title: One-year follow-up effects of diabetes rehabilitation for patients with prolonged self-management difficulties.
abstract: The aim of this study is to determine effects and the role of facilitators of empowerment of a Multidisciplinary Intensive Education Programme (MIEP) for diabetic patients with prolonged self-management difficulties. Glycemic control (HbA1c), health-related quality of life (HR-QoL) and facilitators of empowerment (health locus of control and coping) were measured in 99 participants of MIEP at baseline (T0), 3 (T1) and 12 months (T2) follow-up and in 231 non-referred consecutive outpatients. HbA1c improved at T2, although initial improvement was partially lost. Patients improved in most HR-QoL domains, without any relapse at T2. At T2, participants no longer differed from the average outpatients in any outcome. Initially, the HbA1c of men and women improved equally, but at T2 women consolidated improvement, whereas men relapsed. After MIEP, patients became more empowered (both at T1 and T2), explaining additional variance in HR-QoL improvement. The aim of MIEP to empower patients, rather than trying to solve problems for them seems effective.
authors.affiliation: Northern Centre for Healthcare Research, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands. j.c.keers@med.rug.nl
authors.forename: Joost C
authors.initials: JC
authors.lastname: Keers
authors.forename: Jelte
authors.initials: J
authors.lastname: Bouma
authors.forename: Thera P
authors.initials: TP
authors.lastname: Links
authors.forename: Jan C
authors.initials: JC
authors.lastname: ter Maaten
authors.forename: Rijk O B
authors.initials: RO
authors.lastname: Gans
authors.forename: Bruce H R
authors.initials: BH
authors.lastname: Wolffenbuttel
authors.forename: Robbert
authors.initials: R
authors.lastname: Sanderman
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003920:Diabetes Mellitus / Q000534:rehabilitation*; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007389:Internal-External Control; D016014:Linear Models; D008875:Middle Aged; D009426:Netherlands; D010353:Patient Education as Topic / Q000379:methods*; D011788:Quality of Life; D012648:Self Care
chemical_list: D006442:Glycated Hemoglobin