&pubmedid=18417444. Accessed August 21, 2009.
19.
Kramish Campbell M., Meier A., Carr C., et al. Health behavior changes after colon cancer: a comparison of findings from face to face and on-line focus groups . Fam Community Health. 2001;24:88-103.
20.
Smith L., Weinert C.Telecommunication support for rural women with diabetes. Diabetes Educ. 2000;26:645-655.
21.
Bond GE, Burr R., Wolf M., Price M., McCurry SM, Teri L.The effect of a web-based intervention on the physical outcomes associated with diabetes among adults age 60 and older: a randomized trial. Diabetes Technol Ther. 2007;9:52-59.
22.
Lorig KR, Laurent DD, Deyo RA, et al. Can a back pain e-mail discussion group improve health status and lower health care costs? Arch Intern Med. 2002;162:792-796.
23.
Verheijden M., Bakx JC, Akkermans R., et al. Web-based targeted nutrition counselling and social support for patients at increased cardiovascular risk in general practice: randomized controlled trial. J Med Internet Res . 2004;6(4):e44. http://www.pubmedcentral .nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15631968. Accessed August 20, 2009.
24.
Glasgow RE, Boles SM, McKay HG, Feil EG, Barrera M. Jr.The D-Net diabetes self-management program: long-term implementation, outcomes, and generalization results. Prev Med. 2003 ;6:410-419.
25.
van Bastelaar KM, Pouwer F., Cuijpers P., Twisk JW, Snoek FJWeb-based cognitive behavioural therapy (W-CBT) for diabetes patients with co-morbid depression: design of a randomised controlled trial. BMC Psychiatry. 2008;8:9.
26.
Mckay HG, Glasgow RE, Feil EG, Boles SM, Barrera M. Jr.Internet-based diabetes self-management and support: initial outcomes from the Diabetes Network project. Rehabil Psychol. 2002;47:31-48.
27.
Radloff LSThe CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;3:385-401.
28.
Teri L., Logsdon RG, Wagner A., Uomoto J.The caregiver role in behavioral treatment of depression in dementia patients . In: Niederehe E, Lebowitz G, eds. Stress Effects on Family Caregivers of Alzheimer’s Patients: Research and Interventions. New York, NY: Springer;1994:185-204.
29.
Radloff LS, Teri L.Use of the Center for Epidemiological Studies-Depression scale with older adults. Clin Gerontol. 1986;5:119-136.
30.
Polonsky WH , Andersen BJ, Lohrer PA, et al. Assessment of diabetes-related distress . Diabetes Care. 1995;18:754-760.
31.
Welch GW, Jacobson AM, Polonsky WHThe Problem Areas in Diabetes Scale. Diabetes Care. 1997;20:760-766.
32.
Anderson RM , Funnell MM, Fitzgerald JT, Marrero DGThe diabetes empowerment scale: a measure of psychological self-efficacy. Diabetes Care. 2000;23:739-743.
33.
Gustafson DH , Hawkins R., Boberg E., et al. Impact of a patient-centered computer-based health information/support system. Am J Prev Med. 1999;16:1-9.
34.
Flatley-Brennan P.Computer network home care demonstrations: a randomized trial in persons living with AIDS. Comp Biol Med. 1998;28:489-508.
35.
Hunkeler EM , Meresman JF, Hargreaves WA, et al. Efficacy a of nurse telehealth care and peer support in augmenting the treatment of depression in primary care . Arch Fam Med. 2000;9: 700-708.
Rubin RR, Peyrot M.Quality of life and diabetes. Diabetes Metab Res Rev. 1999;15:205-218.
38.
Glasgow RE, Ruggiero L., Eakin EG, Dryfoos J., Chobanian L.Quality of life and associated characteristics in a large national sample of adults with diabetes. Diabetes Care. 1997 ;20:562-567.
39.
Klein BE, Klein R., Moss SESelf-rated health and diabetes of long duration: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Diabetes Care. 1998;21:236-240.
40.
Trief PM, Grant W., Elbert K., Weinstock RSFamily environment, glycemic control, and the psychosocial adaptation of adults with diabetes. Diabetes Care. 1998;21:241-245.
41.
UK Prospective Diabetes Study 16. Overview of 6 years’ therapy of type II diabetes: a progressive disease. UK Prospective Diabetes Study Group. Diabetes. 1995;44:1249-1258.
42.
Weyer C., Bogardus C., Mott DM, Pratley REThe natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus. J Clin Invest . 1999;104:787-794.
43.
Porte D. Jr , Kahn SEβ-cell dysfunction and failure in type 2 diabetes: potential mechanisms. Diabetes. 2001;50(suppl 1A):S160-S163.
44.
Mayfield JA , White RDInsulin therapy for type 2 diabetes: rescue, augmentation, and replacement of β-cell function. Am Fam Physician. 2004;70:489-498.
45.
Hayward RA, Manning WG, Kaplan SH, Wagner EH, Greenfield S.Starting insulin therapy in patients with type 2 diabetes: effectiveness, complications, and resource utilization. JAMA. 1997;278:1663-1669.
46.
Cryer PEHypoglycemia is the limiting factor in the management of diabetes. Diabetes Metab Res Rev. 1999;15:42-46.
