Problem solving interventions for diabetes self-management and control: A systematic review of the literature

Abstract

Aims Problem solving is deemed a core skill for patient diabetes self-management education. The purpose of this systematic review is to examine the published literature on the effect of problem-solving interventions on diabetes self-management and disease control. Data Sources We searched PubMed and PsychINFO electronic databases for English language articles published between November 2006 and September 2012. Reference lists from included studies were reviewed to capture additional studies. Study Selection Studies reporting problem-solving intervention or problem solving as an intervention component for diabetes self-management training and disease control were included. Twenty-four studies met inclusion criteria. Data Extraction Study design, sample characteristics, measures, and results were reviewed. Data Synthesis Sixteen intervention studies (11 adult, 5 children/adolescents) were randomized controlled trials, and 8 intervention studies (6 adult, 2 children/adolescents) were quasi-experimental designs. Conclusions Studies varied greatly in their approaches to problem-solving use in patient education. To date, 36% of adult problem-solving interventions and 42% of children/adolescent problem-solving interventions have demonstrated significant improvement in HbA1c, while psychosocial outcomes have been more promising. The next phase of problem-solving intervention research should employ intervention characteristics found to have sufficient potency and intensity to reach therapeutic levels needed to demonstrate change.

The Relationship between Self-Management and Glycemic Control in A Cohort of Children with Type 1 and Type 2 Diabetes

“…These findings are consonant with other reports in the United States and worldwide [8]. Diabetes self-care management involves the interrelation of multiple behaviors and tasks [9]. Adherence to the complex diabetes self-care behaviors is a major barrier to achieve and sustain glycemic control.…”

Every parent tells a story: why non-adherence may persist in children receiving guideline-based comprehensive asthma care

“…The latter has been noted in a survey of diabetes educators. They reported that appropriate problem-solving was the most difficult skill to teach patients [23,24]. A large trial in asthmatic adults showed no benefits of problem-solving education, and the authors suggested that patients' lack of motivation to achieve high adherence was the main reason for this failure [25].…”

Effective strategies for encouraging behavior change in people with diabetes

“…Their work highlighted a synthesis of diabetes education and behavior change strategies. In addition to this early work, several reviews exist on the effectiveness of problem solving interventions [3,37] and those papers can be accessed for complete information on the findings. Problem solving interventions are popular with children and adults, and people with Type 1 or Type 2 diabetes.…”