Emma Shuttlewood1, Nicole De Zoysa2, David Rankin3, Stephanie Amiel4. 1. Diabetes and Nutritional Sciences Division, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK. Electronic address: eshuttlewood@nhs.net. 2. Department of Psychological Medicine, King's College Hospital, Denmark Hill, London SE5 9RS, UK. Electronic address: ndezoysa@nhs.net. 3. Centre for Population Health Sciences, The University of Edinburgh, Medical School, Teviot Place, Edinburgh EH8 9AG, UK. Electronic address: a.d.rankin@ed.ac.uk. 4. Diabetes and Nutritional Sciences Division, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK. Electronic address: stephanie.amiel@kcl.ac.uk.
Abstract
AIMS: Impaired awareness of hypoglycaemia (IAH) in people with type 1 diabetes is a dangerous condition that is associated with a six-fold greater risk of severe hypoglycaemia than for people with awareness. A new psychoeducational programme, DAFNE-HART, has been specifically designed to address persistent IAH. The initial pilot showed promising outcomes including fewer hypoglycaemic episodes and improved hypoglycaemia awareness. This aim of this paper is to report the development and qualitative evaluation of DAFNE-HART from participant interviews. METHODS: DAFNE-HART incorporates diabetes education with two psychological approaches that have demonstrated efficacy in long-term health conditions: motivational interviewing and cognitive behaviour therapy. The course, delivered across two UK locations included both group and individual support over a 6-week period facilitated by DAFNE educators, trained and supervised by a clinical psychologist. Semi-structured interviews were conducted with 19 participants immediately after their courses and the interviews were analysed using grounded theory. RESULTS: Five main themes emerged which describe the behavioural changes people made to their diabetes management, the development of new attitudes and beliefs, their experiences of regaining hypoglycaemia cues, reactions to the course format and the significance of the relationship with their care provider. Participants provide insights into how the course changed their view of IAH and led to practical changes in minimising hypoglycaemia. CONCLUSIONS: Integration of psychological techniques into diabetes education can address the cognitive and motivational barriers to restoring awareness and optimal diabetes management. It is suggested that further research is needed to evaluate this programme in a larger sample, over a longer time frame.
AIMS: Impaired awareness of hypoglycaemia (IAH) in people with type 1 diabetes is a dangerous condition that is associated with a six-fold greater risk of severe hypoglycaemia than for people with awareness. A new psychoeducational programme, DAFNE-HART, has been specifically designed to address persistent IAH. The initial pilot showed promising outcomes including fewer hypoglycaemic episodes and improved hypoglycaemia awareness. This aim of this paper is to report the development and qualitative evaluation of DAFNE-HART from participant interviews. METHODS:DAFNE-HART incorporates diabetes education with two psychological approaches that have demonstrated efficacy in long-term health conditions: motivational interviewing and cognitive behaviour therapy. The course, delivered across two UK locations included both group and individual support over a 6-week period facilitated by DAFNE educators, trained and supervised by a clinical psychologist. Semi-structured interviews were conducted with 19 participants immediately after their courses and the interviews were analysed using grounded theory. RESULTS: Five main themes emerged which describe the behavioural changes people made to their diabetes management, the development of new attitudes and beliefs, their experiences of regaining hypoglycaemia cues, reactions to the course format and the significance of the relationship with their care provider. Participants provide insights into how the course changed their view of IAH and led to practical changes in minimising hypoglycaemia. CONCLUSIONS: Integration of psychological techniques into diabetes education can address the cognitive and motivational barriers to restoring awareness and optimal diabetes management. It is suggested that further research is needed to evaluate this programme in a larger sample, over a longer time frame.
Authors: Stephanie A Amiel; Pratik Choudhary; Peter Jacob; Emma Lauretta Smith; Nicole De Zoysa; Linda Gonder-Frederick; Mike Kendall; Simon Heller; Augustin Brooks; Elena Toschi; Dulmini Kariyawasam; Laura Potts; Andy Healy; Helen Rogers; Nick Sevdalis; Marietta Stadler; Mustabshira Qayyum; Ioannis Bakolis; Kimberley Goldsmith Journal: BMJ Open Date: 2019-06-16 Impact factor: 2.692
Authors: Ioannis Bakolis; Nicole de Zoysa; Stephanie A Amiel; Laura Potts; Kimberley Goldsmith; Peter Jacob; Emma L Smith; Linda Gonder-Frederick; Simon Heller; Elena Toschi; Augustin Brooks; Dulmini Kariyawasam; Pratik Choudhary; Marietta Stadler; Helen Rogers; Mike Kendall; Nick Sevdalis Journal: Nat Commun Date: 2022-04-28 Impact factor: 17.694
Authors: Fiona Campbell; Julia Lawton; David Rankin; Mark Clowes; Elizabeth Coates; Simon Heller; Nicole de Zoysa; Jackie Elliott; Jenna P Breckenridge Journal: BMC Health Serv Res Date: 2018-11-27 Impact factor: 2.655