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Title: The development and evaluation of the UCL-Diabetes Self-Management Programme (UCL-DSMP)
Author: Steed, Elizabeth Anne
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2005
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This thesis describes the development and evaluation of two self-management interventions for patients with type 2 diabetes. The first (the UCL-DSMP) was a theoretically based group intervention, targeting the behavioural and psychosocial demands of diabetes. The second, which was not formally evaluated due to poor uptake, additionally included social support skills training and required attendance with a partner. Development included a systematic review of previous interventions including analysis of component efficacy, focus groups with health care professionals and patients, and piloting of the interventions. For each intervention a manual specifying content and facilitation techniques was produced. The UCL-DSMP was compared to standard treatment in individuals with type 2 diabetes and microalbuminuria or proteinuria. Participants (n=124) completed assessments preintervention, immediately post-intervention (IPI) and at 3 and 9 month follow-ups. The UCL-DSMP significantly improved diet (p 0.001), exercise (p 0.001), and blood glucose monitoring (p 0.001) at IPI relative to controls. Results were retained for exercise and blood glucose monitoring at both 3 and 9 months follow-up (p 0.05). Diabetes specific quality of life was better in the intervention group relative to controls at all follow-ups (p 0.05). There were no differences on generic quality of life or psychological wellbeing. Knowledge was improved by the intervention (p 0.001) as was behaviour specific self- efficacy (p 0.05), which was identified as a significant mediator of change in exercise (p 0.05) and blood glucose monitoring (p 0.05) at 3 and 9 months respectively. Illness beliefs, specifically belief in treatment effectiveness (p 0.01) and control (p 0.05) improved following the intervention at IPI, however results were not retained in the longer term and beliefs were not significant mediators of behaviour change. No clear or consistent predictors of efficacy were identified. These findings suggest the UCL-DSMP may be a useful intervention for patients with type 2 diabetes. Areas for further development and recommendations for clinical practice are discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available