| Objectives:To explore the effect of mindfulness-based stress reduction(MBSR)on negative emotions and life quality of patients with type 2 diabetes mellitus(T2DM).This research can provide theoretical and clinical data support for the development and application of MBSR,and also offer reference and nursing guidance for the application of MBSR to patients with T2DM in Yunnan province.Methods:The subjects of this study were patients with T2DM,who were admitted to the endocrinology department of a class ? grade hospital in Yunnan province from October 2017 to March 2018.All subjects met the criteria of inclusion and obtained informed consent for this study.The patients were divided into the control group(49 cases)and the intervention group(49 cases)according to the method of computer random number.The duration of intervention was 3 months.The routine treatment and care were applied to the control group,including general supportive psychological care,group study and WeChat self-media establishment.The content of group study includes 5 dimensions of diabetes,including diabetes diet,exercise,blood glucose test,psychological nursing and drug treatment.MBSR,the routine treatment and care were implemented to the intervention group for a period of 3 months.The research of this group is divided into three stages.Firstly,before intervention,the intervention teams were formed and team members were homogeneous trained(the training content included the concept of mindfulness,body scanning,meditation,three-minute breathing space theory and practice).Next,during intervention,the establishment of patient profile,WeChat self media intervention group(the role was issuing notices,questions,answers,feedback,etc.),group teaching(the content is the theory and practice of mindfulness concept,body scanning,meditation and three-minute breathing space),meeting of intervention team discussion,home visiting were executed.Finally,after the intervention,the subjective and objective data were collected by the home visiting,telephone calls,WeChat,etc.Subjective indicators(anxiety self-rating scale,self-rating depression scale,diabetes quality of life specific scale,five-factor righteousness scale)and objective indicators(fasting blood glucose,2 hours postprandial blood glucose)were collected of all patients at the time of admission and 3 months after discharge.Data were and statistical analysis by t test and chi-square test statistical methods.The data were statistically analyzed by SPSS17.0 statistical software and compared by t test,chi-square test and other methods.Statistical significance of data was determined by P value.Results:1.There were no significant differences in the general data and disease-related data of the two groups before intervention(P>0.05).2.The score of anxiety self-rating scale(SAS)of overall study subjects was 48.59±9.37 before intervention,which was higher than the domestic norm(33.80±5.90),and the difference was statistically significant(P<0.01).The score of depression self-rating scale(SDS)was 50.83±10.22,which was higher than the domestic norm(41.58±10.57),and the difference was statistically significant(P<0.01).3.Before the intervention,the SAS scale scores of the intervention and the control groups were 49.102±8.586 and 48.082±10.822,respectively.The SDS scale scores were 51.469±9.906 and 50.184±10.594,respectively.There were no significant difference in scores of the two groups(P>0.05).After intervention,the SAS scale scores of the intervention group and the control group were 41.878±7.836 and 46.041±6.856,respectively.The scores of the SDS scale were 43.388±7.038 and 48.163±8.632,respectively.There was a statistically significant difference in scores between the two groups(P<0.01).4.There were no significant differences in the biochemical parameters of the two groups before intervention(P>0.05).There were significant differences in biochemical parameters of the two groups after intervention(P<0.05).5.Before intervention,the total scores of the five-factor righteousness scale(FFMQ)of intervention group and control group were 111.592±9.443 and 112.347±9.765,respectively.The scores of the observed dimension were 20.429±4.257 and 20.245±4.161,respectively.The description dimension scores were 22.245±3.887 and 22.735±3.610,respectively.The action dimension scores were 23.918±3.115 and 23.714±2.865,respectively.The scores of non-judgment dimension were 25.245±3.609 and 24.980±3.805,respectively.The scores of non-response dimensions were 19.755±4.366 and 20.674±3.971,respectively.There was no significant difference between the scores oftotal points and each dimension of the two groups(P>0.05).After the intervention,the total FFMQ scores of intervention group and control group were 120.388±10.412 and 111.102±8.828,respectively.The scores of observation dimensions were 23.898±4.298 and 20.531±4.378,respectively.The scores of dimensions without judgment were 28.184±5.310 and 25.245±3.609,respectively.There were statistically significant differences in the scores of total scores,observation and non-judgment dimensions between the two groups(P<0.01).After the intervention,the descriptive dimension scores of the intervention group and the control group were 23.347±3.364 and 22.184±3.689,respectively.The scores of action dimension were 24.327±3.092 and 23.184±3.661,respectively.The scores of non-response dimensions were 20.633±5.330 and 19.959±4.228,respectively.There was no significant difference in the scores of description,action and non-response dimensions between the two groups(P>0.05).The comparison results of patients'scores before and after FFMQ intervention between the two groups showed that the total score was statistically significant for intervention group(P<0.01).The difference between the scores of observation and non-judgement dimensions before and after intervention were statistically significant for intervention group(P<0.01).There was no statistical significance before and after intervention in the dimensions of description,action and non-response for intervention group(P>0.05).There was no statistically significant difference in the total score,observation,description,action,non-judgment and non-response before and after intervention for the control group(P>0.05).6.Before intervention,the life-specificity quality scale(DSQL)of patients was 61.776±12.058,in which the highest score was the psychological dimension"1 Does diabetes often cause trouble and inconvenience to your daily life?".The total,the intervention group and the control group scores were 3,184±1.128,3.204±1.099 and 3.163±1.179,respectively.There were no significant differences in the scores of two groups(P>0.05).7.Before the intervention,the total scores of DSQL of the intervention group and the control group were 62.102±11.815 and 61.449±12.532,respectively.The physiological dimension scores were 26.959±6.484 and 28.286±6.285,respectively.The psychological dimension scores were 15.122±2.870 and 17.980±3.038,respectively.The treatment dimension scores were 4.857±1.080 and 6.429±1.670,respectively.There were no significant differences in the scores of the total,physiological,psychological,social and therapeutic dimensions between the two groups(P>0.05).8.After intervention,for the DSQL,the scores of psychological dimension entry 1"Diabetes often causes trouble and inconvenience to your daily life" of the intervention group and the control group were 2.306±0.940 and 3.122±1.013,respectively,and the scores difference of the two groups were statistically significant(P<0.01).After intervention,the total scores of DSQL in the intervention group and the control group were 49.449±6.232 and 60.735±8.111,respectively.The physiological dimension scores were 22.755±3.533 and 28.388±4.434,respectively.The psychological dimension scores were 15.122±2.870 and 17.980±3.038,respectively.The social dimension scores were 6.714±1.258 and 7.939±1.784,respectively.The treatment dimension scores were 4.857±1.080 and 6.429±1.670,respectively.There were significant statistical differences in scores of psychological,social and therapeutic dimension(P<0.01).The self-comparison scores of the two groups before and after intervention showed that the scores of total,each dimension were statistically significant for intervention group(P<0.01).There was no statistically significant difference in the total score and each dimension scores between the control group before and after intervention(P>0.05).Conclusions:1.The scores of anxiety and depression of patients with T2DM in this study were higher than the domestic norm.2.The level of mindfulness of patients with T2DM in this study remained a lower-middle level and the quality of life was relatively low.3.This study demonstrates that MB SR is an effective method to reduce negative emotions and biochemical parameters(Fasting plasma glucose?2-hours plasma glucose?HemoglobinAlc)of patients with T2DM.4.The practice of mindfulness decompression therapy can improve the patients'mindfulness level,assist them to develop a life habit beneficial to the disease,reduce their biochemical indicators,thus delaying the occurrence and development of complications,and ultimately effectively improve the patients'quality of life. |
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