Patient Participation in Medical Care - Essay Example

Running Head: CHRONIC ILLNESS – DIABETES TYPE II CHRONIC ILLNESS – DIABETES TYPE II [Name Of Student] [Name Of Institution] CHRONIC ILLNESS – DIABETES TYPE II INTRODUCTION Diabetes is divided into two major categories: insulin-dependent diabetes mellitus (IDDM), or Type I diabetes; and non-insulin-dependent diabetes (NIDDM), or Type II diabetes. Both are characterized by abnormalities in glucose metabolism caused by deficiencies in insulin production or utilization, or both, which lead to chronically high blood glucose (BG) levels or hyperglycemia (Tsalikian, 2005; Zimmerman, 2005, 211). There are, however, significant differences in etiology, pathology, and nursing treatment. IDDM is caused by a combination of genetic and autoimmunological processes that destroy the pancreatic beta cells that produce insulin, a hormone essential for glucose utilization and storage. The resulting insulin deficiencies lead to the accumulation of glucose in the bloodstream, or hyperglycemia. Compensatory fat metabolism produces ketones, which can lead to ketoacidosis and coma. IDDM can occur at any age but typically is diagnosed during childhood and adolescence. It is the most common childhood metabolic disease. In this paper I will discuss in detail a chronic illness. I have chosen diabetes as my subject for detailed analysis. Through this paper, I will demonstrate my knowledge of the chronic condition, in terms of its prevalence in the community, the reasons for its prevalence, and present a brief overview of its pathophysiology and common signs/symptoms. Moreover , I will discuss the Critical Intervention Points for Care and Support under the National Service Improvement Framework for the selected chronic condition that is Diabetes (Type II). DISCUSSION People with chronic illness actively construct mental representations of their disease and use these representations to guide self-nursing treatment decisions. For example, individuals with diabetes believe certain symptoms indicate that their BG levels are low or high and act on these beliefs to raise or lower BG levels without validating BG through objective glucometer testing procedures. People who are relatively accurate in their BG symptom beliefs display better metabolic control than those who are inaccurate, and interventions that improve symptom perception accuracy tend to improve long-term BG control. Thus, BG symptom beliefs appear to play an important role in ongoing diabetes self-management. People with diabetes vary widely in their ability to detect symptoms and accurately estimate BG excursions. These data suggest that some people with diabetes develop symptom beliefs that can guide appropriate self-nursing treatment decisions, whereas others develop beliefs that may lead to nursing treatment errors.NIDDM has a strong hereditary component and is caused by a combination of beta cell dysfunction and insulin resistance. Approximately 80% of NIDDM patients are obese, which is a major contributor to insulin resistance. For this reason, weight reduction alone can often normalize BG metabolism. Onset of NIDDM usually occurs after age 40 and is often asymptomatic. Ketoacidosis is very rare. Until lately, TYPE II DIABETES has been taken care of in the severe care unit. Changes in health care backing and improved management of patients suffering from diabetes have lead to treating growing numbers of patients with TYPE II DIABETES on universal medical-surgical elements. As patients with TYPE II DIABETES necessitate intensive check and medical interference, medical-surgical nurses should have a wide-ranging accepting of the pathophysiologic means, clinical demonstrations, and handling protocols specified for these patients. The preliminary reply of the nurses was in treaty with the universal character of nursing text that is very affirmative on the subject of the nurse's role in managing chronic diseases. With the precedence accorded to teaching in nurse preparation (United Kingdom Central Council for Nursing, Midwifery and Health Visiting 2003) nurses are said to be exclusively located to review their patients' needs for acquaintance and their keenness to be trained. The all-purpose practice surroundings has been seen as contribution the practice nurse the chance to enlarge her skills in this district as well as giving the tolerant the assistance of stability of care. (Greenhalgh 2000, 62-78). The benefit of knowing patients over a lengthy stage of time is strained as one of the principles for a winning patient treating programme (Brown 1998, 95), a key constituent of first-rate care of patients with chronic diseases. The significance of the interpersonal affiliation has been a decisive standard of nursing hypothesis and is another time being reasserted with an importance on the gentle features of nursing and the indispensable 'being with patients' that leave further than the scientific task. (Doona et al. 2004, Gavin 2004, 36). In short, the stress on nurse training, the fresh growths in the practice nurse's responsibility, and the modern awareness in the character of the nurse-patient bond all add to ensuring that the job is likely to be compassionate and individual nurses to hold close to the addition of their position in supervising patients with chronic illnesses. The dispute posed by diabetes Diabetes is a set of widespread chronic disorders distressing at least 2% of the populace of Australia, being predominantly widespread in the aged and some racial minorities. Its fitness care costs are towering with a minimum of 4% of the National Health Service (NHS) resources being spent on citizens with diabetes (CSAG 2000 98). The dimension of the trouble and the stress on the NHS are understandable and were echoed in the precedence accorded to diabetes in executive goal setting. Type II diabetics’ calls for firm control of diet, mass and other standard of living behaviors if long-term problems are to be reduced. This is attained by customary evaluations of experimental measurements, way of life and medicine. Nevertheless, as nearly all of the Type II patients are old and few have any immense eagerness for varying life-long habits they can pretense an extensive confrontation for both the principal care group and professional nurses. Both IDDM and NIDDM are associated with long-term complications including heart disease, peripheral vascular disease, neuropathy, retinopathy, and renal disease. Diabetes is the leading cause of blindness, lower extremity amputations, and kidney transplants in the United States. Research strongly suggests that chronic hyperglycemia is a major factor contributing to long-term complications. A 10-year study funded by the National Institutes of Health, the Diabetes Control and Complications Trial (DCCT Research Group, 2003, 11), is now under way to assess the relationship between long-term glycemic control and diabetic complications. Long-term glycemic control in this and numerous other diabetes studies is monitored by measurements of glycosylated hemoglobin (HbA1 ) , a short-lived protein which is structurally altered by the attachment of glucose molecules. Thus, HbA provides a biological marker of hyperglycemia over a 2- to 3-month period. Because of the belief that chronic glycemic control is critical, efforts to manage diabetic hyperglycemia have become more aggressive. Nursing treatment goals for both IDDM and NIDDM are to normalize BG levels (70–180 mg/dl) and prevent long-term complications. The four major components of diabetes management are medication, diet, exercise, and self-monitoring of BG (SMBG). Because diabetes and its nursing treatment are so complex, education is also included in the American Diabetes Association's regimen recommendations. The major difference in nursing treatment regimens is that insulin injections are necessary for the IDDM individual to survive. Insulin regimens vary greatly, however, depending on targeted BG control and patient motivation. Some patients may take only one or two daily injections, whereas others follow more intensive insulin regimens involving several daily injections or insulin pumps for continuous insulin delivery. Frequent SMBG is essential with the intensive insulin regimens, requiring 3 to 5 daily self-tests. With NIDDM, initial nursing treatment often focuses on diet and exercise therapy to reduce weight. In addition, oral medications or insulin injections may be necessary to control BG. SMBG is also recommended, especially for NIDDM patients on BG-lowering medications. Self-Nursing treatment Because the characteristics of the diabetes regimen (e.g., complexity, chronicity, demand, and patient responsibility) typically predict poor adherence, regimen adherence is of special interest in diabetes research. However, there has been a growing realization that the study of adherence in diabetes presents several unique conceptual and methodological problems (Glasgow, Wilson, & McCaul, 2002; Johnson, 2005, 87-110). For example, it is not always possible to assess adherence because patients have not received explicit prescriptions but, rather, general instructions such as “try to exercise more.” This means that the adequacy of diabetes self-care behaviors, and not adherence to it, is often the construct of interest. Diabetes research shares with other illnesses the problem of obtaining valid measures of selfcare behavior and, by necessity, must often rely on self-report data. Patient Characteristics In both children and adults, the presence of psychological disturbance such as depression and anxiety has been associated with poor diabetes management, although some studies have not replicated this relationship (Nagasawa, Smith, Barnes, & Fincham, 2005, 362). Personality characteristics may also influence self-nursing treatment. A recent study found that patients with alienated, opportunistic, and explosive temperaments were in poorer glucose control (Lustman, Frank, & McGill, 2001). Individual coping skills, both in terms of diabetes-specific problem solving and ability to cope with life stress, can also influence self-care and nursing treatment outcome (Delamater, Kurtz, Bubb, White, & Santiago, 2004, 44; Hanson et al., 1999, 41). More interest has recently focused on the role of patients' health beliefs, including beliefs about symptoms, disease severity, vulnerability to negative consequences, nursing treatment benefits and costs, and perceived ability to successfully perform self-care tasks (i.e., perceived self-efficacy; Glasgow, 2001, 95; Grossman, Brink, & Hauser, 2004, 132-8; Kurtz, 2005, 77). Although health beliefs have repeatedly related to self-care in patients with both IDDM and NIDDM, the types of beliefs predicting adherence differ across studies (Brownlee-Duffeck et al., 2004; Cerkoney & Hart, 2005, 56; Hampson, Glasgow, & Toobert, 2005, 22; Wilson et al., 2003). Harris, Skyler, Linn, Pollack, and Tewksbury (2001, 62) have suggested that different health beliefs influence adherence to specific regimen tasks. Social and Familial Factors It is not surprising that family relationships and interactions can either enhance or interfere with diabetes management. In children, family conflict and dysfunction is predictive of adherence difficulty, whereas increased levels of family support, cohesion, and organization are associated with better adherence and metabolic control (Anderson, 2005; Hanson, Henggeler, & Burghen, 2004; Hauser et al., 2005, 301-8). The Family Behavior Checklist, which measures both supportive and nonsupportive familial behaviors, has been found to predict adherence in adolescents and adults (Glasgow & Toobert, 1998; Hansen et al., 2004; Schafer, Glasgow, McCaul, & Dreher, 2000; Schafer, McCaul, & Glasgow, 2003, 145-7). Glasgow and Toobert (1998) have also demonstrated that this diabetes-specific measure is a better predictor than global measures of support. Support from non-family members of the social network has not yet been investigated. Another important but empirically neglected social influence is the patient–physician relationship. We do know that patients with both IDDM and NIDDM who discontinue follow-up or infrequently attend clinics tend to be in poorer health and worse glycemic control than patients with regular follow-up (Hammersley, Holland, Walford, & Thorn, 2002, 109-23; Jacobson, Adler, Derby, Anderson, & Wolfsdorf, 2001, 32). Although there may be many reasons for failure to attend clinics, Jacobson et al. (2001) found that infrequent attendance was not associated with health insurance coverage or traveling distance. Rather, patients who attended infrequently had no interest in discussing their nursing treatment with or receiving advice from their physician. Environmental Factors and Behavioral Contingencies Some of the most interesting work in this area has examined environmental “barriers to adherence” from the patient's perspective, such as cost, time, resource availability, and competing demands, all of which predict self-care in both IDDM and NIDDM patients (Glasgow et al., 1999; Irvine, Saunders, Blank, & Carter, 2005, 55). Natural contingencies associated with diabetes and its nursing treatment are another important factor. For example, adherence can have negative consequences, such as the increased risk of hypoglycemia or weight gain associated with more intensive insulin regimens. Self-monitoring of BG levels can also act as a form of punishment because patients often obtain measurements indicating their BG is too low or high (Jones, 2005). Consequently, patients are more likely to self-test on days when they have followed the prescribed regimen. Moreover, better adherence does not necessarily lead to better diabetes control. From a behavioral perspective, improvements in self-care followed by failure to improve control should reduce future efforts. As of yet, research has not addressed these potentially significant effects on patient behavior. A critical issue facing researchers is the identification of patients at high risk for self-care problems and development of effective interventions to achieve optimal diabetes management. A major obstacle to such intervention is the difficulty of developing programs that are pragmatic, feasible, and cost-effective for wide-scale application (Glasgow, Toobert, & Hampson, 2001, 34). However, the possibility of pragmatic intervention is suggested by creative solutions such as integrating problem-solving training into routine clinic visits (Anderson et al., 1999, 58) and cost-effective methods such as supportive telephone followup (Estey et al., 2005, 11-8). Another future challenge is developing methods to maintain self-care improvements over time. Rubin et al. (2005), for example, found that improvements in insulin adjustment and SMBG were maintained after intervention, but changes in diet and exercise were not. Psychosocial Impact The impact of and adjustment to diabetes begins with diagnosis. Most research investigating the effects of diagnosis has concentrated on children and adolescents, with recent studies following patients and their families across the first year after diagnosis (Jacobson et al., 2004; Kovacs, Iyengar, Goldston, Stewart, Obrosky, & Marsh, 2005, 67). Many patients experience psychosocial disturbance following diagnosis, including depression, anxiety, and social withdrawal. However, significant levels of distress are seen in only approximately one third of patients and, by the end of the first year, almost all children recover (Jacobson et al., 2003; Kovacs, Brent, Steinberg, Paulauskas, & Reid, 2003, 66-78). Parents' psychological response to the diagnosis is an important predictor of the child's adjustment. In NIDDM adults, psychological distress is also observed following diagnosis (Cassileth et al., 2000), but patients typically return to premorbid levels of functioning after adjustment (Jones, 2005, 26-8). As diabetes progresses, psychosocial problems often occur secondary to the onset of complications. For example, patients who experience loss of vision exhibit symptoms of emotional distress, primarily depression and decreased self-esteem (Wulsin, Jacobson, & Rand, 2004, 19-41). However, patients with stabilized vision loss show less disturbance in mental health than patients with fluctuating vision (Bernbaum, Albert, & Duckro, 1998, 62). In this study, rehabilitative training for patients with fluctuating vision loss improved psychological status, suggesting the need for early intervention. Diabetes can also have a negative impact on marital and sexual satisfaction (Schreiner-Engel, Schiavi, Vietorisz, & Smith, 2004,44). In many cases, this is secondary to problems in sexual functioning, which are prevalent among diabetic men (see Cox, Gonder-Frederick, & Saunders, 2001, 200). Although diabetic impotence is more likely to be organic in etiology than in other groups, the problem may be exacerbated by psychological and behavioral factors. Several studies have found a higher incidence of depression and anxiety disorders in both IDDM and NIDDM patients, independent of such factors as diabetic complications and loss of function (Geringer, Perlmuter, Stern, & Nathan, 1998; Lustman, Griffith, Clouse, & Cryer, 2003; Popkin, Callies, Lentz, Colon, & Sutherland, 1998, 165). Lustman et al. (2003), for example, reported a twofold increase in psychiatric disorders in diabetic patients, a higher rate than either the general population or other groups with chronic illnesses show. In addition, patients with a history of depression have shown a fivefold increase of recurrence risk, leading to the conclusion that the course of depression is more severe in diabetic populations (Lustman, Griffith, & Clouse, 1998). Another study recently found an increased prevalence of depression and anxiety disorders in 113 young adults with IDDM (Mayou et al., 2001, 21). Some researchers believe there is a unique relationship between depression and diabetes and speculate that a similar biological abnormality may contribute to both, such as elevated cortisol, decreased norepinephrine and serotonin, or cerebrovascular disease (Geringer, 2005; Popkin et al., 1998, 32). However, this conclusion remains tentative. A survey of more than 3,000 individuals in the Los Angeles area found that diabetic subjects had a higher rate of affective and anxiety disorders than those with no chronic illnesses, but not a higher rate than subjects with other chronic illnesses such as arthritis and heart disease (Wells, Golding, & Burnam, 1999, 47). Behavioral Weight Loss Interventions Obesity is uniquely relevant to NIDDM. A 10-pound weight loss has been associated with improved metabolic control, whereas correlations of retrospective data suggest a 3- to 4-month increase in life expectancy for every 2.2 pounds lost (Lean, Powrie, Anderson, & Garthwaite, 2005, 58-61, 72). Experimental studies have investigated a variety of different nursing treatment parameters. Heitzmann et al. (2004) reported that behavior modification was superior to control, cognitive, or cognitive plus behavior modification therapy in terms of weight loss and that men responded better to behavior modification. Regardless of nursing treatment group, men showed greater improvement in HbA1 at the 18-month follow-up. Wing, Epstein, Paternostro-Bayles et al. (1998) reported two studies comparing behavioral weight loss programs with and without exercise: one compared stretching versus walking 3 miles three times a week, and the other compared no exercise with walking 3 miles four times a week. Only the latter comparison showed a specific nursing treatment effect for both weight loss and HbA1 . In the context of a behavioral weight loss program, Wing (1999) evaluated the relative role of teaching patients how to make self-care decisions (e.g. reduce calories, increase exercise, and adjust medications) on the basis of SMBG results, compared with simply providing BG measurements. They found no beneficial effects in teaching self-care decision making. Cognitive-Motor Deficits The brain can neither effectively store glucose nor utilize metabolic fuels other than glucose. Reduced BG to the brain can result in transient dysfunctions, whereas prolonged and severe hypoglycemia may lead to permanent brain damage. In addition to hypoglycemia, prolonged and extreme hyperglycemia may lead to permanent dysfunctions. Although there has been a literal explosion of diabetic neurobehavioral research, we address the more recent and striking findings. CONCLUSION Interpretations are also limited by the study sample. Adolescents often display poor diabetes control, in part, because of hormonal changes. Different findings may have emerged had we studied a sample that displays tighter diabetes control and thus experiences more hypoglycemia. One of the purposes of the study was to determine how one psychological variable—negative affectivity (NA)—influences these self-regulatory aspects of diabetes management. It should be noted, however, that the BG threshold at which symptoms occur varies greatly across patients, moderate levels of hypoglycemia are often symptomatic, and the magnitude of change in physiological functioning as opposed to only the absolute level of physiological functioning contributes to subjective symptomatology. Yet, we do acknowledge that associations among trait anxiety, actual low BG symptoms, and the accuracy of low BG symptom beliefs could have been affected by the low frequency of extreme hypoglycemia. Replication of these findings with different patient samples may thus clarify their interpretation. Despite these limitations, this study supported a symptom-perception explanation of the association between NA and BG symptom reports and suggested that NA-related constructs play a role in diabetes management. Specifically, the combination of high trait anxiety with high internal focus may not bode well for tight diabetes control. Additional research that disentangles the potential self-regulatory processes mediating these associations could, thus, have important clinical implications. REFERENCES Armstrong D. (2001) The social context of technology in diabetes care: 'compliance' and 'control'. In The Technology of Diabetes Care (Bradley C., Home P. &. Christie M. eds), Harwood Academic Publishers, Reading, pp. 17-23. Bottorff J.D., Ratner P.A. & Johnson J.L. (2003) Uncertainties and Challenges. Communicating Risk in the Context of Familial Cancer. Report to the National Institute of Canada, Vancouver. School of Nursing, University of British Columbia, Vancouver. Brown S. (1998) Effects of educational intervention in diabetes care: a meta-analysis of findings. Nursing Research 37, 223-230. Clinical Standards Advisory Group (2000) Standards of Clinical Care for People with Diabetes HMSO, London. Doona M., Haggerty L. & Chase S. (2004) Nursing presence: an existential exploration of the concept. Scholarly Enquiry for Nursing Practice 11(1), 3-14. Gavin J. (2004) Nursing ideology and the 'generic carer'. Journal of Advanced Nursing 26, 692-697. Greenfield S., Kaplan S.H. & Ware J.E. (1998) Patient participation in medical care: effects on blood sugar and quality of life in diabetes. Journal of General Internal Medicine 3, 448-457. Greenhalgh T. (2000) Shared Care for Diabetes: A Systematic Review. Occasional Paper 67. The Royal College of General Practitioners, London. Kelleher D. (1998) Coming to terms with diabetes: coping strategies and non-compliance. In Living with Chronic Illness: The Experiences of Patients and Their Families (Anderson R. & Bury M. eds), Unwin Hyman, London, pp. 137-155. Luker K. & Caress A. (1999) Rethinking patient education. Journal of Advanced Nursing 14, 711-718. Murphy E., Kinmonth A.-l. & Marteau T. (2001) General practice-based diabetes surveillance: the views of patients. British Journal of General Practice 42, 279-283. Noble C. (2001) Are nurses good patient educators? Journal of Advanced Nursing 16, 1185-1189. Pill R., Stott N.C.H., Rollnick S. & Rees M. (1998) A randomised trial of an intervention designed to improve the care given in general practice to Type II diabetic patients: patient outcomes and professional ability to change behaviour. Family Practice 15(3), 229-235. Rollnick S. & Miller W.R. (2002) What is motivational interviewing? Behavioural and Cognitive Therapy 23, 325-334. Stewart M., Brown J.B., Weston W.W. et al. (2002) Patient-Centred Medicine: Transforming the Clinical Method. Sage, London. Stott N.C.H. & Pill R. (2005) 'Advise yes, dictate no': patients' views on health promotion in the consultation. Family Practice 17, 125-131. Stott N.C.H., Rees M., Rollnick S., Pill R.M. & Hackett P. (2003) Professional responses to innovation in clinical method and negotiating skills. Patient Education and Counselling 29, 67-73. Stott N.C.H., Rollnick S.R., Rees M. & Pill R. (2002) Innovation in clinical method, diabetes care and negotiating skills. Family Practice 12, 413-418. Strauss A. (2004) Qualitative Analysis for Social Scientists. Cambridge University Press, Cambridge. United Kingdom Central Council for Nursing, Midwifery and Health Visiting (2003) Project 2000: A New Preparation for Practice. UKCC, London. Wiles (2004) Empowering practice nurses in the follow-up of patients with established heart disease: lessons from patients. Journal of Advanced Nursing 26, 729-735. Abel, G. G., Becker, J. V., Cunningham-Rathner, J., Mittelman, M., & Primack, M. (2001). Differential diagnosis of impotence in diabetics: The validity of sexual symptomatology. Neurourology and Urodynamics, 1, 57–69. Ader, D. N., Johnson, S. B., Huang, S. W., & Riley, W. J. (in press). Group size, cage shelf level, and emotionality in NOD mice: Impact on onset and incidence of IDDM. Psychosomatic Medicine Anderson, B. J. (2005). Diabetes and adaptation in family systems. In C. S.Holmes (Ed.), Neuropsychological and behavioral aspects of diabetes (pp. 85–101). New York: Springer-Verlag. Anderson, B. J., Miller, J. P., Auslander, W. F., & Santiago, J. V. (1999). Family characteristics of diabetic adolescents: Relationship to metabolic control. Diabetes CARE, 4, 580–594. Barglow, P., Hatcher, R., Berndt, D., & Phelps, R. (2002). Psychosocial childbearing stress and metabolic control in pregnant diabetics. Journal of Nervous and Mental Disease, 173, 615–620. Bernbaum, M., Albert, S. G., & Duckro, P. N. (1998). Psychosocial profiles in patients with visual impairment due to diabetic retinopathy. Diabetes CARE, 11, 551–557. Bradley, C., & Lewis, K. S. (2005). Measures of psychological well-being and nursing treatment satisfaction developed from the responses of people with tablet-treated diabetes. Diabetic Medicine, 7, 445–451. Bradley, C., Lewis, K. S., Jennings, A. M., & Ward, J. D. (2005). Scales to measure perceived control developed specifically for people with tablet-treated diabetes. Diabetic Medicine, 7, 685–694. Brownlee-Duffeck, M., Peterson, L., Simonds, J. F., Goldstein, D., Kilo, C., & Hoette, S. (2004). The role of health beliefs in the regimen adherence and metabolic control of adolescents and adults with diabetes mellitus. Diabetes CARE, 55, 139–144. Capponi, R., Kawada, M. E., Varela, C., & Vargas, L. (2005). Diabetes mellitus by repeated stress in rats bearing chemical diabetes. Hormonal Metabolic Research, 12, 411–412. Carter, W. R., Herrman, J. J., Stokes, K., & Cox, D. J. (2004). Promotion of diabetic onset by stress in the BB rat. Diabetologia, 30, 674–675. Cassileth, R. R., Lusk, E. J., Strouse, T. B., Miller, D. S., Brown, L. L., Cross, P. A., & Tenaglia, B. S. (2000). Psychosocial status in chronic illness. New England Journal of Medicine, 311, 506–511. Cerkoney, K. A. B., & Hart, L. K. (2005). The relationship between the health belief model and compliance of persons with diabetes mellitus. Diabetes CARE, 3, 594–598. Cox, D. J., & Clarke, W. L. (in press). Acute and chronic cognitive-motor impairments in diabetes mellitus. Diabetic Medicine Cox, D. J., & Gonder-Frederick, L. A. (2001). Stress and diabetes mellitus. In P.McCabe, N.Schneiderman, T.Field, & J.Skyler (Eds.), Stress and coping (pp. 119–134). Hillsdale, NJ: Erlbaum. Cox, D. J., Gonder-Frederick, L. A., & Clarke, W. L. (2001). Driving impairments in Type I diabetes during englycemia, moderate and severe hypoglycemia. Diabetes, 40, 557A. Cox, D. J., Gonder-Frederick, L. A., Julian, D. M., Cryer, P. E., Lee, J. H., Richards, F. E., & Clarke, W. L. (2001). Intensive vs standard Blood Glucose Awareness Training (BGAT) with insulin dependent diabetes: Mechanisms and ancillary effects. Psychosomatic Medicine, 53, 453–462. Cox, D. J., Gonder-Frederick, L., & Saunders, J. T. (2001). Diabetes: Clinical issues and management. In J. J.Sweet, R. H.Rozensky, & S. M.Tovian, Handbook of clinical psychology in medical settings (pp. 473–496). New York: Plenum Press. Cox, D. J., Taylor, A. G., Nowacek, G., Holley-Wilcox, P., Pohl, S. L., & Guthrow, E. (2000). The relationship between psychological stress and insulin-dependent diabetic blood glucose control: Preliminary investigations. Health Psychology, 3, 63–75. Davis, W. K., Hess, G. E., Harrison, R. V., & Hiss, R. G. (2004). Psychosocial adjustment to and control of diabetes mellitus: Differences by disease type and nursing treatment. Health Psychology, 6, 1–14. Davis, W. K., Hess, G. E., & Hiss, R. G. (1998). Psychosocial correlates of survival in diabetes. Diabetes CARE, 11, 538–545. DCCT Research Group. (2003). The Diabetes Control and Complications Trial (DCCT): Design and methodologic considerations for the feasibility phase. Diabetes CARE, 35, 530–545. DCCT Research Group. (1998). Reliability and validity of a diabetes quality-of-life measure for the Diabetes Control and Complications Trial (DCCT). Diabetes CARE, 11, 725–732. Delamater, A. M., Kurtz, S. M., Bubb, J., White, N. H., & Santiago, J. V. (2004). Stress and coping in relation to metabolic control of adolescents with Type I diabetes. Developmental and Behavioral Pediatrics, 8, 136–140. Dunn, S. M., Smartt, H. H., Beeney, L. J., & Turtle, J. R. (2003). Measurement of emotional adjustment in diabetic patients: Validity and reliability of ATT39. Diabetes, CARE, 9, 480–489. Estey, A. L., Tan, M. H., & Mann, K. (2005). Follow-up intervention: Its effect on compliance behavior to a diabetes regimen. The Diabetes Educator, 16, 291–295. Feinglos, M. N., Hastedt, P., & Surwit, R. S. (2004). Effects of relaxation therapy on patients with Type I diabetes mellitus. Diabetes CARE, 10, 72–75. Fisher, E. B., Delamater, A. M., Bertelson, A. D., & Kirkley, B. G. (2001). Psychological factors in diabetes and its nursing treatment. Journal of Consulting and Clinical Psychology, 50, 993–1003. Frenzel, M. P., McCaul, K. D., Glasgow, R. E., & Schafer, L. C. (1998). The relationship of stress and coping to regimen adherence and glycemic control of diabetes. Journal of Social and Clinical Psychology, 6, 77–87. Garrard, J., Joynes, J. O., Mullen, L., McNeil, L., Mensin, C., Feste, C., & Etwiler, B. D. (2004). Psychometric study of patient knowledge test. Diabetes CARE, 10, 500–509. Garrison, W. T., & Biggs, D. (2005). Young children's subjective reports about their diabetes mellitus: A validation of the diabetes pictorial scale. Diabetes Educator, 16, 304–308. Geringer, E. S. (2005). Affective disorders and diabetes mellitus. In C. S.Holmes (Ed.), Neuropsychological and behavioral aspects of diabetes (pp. 239–264). New York: Springer-Verlag. Geringer, E., Perlmuter, L., Stern, T., & Nathan, D. (1998). Depression and diabetic neuropathy: A complex relationship. Journal of Geriatric Psychiatry & Neurology, 1, 11–15. Glasgow, R. E. (2001). Compliance to diabetes regimens: Conceptualization, complexity and determinants. In J. A.Cramer & B.Spilker (Eds.), Patient compliance in medical practice and clinical trials (pp. 209–224). New York: Raven Press. Glasgow, R. E., McCaul, K. D., & Schafer, L. C. (2004). Self-care behaviors and glycemic control in Type I diabetes. Journal of Chronic Diseases, 40, 399–412. Glasgow, R. E., & Toobert, D. J. (1998). Social environment and regimen adherence among Type II diabetic patients. Diabetes CARE, 11, 377–386. Glasgow, R. E., Toobert, D. J., & Hampson, S. E. (2001). Participation in outpatient diabetes education programs: How many patients take part and how representative are they?Diabetes Educator, 17, 376–380. Glasgow, R. E., Toobert, D. J., Riddle, M., Donnelly, J., Mitchell, D. L., & Calder, D. (1999). Diabetes-specific social learning variables and self-care behaviors among persons with Type II diabetes. Health Psychology, 8, 285–303. Glasgow, R. E., Wilson, W., & McCaul, K. D. (2002). Regimen adherence: A problematic construct in diabetes research. Diabetes CARE, 8, 300–301. Goetsch, V. L., Wiebe, D. J., Veltum, L. G., & VanDorsten, B. (2005). Stress and blood glucoses in Type II diabetes mellitus. Behavior Research and Therapy, 28, 531–537. Gonder-Frederick, L. A., Carter, W. R., Cox, D. J., & Clarke, W. L. (2005). Environmental stress and blood glucose change in insulin-dependent diabetes mellitus. Health Psychology, 9, 503–515. Gonder-Frederick, L. A., & Cox, D. J. (2001). Symptom perception, symptom beliefs, and blood glucose discrimination in the self-nursing treatment of insulin-dependent diabetes. In J. A.Skelton and R. T.Croyle (Eds.), Mental representation in health and illness (pp. 217–246). New York: Springer-Verlag. Gonder-Frederick, L. A., Cox, D. J., Bobbitt, S. A., & Pennebaker, J. W. (1999). Changes in mood state associated with blood glucose fluctuations in insulin-dependent diabetes mellitus. Health Psychology, 8, 45–59. Gonder-Frederick, L. A., Cox, D. J., Richards, F., Cryer, P., Lee, J. H., & Clarke, W. L. (2001). Antecedent metabolic parameters mediate blood glucose response to psychological stress in insulin-dependent diabetes mellitus. Manuscript submitted for publication. Griffith, L. S., Field, B. J., & Lustman, P. J. (2005). Life stress and social support in diabetes: Association with glycemic control. International Journal of Psychiatry in Medicine, 20, 365–372. Grossman, H. Y., Brink, S., & Hauser, S. T. (2004). Self-efficacy in adolescent girls and boys with insulin-dependent diabetes mellitus. Diabetes CARE, 10, 324–329. Halford, W. K., Cuddihy, S., & Mortimer, R. H. (2005). Psychological stress and blood glucose regulation in Type I diabetic patients. Health Psychology, 9, 516–528. Hammersley, M. S., Holland, M. R., Walford, S., & Thorn, P. A. (2002). What happens to defaulters from a diabetic clinic?British Medical Journal, 291, 1330–1332. Hampson, S. E., Glasgow, R. E., & Toobert, D. J. (2005). Personal models of diabetes and their relation to self-care activities. Health Psychology, 9, 632–646. Hanson, C. L., Cigrant, J. A., Harris, M. A., Carle, D. L., Relyea, G., & Burghen, G. A. (1999). Coping styles in youths with insulin-dependent diabetes mellitus. Journal of Consulting and Clinical Psychology, 57, 644–651. Hanson, C. L., Henggeler, S. W., & Burghen, G. A. (2004). Social competence and parental support as mediators of the link between stress and metabolic control in adolescents with insulin-dependent diabetes mellitus. Journal of Consulting and Clinical Psychology, 55, 529–533. Hanson, C. L., & Pritchert, J. W. (2003). Perceived stress and diabetes control in adolescents. Health Psychology, 5, 439–452. Harris, R., Linn, M. W., Skyler, J. S., & Sandifer, R. (2004). Development of the Diabetes Health Belief Scale. Diabetes Educator, 13, 292–297. Harris, R., Skyler, J. S., Linn, M. W., Pollack, L. W., & Tewksbury, D. (2001). The relationship between the health belief model and compliance as a basis for intervention in diabetes mellitus. Pediatric & Adolescent Endocrinology, 10, 123–132. Hauser, S. T., Jacobson, A. M., Lavori, P., Wolfsdorf, J. I., Herskowitz, R. D., Milley, J. E., & Bliss, R. (2005). Adherence among children and adolescents with insulin-dependent diabetes mellitus over a four-year longitudinal follow-up: II. Immediate and long-term linkages with the family milieu. Journal of Pediatric Psychology, 15, 527–542. Heitzmann, C. A., Kaplan, R. M., Wilson, D. K., & Sandler, J. (2004). Sex differences in weight loss among adults with Type II diabetes mellitus. Journal of Behavioral Medicine, 10, 199–210. Holmes, C. S., Dunlap, W. P., Chen, R. S., & Cornwell, J. M. (in press). Gender differences in the learning status of diabetic children. Journal of Consulting and Clinical Psychology Holmes, D. M. (2003). The person and diabetes in psychosocial context. Diabetes CARE, 9, 194–206. Huang, S. W., Plaut, S. M., Taylor, G., & Wareheim, B. A. (2001). Effect of stressful stimulation on the incidence of streptozotocin-induced diabetes in mice. Psychosomatic Medicine, 43, 431–437. Irvine, A. A., Cox, D. J., & Gonder-Frederick, L. A. (2001). Fear of hypoglycemia: Relationship to glycemic control and psychological factors in IDDM patients. Health Psychology, 11, 135–138. Irvine, A. A., Saunders, J. T., Blank, M. B., & Carter, W. R. (2005). Validation of scale measuring environmental barriers to diabetes-regimen adherence. Diabetes CARE, 13, 705–711. Jacobson, A. M., Adler, A. G., Derby, L., Anderson, B. J., & Wolfsdorf, J. I. (2001). Clinic attendance and glycemic control: Study of contrasting groups of patients with IDDM. Diabetes CARE, 14, 599–601. Jacobson, A. M., Hauser, S. T., Wertlieb, D., Wolfsdorf, J. I., Orleans, J., & Vieyra, M. (2003). Psychological adjustment of children with recently diagnosed diabetes mellitus. Diabetes CARE, 9, 323–329. Jacobson, A. M., Hauser, S. T., Wolfsdorf, J. I., Houlihan, J., Milley, J. E., Herskowitz, R. D., Wertlieb, D., & Watt, E. (2004). Psychologic predictors of compliance in children with recent onset of diabetes mellitus. Journal of Pediatrics, 110, 805–811. Johnson, S. B. (2005). Adherence behaviors and health status in childhood diabetes. In C. S.Holmes (Ed.), Neuropsychological and behavioral aspects of diabetes (pp. 30–57). New York: Springer-Verlag. Johnson, S. B., Freund, A., Silverstein, J., Hansen, C. A., & Malone, J. (2005). Adherence-health status relationships in childhood diabetes. Health Psychology, 9, 606–631. Jones, P. M. (2005). Use of a course on self-control behavior techniques to increase adherence to prescribed frequency for self-monitoring blood glucose. Diabetes Educator, 16, 296–303. Kovacs, M., Brent, D., Steinberg, T. F., Paulauskas, S., & Reid, J. (2003). Children's self-reports of psychologic adjustment and coping strategies during the first year of insulin-dependent diabetes mellitus. Diabetes CARE, 9, 472–479. Kovacs, M., Iyengar, A., Goldston, D., Stewart, J., Obrosky, D. S., & Marsh, J. (2005). Psychological functioning of children with insulin-dependent diabetes mellitus: A longitudinal study. Journal of Pediatric Psychology, 15, 619–632. Kurtz, S. M. S. (2005). Adherence to diabetes regimens: Empirical status and clinical applications. Diabetes Educator, 16, 50–56. Kuttner, M. J., Delamater, A. M., & Santiago, J. V. (2005). Journal of Pediatric Psychology, 15, 581–594. La Greca, A. M., Schwarz, L. T., & Satin, W. (2004). Eating patterns in young women with IDDM: Another look. Diabetes CARE, 10, 659–660. Langan, S. J., Deary, I. J., Hepburn, D. A., & Frier, B. M. (2001). Cumulative cognitive impairment following recurrent severe hypoglycaemia in adult patients with insulin-treated diabetes. Diabetologia, 34, 333–343. Lean, M. E. J., Powrie, J. K., Anderson, A. S., & Garthwaite, P. H. (2005). Obesity, weight loss and prognosis in Type II diabetes. Diabetic Medicine, 7, 228–233. Lewis, K. S., Jennings, A. M., Ward, J. D., & Bradley, C. (1999). Health belief scales developed specifically for people with tablet-treated Type 2 diabetes. Diabetic Medicine, 7, 148–155. Littlefield, C. H., Rodin, G. M., Murray, M. A., & Craven, J. L. (2005). Influence of functional impairment and social support on depressive symptoms in persons with diabetes. Health Psychology, 9, 737–749. Lustman, P. J., Frank, B. L., & McGill, J. B. (2001). Relationship of personality characteristics to glucose regulation in adults with diabetes. Psychosomatic Medicine, 53, 305–312. Lustman, P. J., Griffith, L. S., & Clouse, R. E. (1998). Depression in adults with diabetes: Results of 5-year follow-up study. Diabetes CARE, 11, 605–612. Lustman, P. J., Griffith, L. S., Clouse, R. E., & Cryer, P. E. (2003). Psychiatric illness in diabetes mellitus: Relationship to symptoms and glucose control. Journal of Nervous & Mental Disease, 174, 736–742. Marcus, M. D., & Wing, R. R. (2005). Eating disorder and diabetes. In C. S.Holmes (Ed.), Neuropsychological and behavioral aspects of diabetes (pp. 102–121). New York: Springer-Verlag. Mayou, R., Peveler, R., Davies, B., Mann, J., & Fairburn, C. (2001). Psychiatric morbidity in young adults with insulin-dependent diabetes mellitus. Psychological Medicine, 21, 639–645. McGrady, A., Bailey, B. K., & Good, M. P. (2001). Controlled study of biofeedback-assisted relaxation in Type I diabetes. Diabetes CARE, 14, 360–365. Nagasawa, M., Smith, M. C., Barnes, J. H., & Fincham, J. E. (2005). Meta-analysis of correlates of diabetes patients' compliance with prescribed medications. Diabetes Educator, 16, 192–200. Naliboff, B. D., Cohen, M. J., & Sowers, J. D. (2002). Physiological and metabolic responses to brief stress in non-insulin dependent diabetic and control subjects. Journal of Psychosomatic Research, 29, 367–374. Padgett, D., Mumford, E., & Haynes, M. (1998). Meta-analysis of the effects of educational and psychosocial interventions on management of diabetes mellitus. Journal of Clinical Epidemiology, 41, 1007–1030. Peyrot, M., & McMurray, J. F. (2002). Psychosocial factors in diabetes control: Adjustment of insulin-treated adults. Psychosomatic Medicine, 47, 542–557. Pless, I. B., Heller, A., Belmonte, M., & Zvagulis, I. (1998). Expected diabetic control in childhood and psychosocial functioning in early adult life. Diabetes CARE, 11, 387–392. Popkin, M. K., Callies, A. L., Lentz, R. D., Colon, E. A., & Sutherland, D. E. (1998). Prevalence of major depression, simple phobia, and other psychiatric disorders in patients with long-standing Type I diabetes mellitus. Archives of General Psychiatry, 45, 64–68. Reaven, G. M., Thompson, L. W., Nahum, D., & Haskins, E. (2005). Relationship between hyperglycemia and cognitive function in older NIDDM patients. Diabetes CARE, 13, 16–21. Robinson, N., & Fuller, J. H. (2003). Severe life events and their relationship to the etiology of insulin-dependent (Type I) diabetes mellitus. Pediatric Adolescent Endocrinology, 15, 129–133. Rubin, R. R., Peyrot, M., & Saudek, C. D. (1999). Effect of diabetes education on self-care, metabolic control, and emotional well-being. Diabetes CARE, 12, 673–679. Ryan, C., Atchison, J., Puczynski, S., Puczynski, M., Arslanian, S., & Becker, D. (2005). Mild hypoglycemia associated with deterioration of mental efficiency in children with insulin-dependent diabetes mellitus. Journal of Pediatrics, 117, 32–38. Ryan, C. M., Williams, T. M., Orchard, T. J., & Finegold, D. N. (2001). Psychomotor slowing is associated with distal symmetrical polyneuropathy in adults with diabetes mellitus. Diabetes, 41, 107–113. Ryan, D., Vaga, A., & Drash, A. (2002). Cognitive deficits in adolescents who developed diabetes early in life. Pediatrics, 75, 921–927. Schafer, L. C., Glasgow, R. E., McCaul, K. D., & Dreher, M. (2000). Adherence to IDDM regimens: Relationship to psychosocial variables and metabolic control. Diabetes CARE, 6, 493–498. Schafer, L. C., McCaul, K. D., & Glasgow, R. E. (2003). Supportive and nonsupportive family behaviors: Relationships to adherence and metabolic control in persons with Type I diabetes. Diabetes CARE, 9, 179–185. Schreiner-Engel, P., Schiavi, R. C., Vietorisz, D., & Smith, H. (2004). The differential impact of diabetes type in female sexuality. Journal of Psychosomatic Research, 31, 23–33. Scialli, P., Cox, D. J., Schroeder, D. B., & Clarke, W. L. (1998). Looking beyond the retina. Journal of the American Medical Association, 259, 3405–3406. Stabler, B. S., Morris, M. A., Litton, J., Feinglos, M. N., & Surwit, R. S. (2003). Differential glycemic response to stress in Type A and Type B individuals with IDDM. Diabetes CARE, 9, 550–552. Surwit, R. S., & Feinglos, M. N. (2000). The effects of relaxation on glucose tolerance in non-insulin dependent diabetes mellitus. Diabetes CARE, 7, 203–204. Surwit, R. S., & Feinglos, M. N. (1998). Stress and autonomic nervous system in Type II diabetes. Diabetes CARE, 11, 83–85. Surwit, R. S., Feinglos, M. N., Livingston, E. G., Kuhn, C. M., & McCubbin, J. A. (2000). Behavioral manipulation of the diabetic phenotype in ob/ob mice. Diabetes, 33, 616–618. Surwit, R. S., McCubbin, J. A., Kuhn, C. M., McGee, D., Gerstenfeld, D., & Feinglos, M. N. (2003). Alprazolam reduces stress hyperglycemia in ob/ob mice. Psychosomatic Medicine, 48, 278–282. Surwit, R. S., McCubbin, J. A., Livingston, E. G., & Feinglos, M. N. (2002). Classically conditioned hyperglycemia in the obese mouse. Psychosomatic Medicine, 47, 565–568. Tsalikian, E. (2005). Insulin-dependent (Type I) diabetes mellitus: Medical overview. In C. S.Holmes (Ed.), Neuropsychological and behavioral aspects of diabetes (pp. 3–11). New York: Springer-Verlag. Wells, K. B., Golding, J. M., & Burnam, M. A. (1999). Affective, substance use, and anxiety disorders in persons with arthritis, diabetes, heart disease, high blood pressure, or chronic lung conditions. General Hospital Psychiatry, 11, 320–327. Widom, B., & Simonson, D. C. (2005). Glycemic control and neuropsychologic function during hypoglycemia in patients with insulin-dependent diabetes mellitus. Annals of Internal Medicine, 112, 904–912. Wilson, W., Ary, D. V., Biglan, A., Glasgow, R. E., Toobert, D. J., & Campbell, D. R. (2003). Psychosocial predictors of self-care behaviors (compliance) and glycemic control in non-insulin-dependent diabetes mellitus. Diabetes CARE, 9, 614–622. Wing, R. R. (1999). Behavioral strategies for weight reduction in obese Type II diabetic patients. Diabetes CARE, 12, 139–144. Wing, R. R. (2001). Behavioral nursing treatment of severe obesity. American Journal of Clinical Nutrition, 55, 545–551. Wing, R. R., Epstein, L. H., Nowalk, M. P., Koeske, R., & Hagg, S. (2002). Behavior change, weight loss, and physiological improvements in Type II diabetic patients. Journal of Consulting and Clinical Psychology, 53, 111–122. Wing, R. R., Epstein, L. H., Nowalk, M. P., & Lamparski, D. M. (2003). Behavioral self-regulation in the nursing treatment of patients with diabetes mellitus. Psychological Bulletin, 99, 78–89. Wing, R. R., Epstein, L. H., Nowalk, M. P., & Scott, N. (1998). Self-regulation in the nursing treatment of Type II diabetes. Behavior Therapy, 19, 11–23. Wing, R. R., Epstein, L. H., Paternostro-Bayles, M., Kriska, A., Nowalk, M. P., & Gooding, W. (1998). Exercise in a behavioural weight control programme for obese patients with Type 2 (non-insulin-dependent) diabetes. Diabetologia, 31, 902–909. Wing, R. R., Marcus, M. D., Epstein, L. H., & Jawad, A. (2001). A “family-based” approach to the nursing treatment of obese Type II diabetic patients. Journal of Consulting and Clinical Psychology, 59, 156–162. Wing, R. R., Marcus, M. D., Salata, R., Epstein, L. H., Miaskiewicz, S., & Blair, E. H. (2001). Effects of a very-low-calorie diet on long-term glycemic control in obese Type II diabetic subjects. Archives of Internal Medicine, 151, 1334–1340. Wing, R. R., Nowalk, M. P., Marcus, M. D., Koeske, R., & Finegold, D. (2003). Subclinical eating disorders and glycemic control in adolescents with Type I diabetes. Diabetes CARE, 9, 162–167. Wulsin, L. R., Jacobson, A. M., & Rand, L. I. (2004). Psychosocial aspects of diabetic retinopathy. Diabetes CARE, 10, 367–373. Zimmerman, B. R. (2005). Non-insulin-dependent (Type II) diabetes: Medical overview. In C. S.Holmes (Ed.), Neuropsychological and behavioral aspects of diabetes (pp. 177–183). New York: Springer-Verlag. Read More