Toward effective interventions to reduce diabetes distress among adults with type 1 diabetes: Enhancing Emotion regulation and cognitive skills.
Lawrence Fisher, Danielle Hessler, William Polonsky and 3 others
PMID 30952482WHAT IT FOUND
For adults with type 1 diabetes and high distress, lower diabetes distress was linked to better emotion regulation and problem solving.
Both education and emotional coping programs improved distress, with no clear difference between arms.
Key findings
01The primary change model showed significant directional pathways from emotion regulation and cognitive skills to diabetes distress domains.
02Diabetes distress and most emotion regulation and cognitive variables showed significant time effects, with no significant time by intervention group effect.
03The reverse and bidirectional models fit the data but showed fewer significant pathways than the primary model.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was mostly women, well educated, and in their 40s, and participants had higher baseline distress than those who declined, so results may not apply to other adults with type 1 diabetes. Attrition at 9 months was 12%, and dropouts had higher HbA1C, higher distress, more complications, and were younger than those who remained. The models included only two emotion regulation and two cognition measures, so other emotional or cognitive processes may matter. The analysis used change data from two trial arms and did not isolate the effect of any single component. The paper reports model pathways from measured changes, not a direct test of which intervention component caused distress reduction.
Declared interests
No conflict-of-interest or funding statement is included in the supplied text; the publication types list N.I.H. extramural research support.
The easy way to misread this
Do not conclude that either KnowIt or OnTrack was superior, or that improving emotion regulation or problem solving alone will reduce diabetes distress. The trial arms did not differ significantly on outcomes, and the models describe pathways among measured changes rather than isolated component tests.