A Combined Approach of Individual Psychological Counseling with Psychological Group Work for Patients with Diabetes Mellitus

Objective : This study investigated the impact of psychological intervention on quality of life (QOL), including self-perception of health status, self-efficacy on self-management of diabetes, and mood disturbance among patients with diabetes mellitus. Subjects : A total of thirty seven patients aged 22 to 85 (mean 60.2±12.3 years) who were hospitalized for treatment of diabetes mellitus were randomly assigned to psychological group work, either only to the group session (G group ; n=13) or to one individual counseling session in addition to the group session (IG group ; n=24). Methods : QOL was assessed in all participants at the baseline and at the end of the intervention during hospitalization using a questionnaire originally developed for evaluating their health status and self-efficacy on self-management of diabetes, along with a Profile of Mood States (POMS) for evaluating emotional distress. These two questionnaires were self-administered. Fasting plasma glucose (FPG) was assessed in all participants at the baseline and at the end of the hospitalization, and glycosylated hemoglobinA_<1c> (HbA_<1c>) and body weight were assessed at the baseline and three months after the intervention. The psychological intervention was conducted as part of a twelve-day education program for diabetes inpatients. The psychological group work consisted of two, one-hour weekly sessions focusing on problem solving and stress management. The individual fifty-minute counseling focused on exploring their perception of diabetes and history of self-management including emotional aspects, and then making up concentrate self-management plans. A certified clinical psychologist implemented both interventions. Results : A repeated measure analysis of variance (ANOVA) revealed a significant Group×Time interaction, with the IG group showing a greater reduction of anger/hostility during the period from pre-intervention to post intervention according to the POMS, whereas no change in the G group. A repeated measure ANOVA revealed some significant Time effects, showing a greater improvement in self-perception of health status, self-efficacy on self-management of diabetes, and vigor according to the POMS. FPG from pre-intervention to post intervention at the time of discharge as well as HbA_<1c> and body weight from pre-intervention to three months after the intervention also showed significant improvement in both groups. Conclusion : The combined psychological approach of group work and individual single-session counseling for patients with diabetes mellitus effectively reduced patients' anger and/or hostility. The improvement of QOL may be beneficial for establishing positive self-management habits and better glycemic control. More studies including longitudinal research with more participants are needed to confirm these results.