Psychological interventions for adherence, metabolic control, and coping with stress in adolescents with type 1 diabetes
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REVIEW ARTICLE
Psychological interventions for adherence, metabolic control, and coping with stress in adolescents with type 1 diabetes: a systematic review Yousef M. Aljawarneh1 · Nesreen M. Al‑Qaissi2 · Hana Y. Ghunaim3 Received: 15 September 2019 / Accepted: 27 February 2020 © Children’s Hospital, Zhejiang University School of Medicine 2020
Abstract Background The aim of this review was to summarize and identify the variations in the effectiveness of psychological interventions on adherence, metabolic control, and coping with stress in adolescents with type 1 diabetes (T1D). Methods An electronic search of literature was performed using PubMed (NLM), Embase (Ovid), CINAHL Plus (EBSCOhost), PsycINFO (Ovid), and Google Scholar. The search was limited to include articles reported the effect of one of the psychological interventions: cognitive behavioral therapy (CBT), coping skills training (CST), stress management, or psychotherapy intervention. The report included peer-reviewed articles published in English from January 1990 until May 2019 in adolescents with T1D, and summarizes the results of 24 studies that met the inclusion criteria. Results Psychological interventions showed differential effects on adherence, metabolic control, and coping with stress in adolescents with T1D. Behavioral interventions using principles of CBT appear to have a superior positive effect on regimen adherence compared with other types of psychological protocols. In contrast, metabolic control was significantly improved with the implementation of CST and some forms of CBT. Stress management and psychotherapy interventions showed significant promises for adolescents to cope with their diabetes-related daily stressors. Conclusions However, the findings may add some promises to diabetes management in adolescents, additional research to understand the effect of these interventions is needed. Keywords Adherence · Adolescents · Coping · Metabolic control · Type 1 diabetes
Introduction Type 1 diabetes (T1D) is the second leading chronic illness in adolescents with around 1.25 million Americans diagnosed with T1D [1]. Management of T1D requires a complex daily regimen and follow-up which can produce a great psychological burden on both the adolescent and family [2]. The recommended treatment for T1D involves * Yousef M. Aljawarneh [email protected] 1
Health Sciences Division, School of Nursing, Higher Colleges of Technology, P.O.Box 1626, Fujairah, United Arab Emirates
2
Higher Colleges of Technology, P.O.Box 1626, Fujairah, United Arab Emirates
3
Fatima College of Health Sciences, Institute of Applied Technology, P.O.Box 24162, Al Ain, United Arab Emirates
blood glucose monitoring, daily insulin injections, controlling carbohydrate intake, and performing physical activity [3]. Adherence in diabetes is typically measured by the number of times the patient administers insulin at the prescribed times, self-monitoring of blood glucose, exercise at least 20 minutes a day, and follows the prescribed diet [4]. Diabetes-re
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