The development of a psychoeducational group intervention for overweight women with type 2 diabetes mellitus: a service evaluation
Authors: Gamsu DS , Sutton MS , Bennett L , Ward JD 
Published: August 2002

Aims:

A psychoeducational group intervention was developed and evaluated as a new service for overweight women with type 2 diabetes. The intervention was holistic in its focus – and aimed to enhance self esteem and body image in addition to encouraging realistic and gradual weight loss using a ‘healthy eating’ model.

Methods:

The intervention encompassed sessions on healthy eating, activity, education and improving self‐esteem. Assessment data was collected at four time points (1) Pre‐run in, (2) Pre‐intervention, (3) Post‐intervention, (4) Six month follow‐up; and consisted of physiological measures (HbA1c, total cholesterol, LDL, HDL and weight) and self‐report measures of mood (Hospital Anxiety and Depression Scale), self‐esteem (Culture‐free Self‐Esteem Inventory), interpersonal problems (Inventory of Interpersonal Problems), eating attitudes and behaviours (Eating Disorder Inventory and the Three Factor Eating Questionnaire). Participants also completed an open ended questionnaire enabling a brief weekly qualitative evaluation of the group process and content.

Results:

Two groups completed the intervention (n = 19). Having ensured there were no baseline differences of concern between the two groups their data was combined for the purpose of analysis. Repeated measures multivariate analyses of variance were used to explore predicted changes in physiological and psychological outcomes across the intervention period. Weight was maintained across the intervention and follow‐up period with no significant weight gain or loss for the combined group. There were significant improvements across the intervention period on the following psychological measures – Inventory of Interpersonal problems (‘Difficulties socialising’ (F = 7.89, p < .05), ‘Difficulties getting involved with others’ (F = 4.30, p < .005), and ‘Being too dependent on others’ (F = 3.81, p < .025); and Self‐esteem (F = 4.39, p < .025). These changes were maintained at follow‐up. Comparisons across the control (run‐in) period and the follow‐up indicated significant improvements in Self‐esteem (F = 4.39, p < .005); Interpersonal problems – ‘Being too dependent on others’ (F = 3.81, p < .05), ‘Being too caring towards others’ (F = 2.69, p < .025); and Eating behaviours – a reduction in binge eating (F = 4.47, p < .005) and disinhibition (F = 3.29, p < .025) as measured by the Eating Disorder Inventory and Three Factor Eating Questionnaire respectively.

Conclusion:

The intervention was helpful in bringing about significant change on a number of important psychological measures – there was no significant change in weight for the group across the period of the evaluation. Qualitative data highlighted the positive experiences of being in a group, and concerns about previous experiences of health care and understanding of diabetes. Some of the limitations of service evaluations are highlighted and the results are discussed in the context of recommendations to develop interventions matched to the needs of individual patients. Copyright © 2002 John Wiley & Sons, Ltd.