title: Problem-solving therapy for adults with diabetic retinopathy and diabetes-specific distress: a pilot randomized controlled trial.
abstract: OBJECTIVE
  To provide preliminary evidence for the impact of problem-solving therapy for diabetes (PST-D) in adults with diabetic retinopathy (DR) and diabetes distress.
  
  
  METHODS
  In a pilot randomized controlled trial, 40 participants with DR and diabetes distress were allocated to the PST-D or control groups. Diabetes distress (DDS), depressive symptoms (PHQ-9), self-care activities (SDSCA), and HbA1cwere assessed at baseline, and 3 and 6-month follow-ups.
  
  
  RESULTS
  At the 6-month follow-up, the PST-D group showed significant improvements relative to the control group, in 'regimen-related distress' (PST-D: -1.3±1.4; control: -0.4±1.1), depressive symptoms (PST-D: -4.3±6.1; control: -0.3±4.6), and HbA1c(PST-D: -1.2%±1.01; control: 0.2%±1.2%) (all p<0.05). In multiple regression analysis, adjusting for baseline values and sociodemographic factors, PST-D was associated with significant improvement in 'regimen-related distress', depressive symptoms, and HbA1cat the 6-month follow-up (p<0.05).
  
  
  CONCLUSIONS
  PST-D is a promising intervention for improving psychological outcomes and glycemic control. A fully powered study is required to confirm these findings and examine mechanisms of change in HbA1c.
  
  
  BACKGROUND
  ACTRN12616001010482; results.
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne , Melbourne , Australia.
authors.forename: Gwyneth
authors.initials: G
authors.lastname: Rees
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne , Melbourne , Australia.
authors.forename: Fleur
authors.initials: F
authors.lastname: O'Hare
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne , Melbourne , Australia.
authors.forename: Marian
authors.initials: M
authors.lastname: Saeed
authors.affiliation: Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia; Deakin University, School of Psychology,Geelong, Australia.
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Sudholz
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne , Melbourne , Australia.
authors.forename: Bonnie A
authors.initials: BA
authors.lastname: Sturrock
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne , Melbourne , Australia.
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.affiliation: Deakin University, School of Psychology,Geelong, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia; AHP Research, Hornchurch, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Speight
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia; Singapore Eye Research Institute, National University of Singapore, Singapore, Singapore; Duke-NUS Medical School, Singapore, Singapore.
authors.forename: Ecosse L
authors.initials: EL
authors.lastname: Lamoureux
keywords: Psychological Aspects; Psychology/Behavior; Psychosocial Depression; Retinopathy