Francisco Sobral do Rosário1, Diana V Almeida2, Jorge Oliveira3, Maria Luisa Lima4, João Filipe Raposo5. 1. Diabetology Department, Diabetes Portugal, Lisbon, Portugal. Electronic address: franciscosobraldorosario@gmail.com. 2. Narrative & Medicine Research Group, Lisbon University Center for English Studies, Lisbon, Portugal. 3. School of Psychology and Life Sciences, University Lusófona de Humanidades e Tecnologias, Lisbon, Portugal. 4. Centro de Investigação e Intervenção Social, Instituto Universitário de Lisboa, Lisbon, Portugal. 5. Diabetology Department, Diabetes Portugal, Lisbon, Portugal.
Abstract
OBJECTIVES: Group care for individuals with diabetes is a recognized educational practice, but techniques from narrative medicine using of literary works have never been incorporated in these programs. We designed a new educational model (i.e. the Close Reading and Creative Writing program) of group care for individuals with diabetes incorporating close reading and creative writing in group education. A randomized trial was designed to evaluate this intervention. METHODS: A total of 49 individuals with type 2 diabetes, aged <85 years and with >6 years of school education, were randomized to 2 different group care dynamics: (a) a "control group," with a classical structured educational approach currently used at our institution; and (b) an "intervention group," with introduction of literary texts, narrative skills, close reading and creative writing. Evaluation included anthropometric measures, glycated hemoglobin (A1C) and questionnaires for psychological evaluation. Individual A1C levels in the 6-year period before the trial were collected from clinical records. RESULTS: A significant reduction of A1C was observed in the intervention group, showing noninferiority in relation to the classical approach. A significant decrease in A1C was observed in relation to the 6 previous years. A significant increase in satisfaction with the therapist and group process was observed. CONCLUSIONS: This is the first randomized trial designed to evaluate a group care intervention to manage type 2 diabetes using narrative techniques. The results suggest that this may be a useful model for more highly schooled individuals, and may represent an alternative for the educational process.
RCT Entities:
OBJECTIVES: Group care for individuals with diabetes is a recognized educational practice, but techniques from narrative medicine using of literary works have never been incorporated in these programs. We designed a new educational model (i.e. the Close Reading and Creative Writing program) of group care for individuals with diabetes incorporating close reading and creative writing in group education. A randomized trial was designed to evaluate this intervention. METHODS: A total of 49 individuals with type 2 diabetes, aged <85 years and with >6 years of school education, were randomized to 2 different group care dynamics: (a) a "control group," with a classical structured educational approach currently used at our institution; and (b) an "intervention group," with introduction of literary texts, narrative skills, close reading and creative writing. Evaluation included anthropometric measures, glycated hemoglobin (A1C) and questionnaires for psychological evaluation. Individual A1C levels in the 6-year period before the trial were collected from clinical records. RESULTS: A significant reduction of A1C was observed in the intervention group, showing noninferiority in relation to the classical approach. A significant decrease in A1C was observed in relation to the 6 previous years. A significant increase in satisfaction with the therapist and group process was observed. CONCLUSIONS: This is the first randomized trial designed to evaluate a group care intervention to manage type 2 diabetes using narrative techniques. The results suggest that this may be a useful model for more highly schooled individuals, and may represent an alternative for the educational process.
Keywords:
diabetes; diabète; education; essai à répartition aléatoire; formation; group care; médecine narrative; narrative medicine; randomized trial; soins de groupe