title: Cognitive behavioural group training (CBGT) for patients with type 1 diabetes in persistent poor glycaemic control: who do we reach?
abstract: Approximately a quarter of adults with type 1 diabetes do not succeed in achieving satisfactory glycaemic control, partly due to problems with the demanding self-management regimen. To improve glycaemic control, interventions with a cognitive behavioural approach, aimed at modifying dysfunctional beliefs, reducing negative emotions and enhancing self-care practices are a potentially successful tool. Little is known about the reach of such an approach. This article describes characteristics of participants in a randomized, controlled trial of cognitive behavioural group training for patients with type 1 diabetes in poor glycaemic control. Results show that outpatients from seven hospitals in the area of Amsterdam, selected on long-standing high HbA1c and volunteering to participate, report high levels of psychological distress and depressive symptoms. Furthermore, self-care behaviours were perceived as important, but burdensome. Diabetes-specific self-efficacy was relatively low. It is concluded that this selected group of adults with type 1 diabetes would potentially benefit from a cognitive-behavioural intervention in order to reduce negative emotions, enhance diabetes self-efficacy, self-care behaviour and glycaemic outcomes.
authors.affiliation: Diabetes Research Group, Department of Medical Psychology, VU University Medical Centre, vd Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
authors.forename: Nicole C W
authors.initials: NC
authors.lastname: van der Ven
authors.forename: Caroline H C
authors.initials: CH
authors.lastname: Lubach
authors.forename: Marloes H E
authors.initials: MH
authors.lastname: Hogenelst
authors.forename: Ada
authors.initials: A
authors.lastname: van Iperen
authors.forename: Anita M E
authors.initials: AM
authors.lastname: Tromp-Wever
authors.forename: Annelies
authors.initials: A
authors.lastname: Vriend
authors.forename: Henk M
authors.initials: HM
authors.lastname: van der Ploeg
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Heine
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Snoek
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000458:organization & administration*; D017281:Cost of Illness; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000378:metabolism / Q000517:prevention & control* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009341:Negativism; D009426:Netherlands; D010044:Outpatient Clinics, Hospital; D010349:Patient Compliance / Q000523:psychology*; D011615:Psychotherapy, Group / Q000458:organization & administration*; D011788:Quality of Life; D012648:Self Care / Q000523:psychology* / Q000592:standards; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control