Patient Experiences of a Theory-Based Lifestyle-Focused Group Treatment in the Prevention of Cardiovascular Diseases and Type 2 Diabetes
Cardiovascular disease and type 2 diabetes are two of the most common public health diseases, and up to 80 % of the cases may be prevented by lifestyle modification. The physiological effects of lifestyle-focused treatment are relatively well studied, but how patients actually experience such treatments is still rather unclear.
The aim of this study was to explore how patients experience lifestyle-focused group treatment in primary and secondary prevention of cardiovascular disease and type 2 diabetes.
Qualitative interviews were conducted with 19 patients attending lifestyle-focused group treatment based on social cognitive theory at a behavioral medicine clinic in northern Sweden. The interviews were transcribed verbatim and analyzed according to Malterud’s systematic text condensation.
The study shows that patients participating in this kind of group-based lifestyle treatment went through a process of self-development which deepened their understanding of own responsibility for health and improved their skills in finding support in others. The process could be tracked through three different themes (the holistic view, personal responsibility, and group treatment) which together reflected the most essential parts of the informants’ experience and showed the patient as an active decision maker struggling to adopt the principles of behavioral change.
Lifestyle-focused group treatment, based on social cognitive theory, was shown to stimulate different components that strengthen patients’ self-efficacy for long-term behavioral change.
- World Health Organization. Fact sheet no 317, cardiovascular diseases. September 2011. http://www.who.int/mediacentre/factsheets/fs317/en/index.html. Accessed 22 Nov 2011.
- Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes—estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–53. CrossRef
- World Health Organization. Preventing chronic diseases—a vital investment: WHO global report. Switzerland: Geneva; 2005.
- Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose intolerance. N Engl J Med. 2001;344(18):1343–50. CrossRef
- Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403. CrossRef
- Lindahl B, Nilsson TK, Borch-Johnsen K, Røder ME, Söderberg S, Widman L, et al. A randomized lifestyle intervention with 5-year follow-up in subjects with impaired glucose tolerance: pronounced short-term impact but long-term adherence problems. Scand J Public Health. 2009;37:434–42. CrossRef
- Vidal J. Updated review on the benefits of weight loss. Int J Obesity. 2002;26(4):S25–8. CrossRef
- Michie S, Abraham C. Interventions to change health behaviours: evidence-based or evidence-inspired? Psychol Health. 2004;19(1):29–49. CrossRef
- Baranowski T, Perry CL, Parcel GS. How individuals, environments and health behavior interact: social cognitive theory. In: Glanz K, Rimer BK, Lewis FM, editors. Health behavior and health education. 3rd ed. San Francisco: Jossey-Bass; 2002. p. 165–84.
- Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215. CrossRef
- Angermayr L, Melchart D, Linde K. Multifactorial lifestyle interventions in the primary and secondary prevention of cardiovascular disease and type 2 diabetes mellitus—a systematic review of randomized controlled trials. Ann Behav Med. 2010;40:49–64. CrossRef
- Orozco LJ, Buchleitner AM, Gimenez-Perez G, Roqué i Figuls M, Richter B, Mauricio D. Exercise or exercise and diet for preventing type 2 diabetes mellitus (review). The Cochrane Library, 2008;3.
- Deakin TA, McShane CE, Cade JE, Williams R. Group based training for self-management strategies in people with type 2 diabetes mellitus (review). The Cochrane Library, 2009;1.
- Duke SAS, Colagiuri S, Colagiuri R. Individual patient education for people with type 2 diabetes mellitus (review). The Cochrane Library, 2009;1.
- Ash S, Reeves M, Bauer J, Dover T, Vivanti A, Leong C, et al. A randomized control trial comparing lifestyle groups, individual counseling and written information in the management of weight and health outcomes over 12 months. Int J Obesity. 2006;30:1557–64. CrossRef
- Jones N, Furlanetto DLC, Jackson JA, Kinn S. An investigation of obese adults’ views of the outcomes of dietary treatment. J Hum Nutr Diet. 2007;20:486–94. CrossRef
- Chan R, Lok K, Sea M, Woo J. Clients’ experiences of a community based lifestyle modification program: a qualitative study. Int J Environ Res Public Health. 2009;6:2608–22. CrossRef
- Brown I, Thompson J, Tod A, Jones G. Primary care support for tackling obesity: a qualitative study of the perceptions of obese patient. Brit J Gen Pract. 2006;56:666–72.
- Malterud K. Shared understanding of the qualitative research process. Guidelines for the medical researcher. Fam Pract. 1993;10(2):201–6. CrossRef
- Miller CK, Davis MS. The influential role of social support in diabetes management. Top Clin Nutr. 2005;20(2):157–65. CrossRef
- Anderson LA, Zimmerman MA. Patient and physician perceptions of their relationship and patient satisfaction—a study of chronic disease management. Patient Educ Couns. 1993;20:27–36. CrossRef
- Fuertes JN, Mislowack A, Bennett J, Paul L, Gilbert TC, Fontan G, Boylan LS. The physician–patient working alliance. Patient Educ Couns. 2007;66:29–36. CrossRef
- Balneaves LG, Long B. An embedded decisional model of stress and coping: implications for exploring treatment decision making by women with breast cancer. J Adv Nurs. 1999;30(6):1321–31. CrossRef
- Muth JL, Cash TF. Body-image attitudes: what difference does gender make? J Appl Soc Psychol. 1997;27(16):1438–52. CrossRef
- Lerman I. Adherence to treatment: the key for avoiding long-term complications of diabetes. Arch Med Res. 2005;36:300–6. CrossRef
- Inelmen EM, Toffanello ED, Enzi G, Gasparini G, Miotto F, Sergi G, Busetto L. Predictors of drop-out in overweight and obese outpatients. Int J Obesity. 2005;29:122–8. CrossRef
- Renjilian DA, Perri MG, Nezu AM, McKelvey WF, Shermer RL, Anton SD. Individual versus group therapy for obesity: effects of matching participants to their treatment preferences. J Consult Clin Psychol. 2001;69(4):717–21. CrossRef
- Patient Experiences of a Theory-Based Lifestyle-Focused Group Treatment in the Prevention of Cardiovascular Diseases and Type 2 Diabetes
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
International Journal of Behavioral Medicine
Volume 20, Issue 3 , pp 378-384
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Behavioral medicine
- Qualitative interviews
- Patient experience
- Author Affiliations
- 1. Department of Food and Nutrition, Umeå University, Umeå, Sweden
- 2. Behavioral Medicine, Umeå University Hospital, Umeå, Sweden
- 3. Department of Public Health and Clinical Medicine, Umeå University, SE-901 87, Umeå, Sweden