semenvatting
Diabetes mellitus is een chronische stofwisselingsziekte die op jonge (type-i) en oudere leeftijd (type-ii) kan ontstaan. De behandeling is erop gericht een zo normaal mogelijke bloedglucosespiegel te bereiken, teneinde het risico van complicaties op korte en langere termijn te beperken. Centraal in de diabetesbehandeling staat self-management, het zelf reguleren van de bloedglucose. Voor een aanzienlijk deel van de mensen met diabetes blijkt een goede instelling moeilijk te bereiken, niet in de laatste plaats omdat dit grote en levenslange gedragsveranderingen vraagt. Naast adequate medische behandeling en diabeteseducatie, lijkt het aanbieden van psychosociale interventies dan ook gerechtvaardigd om patiënten te ondersteunen hun zelfzorg te optimaliseren. Er is gebrek aan welomschreven, goed overdraagbare interventies om patiënten hierbij te helpen. Een benadering vanuit het cognitieve model leidt bij verschillende chronische somatische ziekten tot positieve effecten. In dit artikel wordt de ontwikkeling en toepassing beschreven van een groepsinterventie voor mensen met type-i-diabetes, gebaseerd op cognitieve-gedragstherapie. Het doel van de training is diabetespatiënten met een onvoldoende regulatie van de bloedglucose te helpen deze te verbeteren, met behoud en zo mogelijk verbetering van het emotioneel welbevinden. Alvorens inhoud en werkwijze van de training te beschrijven, zullen we kort ingaan op de invloed van cognities en emoties op de zelfregulatie van diabetes.
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Abstract
Diabetes is a chronic disease which can develop at a young (type-i ) or older age (type-ii). The treatment of diabetes is aimed at control of blood glucose levels, in order to minimize the risk of developing complications on the shorter and longer term. Self- management, by self-regulation of the blood glucose, is the cornerstone of treatment. For a substantial group of patients however, good control is hard to reach, mainly because this involves considerable life-long behavioural changes. To support patients in optimizing their self-care behaviour, it seems therefore justified to offer psychosocial interventions, next to adequate medical treatment and diabetes education. In literature as well as clinical practice there is, however, a great lack of well-described, transferable interventions which have proved their effectiveness. A cognitive behavioural approach has positive effects in various chronic somatic diseases. In this publication, the development and application of a cognitive behavioural group intervention for patients with type-i-diabetes is described. The goal of this intervention is to help patients with poor regulation of their diabetes to improve their blood glucose control, while maintaining and possibly enhancing emotional wellbeing. Before describing content and application of the intervention, we shortly overview the impact of cognitions and emotions on the self-regulation of diabetes.
afdeling Medische Psychologie van het Vrije Universiteit Medisch Centrum te Amsterdam.
Dr. Frank J. Snoek is verbonden aan de Diabetes Research Group, afdeling Medische Psychologie van het Vrije Universiteit Medisch Centrum te Amsterdam.
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van der Ven, N., Snoek, F. Diabetes de baas: ontwikkeling en toepassing van een groepsinterventie, gebaseerd op cognitieve-gedragstherapie voor patiënten met type-i-diabetes. DITH 21, 87–96 (2001). https://doi.org/10.1007/BF03060257
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DOI: https://doi.org/10.1007/BF03060257