Study Of Acceptance And Commitment Therapy In Self-management Of Type 2 Diabetes Patients

Objectives:The low level of psychological flexibility of type 2 diabetics leads to poor self-management and threats to physical health.Acceptance and Commitment Therapy(ACT)improves self-management of illness by enhancing psychological flexibility,so this study explore effective ways to intervene in self-management of type 2 diabetic patients by applying ACT in the self-management.Methods:66 patients with type 2 diabetes in the endocrinology department of a tertiary hospital in Nanchang were randomly divided into experimental group and control group.The control group received conventional health education content;the experimental group received ACT and conventional health education content.The study lasted for 8 weeks,once every week for 40 minutes.A series of data about patients were collected,such as demographic questionnaire,the level of HbA1 c,the Summary of Diabetes Self-Care Activities,Diabetes Self-efficacy Questionnaire,Acceptance and Action Diabetes Questionnaire(AADQ),Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS).Results:(1)The differences of experimental group between before and after intervention,between the before and after three months of intervention,were statistically significant(p<0.05)in the level of HbA1 c,five dimensions of self-management,self-efficacy,SAS,SDS,and AADQ;the intervention effect can still be maintained after three months.(2)The differences of control group between before and after intervention were statistically significant(p<0.05)in level the of HbA1 c,five dimensions of self-management,self-efficacy,SAS,SDS,and AADQ;The differences of control group between before and after three months of intervention were statistically significant(p<0.05)in HbA1 c values,four dimensions of self-management(diet,exercise,glucose monitoring and foot care),self-efficacy and SDS;The differences of control group between before and after three months of intervention weren't statistically significant(p>0.05)in medication dimensions of self-management,SAS and AADQ;the intervention effect can't be maintained after three months.(3)After the intervention,the scores of experimental group ware all higher than control group,and the difference were statistically significant(p<0.05)in the three dimensions of self-management(diet,glucose monitoring and foot care);the differences between control group and experimental group weren't statistically significant(p>0.05)in the two dimensions of self-management(exercise and medication).The scores of experimental group was higher than the control group in self-efficacy ang AADQ;the difference was statistically significant(p<0.05).Compared with control group,the scores of SAS and SDS were lower significantly(p<0.05),the level of Hb A1 c was lower significantly(p<0.05).Conclusion:(1)ACT can improve the self-management ability of patients with type 2 diabetes.(2)ACT can reduce anxiety and depression in type 2 diabetes patients and increase their self-efficacy.(3)ACT can enhance the psychological flexibility of patients with type 2 diabetes and increase the controlling of the stability of blood glucose levels.(4)The effect of ACT in the self-management of type 2 diabetes can effectively maintain,which can provide reference for the formulation of relevant interventions.