title: Guided self-determination improves life skills with type 1 diabetes and A1C in randomized controlled trial.
abstract: OBJECTIVE
  To report 1-year results of newly developed method, guided self-determination (GSD), applied in group training (GSD-GT) for Type 1 diabetes patients with persistent poor glycaemic control.
  
  
  METHODS
  GSD was designed on the basis of qualitative research to help patients develop life skills with diabetes using worksheets filled in at home and coached by nurses in mutual reflection. We randomized 18-49-year-old adults at a Danish university hospital to either 16 h GSD-GT in 2001 or to similar training 1 year later.
  
  
  METHODS
  mean A1C> or =8.0% for at least 2 years, disease onset < or =40 years and insulin treatment from onset.
  
  
  RESULTS
  Thirty GSD-GT patients and 20 controls completed the study. GSD-GT patients did better than control patients in terms of (a) increased autonomy support perceived from health professionals (p<0.01); (b) higher frequency of self-monitored blood glucoses (p<0.001); (c) increased perceived competence in managing diabetes (p<0.01); (d) fewer diabetes-related problems (p<0.05); and (e) improved glycaemic control (p<0.01).
  
  
  CONCLUSIONS
  GSD was effective in improving life skills with diabetes, including A1C, over a period of 1 year.
  
  
  CONCLUSIONS
  GSD is a worthy candidate for further research. We consider it adjustable to people with type 2 diabetes and other chronic conditions.
authors.affiliation: Institute of Public Health, Department of Nursing Science, University of Aarhus, Denmark. vz@nursingscience.au.dk
authors.forename: Vibeke
authors.initials: V
authors.lastname: Zoffmann
authors.forename: Torsten
authors.initials: T
authors.lastname: Lauritzen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D015190:Blood Glucose Self-Monitoring; D003142:Communication; D003718:Denmark; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000517:prevention & control* / Q000523:psychology; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008875:Middle Aged; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D010353:Patient Education as Topic / Q000458:organization & administration*; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D011340:Problem Solving; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin