Person-Centred, Occupation Based Intervention Program Supported with Problem-Solving Therapy for Type 2 Diabetes: a randomized controlled trial

Abstract

Background: Individuals with diabetes mellitus both have difficulty in solving problems in meaningful occupations and have similar difficulties with self-care regimens. We examined the effects of occupation-based intervention supported with problem-solving therapy of individuals with type 2 diabetes mellitus on participation and satisfaction of meaningful occupations, diabetes-related psychosocial self-efficacy, preferred coping strategies and individual well-being. Methods: This study was planned as a single-blind, randomized controlled study with a 3-months follow-up involving sixty-seven adults with type 2 diabetes. The Canadian Occupational Performance Measure, the Diabetes Empowerment Scale, the Brief COPE and the Five-item World Health Organization Well-Being Index were used. The intervention was conducted in six modules for six weeks, and each implemented about 60 minutes and for one session per week. The six modules included evaluations, diabetes education, and problem-solving therapy. The most important feature of the program is its focus on meaningful occupations for the person via a holistic perspective and provided an opportunity for the participants to apply problem-solving therapy through valued occupation. Differences between groups were analysed using the Mann-Whitney U test, and the Friedman test was used to calculate group-time interaction differences (i.e., baseline, after six weeks and after three months). Results: Individuals with type 2 diabetes mellitus in both groups identified the most significant occupational performance problems in self-care as personal care. Significant improvement was reported in the intervention group when compared to the control group regarding the participation in meaningful occupation, the satisfaction of performance, psychological self-efficacy and well-being results (p<0.001) after the six modules and three months follow-up. The participants' use of effective coping strategies, active coping and acceptance strategies, self-efficacy as revealed results suggest improvement in favor of the intervention group (p<0.05). The intervention group showed significantly improving between measurements at baseline and after three months of modules except for ineffective coping style (p<0.001). Conclusions: The occupation-based problem-solving therapy encourages participation in meaningful occupations, positive effects on psychological self-efficacy, and improves effective coping styles and well-being of type 2 diabetes mellitus. Problem-solving therapies that incorporate individuals’ priorities via meaningful occupation can be used to lead a meaningful and quality life of individuals with type 2 diabetes mellitus

The influences of the environment and information on the complications of diabetes on patient outcomes

“…We read with great interest this study, which clarified the effects of problem-solving therapy (PST) on the occupational performance, self-efficacy, and well-being of type 2 diabetic patients in Turkey [ 1 ]. However, we have two concerns about the methodology of this study.…”