ID
Bron
Verkorte titel
Aandoening
emotional distress / emotionele klachten
implementation / implementatie
type 2 diabetes mellitus
primary care / eerstelijnszorg
practice nurse / praktijkondersteuner
minimal psychological intervention / minimale psychologische interventie
daily functioning / dagelijks functioneren
Ondersteuning
Zorgverzekeraar CZ
Huisartsen Oostelijk Zuid Limburg
CAPHRI School for public health and primary care
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
1. Daily functioning as measured by means of the Daily Functioning Thermometer (DFT), a visual analogue scale;<br>
2. Distress Scale of the 4DSQ to assess changes in distress symptoms.
Achtergrond van het onderzoek
Emotional distress is prevalent among type 2 diabetes patients. It may lead to a downward spiral caused by poor adherence, deterioration of the condition and a further decline in daily functioning, which in turn aggravates the emotional problems. A nurse-led minimal psychological intervention for chronically ill appeared to be (cost) effective. For implementation in regular care, adaptations are needed. The adapted Self management Support (SMS) program facilitates practice nurses (PNs) to incorporate a stepped care approach of early detection and treatment of emotional distress accompanied by problems with daily functioning. A pragmatic cluster randomised controlled trial will be carried out with a baseline measurement and follow-ups after 4 and 12 months. The population consists of 46 practice nurses and their eligible diabetic patients (N=460; 10 per practice nurse). Practice nurses of the intervention group receive SMS training. They learn to detect emotional distress and problems with daily functioning, and to provide self management support to eligible patients. Patients with severe problems will be referred to the GP. The study involves an effect evaluation and process evaluation of SMS. Primary outcome measure is daily functioning. Secondary measures include emotional health status, participation and autonomy, control over the disease, self-efficacy, quality of life, patient reported assessment of care, and health care use. Process parameters measured by means of questionnaires and interviews explore the facilitators and barriers regarding successful implementation of SMS.
Onderzoeksopzet
T0: Baseline;
T4: 4 months after baseline;
T12: A year after baseline.
Onderzoeksproduct en/of interventie
PNs of the intervention arm will apply SMS in addition to usual care, i.e. 3-monthly diabetes check-ups according to the current guidelines. They will be trained during three 8-hours educational meetings to carry out SMS. The PNs learn to detect emotional distress and problems with daily functioning during regular consultations. Patients with severe problems will be referred to the GP. Patients with mild to moderate emotional problems (according to the 4DSQ) accompanied by problems with daily functioning (according to the Daily Functioning Thermometer) receive self management support from the PN in max. 2 extra consultations. The self-management support is based on principles of Problem Solving and/or Reattribution.
PNs of the control arm are instructed to provide usual care. They receive SMS training after follow-up.
Algemeen / deelnemers
A.N. Dijk, van - Vries, de
P. Debeyeplein 1
Maastricht 6200 MD
The Netherlands
+31 (0)43 3882315
anneke.vandijk@maastrichtuniversity.nl
Wetenschappers
A.N. Dijk, van - Vries, de
P. Debeyeplein 1
Maastricht 6200 MD
The Netherlands
+31 (0)43 3882315
anneke.vandijk@maastrichtuniversity.nl
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
Patients are eligible if they have a clinically established diagnosis of diabetes type II, are treated in primary care by a practice nurse, experience emotional distress and encounter problems with daily functioning.
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
Patients that are not able to read and write Dutch.
Opzet
Deelname
Opgevolgd door onderstaande (mogelijk meer actuele) registratie
Andere (mogelijk minder actuele) registraties in dit register
Geen registraties gevonden.
In overige registers
| Register | ID |
|---|---|
| NTR-new | NL2636 |
| NTR-old | NTR2764 |
| CCMO | NL31235.068.10 |
| ISRCTN | ISRCTN wordt niet meer aangevraagd. |
| OMON | NL-OMON34709 |
Samenvatting resultaten
<br><br>
Van Dijk – de Vries, A. Het dagelijks functioneren centraal in een diabetesconsult. Implementatie van zelfmanagementondersteuning in de eerstelijns diabeteszorg. Verpleegkundige 2016; 2, 24-27.
<br><br>
Van Dijk – de Vries A, Van Bokhoven MA, Winkens B, Terluin B, Knottnerus JA, Van der Weijden T, Van Eijk JTM. Lessons learnt from a cluster-randomised trial evaluating the effectiveness of Self-Management Support (SMS) delivered by practice nurses in routine diabetes care. BMJ Open 2015; 5(6).
<br><br>
Van Dijk – de Vries A, Van Bokhoven M, Terluin B, Van der Weijden T Van Eijk JTM. Integrating nurse-led Self-Management Support (SMS) in routine primary care: design of a hybrid effectiveness-implementation study among type 2 diabetes patients with problems of daily functioning and emotional distress: a study protocol. BMC Fam Pract 2013; 14:77.