Effectiveness of the Mindfulness-Based Diabetes Self-and Family Management Support Program among Adults with Uncontrolled Diabetes: A Randomized Controlled Trial

Abstract

Adults with type 2 diabetes need to master illness self-management to meaningfully sustain behavior change and mindfulness practice may facilitate this process. This study investigated the effectiveness of the Mindfulness-Based Diabetes Self-and Family Management Support Program to improve glycated hemoglobin among Thai adults with uncontrolled diabetes. This program was developed from a literature review, and in-depth interviews with 15 participants who had poorly controlled diabetes and their family members. The Information-Motivation-Behavioral Skills Model and mindfulness approach was used as a framework to develop study intervention. We conducted a randomized controlled trial from September 2018 to March 2019. Eighty adults with uncontrolled type 2 diabetes were randomized to 12 weeks of either the control group who received only usual care (n = 40) or the experimental group (n = 40) who received an intervention in addition to usual care. Glycated hemoglobin, fasting blood glucose, mindful-eating, self-efficacy, dietary consumption, physical activity, and medication adherence were assessed at baseline, week 12 and week 16. Data were analyzed using descriptive statistics, ANCOVA, Repeated Measures ANOVA, and Independent t-test. The findings showed that participants receiving the intervention improved more between baseline and both weeks 12 and 16 in fasting blood glucose and HbA1c, appropriate dietary consumption, amount of physical activity, medication adherence, mindful eating, and self-efficacy than those in the control group. Nurses can be trained to implement this intervention program in adults with uncontrolled diabetes. However, more studies with a larger number of community participants are recommended with the application of advanced technology such as mobile health.