Behavioural Intervention in the Management of Compliance in Young Type - I Diabetics
P Matam*, V Kumaraiah**, C Munichoodappa+, K MP Kumar++, S Aravind+++
*Clinical Psychologist; **Professor and Head, Department of Clinical Psychology, NIMHANS, Bangalore; +Medical Superintendent, Bangalore Hospital, Bangalore; ++Professor and Head, Department of Endocrinology, MS Ramiah Teaching College and Hospital, Bangalore; +++DIACON Hospital, Bangalore.
Received : 9.7.1999; Accepted : 30.3.2000
Objectives : a) To examine the efficacy of a behavioural intervention programme in the management of compliance in young Type I diabetics, b) To examine the efficacy of a behavioural management programme in enhancing metabolic control in young Type I diabetics, c) To examine the effect of behavioural intervention on level of diabetes knowledge and quality of life in young Type I diabetics.
Methods : A total of 40 patients (Experimental group n=20, Control group n=20) was selected from local hospitalsí pediatric, endocrinology and diabetology units. The experimental group received 15 individual sessions of behavioural intervention, consisting of behavioural counseling for family and significant others, relaxation, diabetes education and specific behavioural and cognitive strategies such as reinforcement, target-setting and cognitive restructuring. Assessment was carried out on various psychological measures as well as the glycosylated hemoglobin test (HbA1), at pre and post treatment periods.
Results : The scores of the two groups were compared at post treatment point. Results indicate that there was significant improvement in the experimental group in compliance and metabolic control. There were also significant changes noted in the level of diabetes knowledge as well as the reported quality of life. These changes in compliance and metabolic control were maintained at a three month follow-up period.
Conclusions : Behavioural intervention can be included as an effective adjunct to routine medical care in the management of young Type I diabetics, especially in the management of compliance and metabolic control, enhancement of knowledge and quality of life. (JAPI 2000; 48 : 967-971)