Living with type 1 diabetes

Title

Living with type 1 diabetes and applying stress management strategies based on Acceptance and Commitment Therapy (ACT)

Background

Self-care in type 1 diabetes is demanding and can be experienced as a major challenge and burden for those living with the disease. Both national and international guidelines stress the importance of addressing psychological aspects of diabetes. Studies have also shown that adults living with type 1 diabetes themselves are calling for not only practical support from the health care system in living with the disease, but also emotional support. Acceptance and Commitment Therapy (ACT) is a form of psychological treatment that has received increased attention in recent years. The goal of ACT is to increase psychological flexibility and thereby find meaningful, functional behaviors that lead to the life that the person wishes to live.

Aim

The overall aim of the thesis is to describe experiences of living as an adult with type 1 diabetes and to evaluate in an RCT study the effects of an ACT-based stress management program for adults with type 1 diabetes. The thesis also aims to psychometrically evaluate the Swedish version of the Acceptance and Action Diabetes Questionnaire (AADQ) which measures acceptance of diabetes-related thoughts and emotions.

Method

The thesis will consist of three studies, two of which are quantitative and one qualitative. The ”Diabetes in Balance” study is a longitudinal randomised controlled trial with repeated measurements to evaluate the effect on glycemic control (HbA1c), self-management and psychosocial factors in individuals with type 1 diabetes and HbA1c >60 mmol/mol. Study II is a psychometric evaluation of AADQ and study III ”Living with Diabetes” is a qualitative semi-structured interview study.

Importance

Introduction of a treatment method that clearly addresses psychological diabetes and stress-related problems. These issues have, according to previous research insufficient space in diabetes care but is of importance to promote glucose control and health in diabetes. The project also leads to diabetes care receiving a psychometrically validated questionnaire AADQ that measure acceptance of thoughts and emotions related to diabetes. Further, increased knowledge of experiences of living with diabetes and knowledge of what needs for support and help adults with type 1 diabetes desire from the care.

Head of research

Ersta Hospital

Funders

The Swedish Diabetes Foundation and Sophiahemmet Foundation.

Contact

Project leader for the thesis project Unn-Britt Johansson, professor Sophiahemmet University. Research group: Therese Anderbro, university lecturer, Stockholms university, Susanne Amsberg, lecturer, Ersta Sköndal Bräcke högskola, Ingrid Wijk, phD student, Sophiahemmet University, Eva Toft, associate professor, Ersta hospital and Karolinska Institutet, Fredrik Livheim, PhD, Karolinska Institutet.