Swipe om te navigeren naar een ander artikel
Type 2 diabetes mellitus (T2DM) is recognized as a worldwide epidemic and the health concern is particularly problematic among indigenous populations. Canada’s Aboriginal population experiences rates of T2DM that are 2.5–5.3 times higher than the non-Aboriginal population. Stress is understood to play a role in both the development and maintenance of diabetes, which makes stress reduction an avenue for health improvement in these patients. Stress is known to be an integral part of life for commonly disadvantaged Aboriginal people and we hypothesized that, due to its known stress reduction effects, a mindfulness intervention could lead to health improvements for those with T2DM. We also thought that the mind/body approach of a mindfulness intervention would be appropriate for, and acceptable to, Aboriginal people whose healing traditions incorporate aspects of mind, body, and spirit. To test the feasibility of such an approach, we recruited Aboriginal participants from urban and rural centres in Manitoba, Canada who took part in an 8-week, modified mindfulness intervention. Following the program, participants (N = 11) experienced significant and clinically important reductions in blood sugar (HbA1c reduced by .43 %, p = .02; d = .37) and blood pressure (mean arterial pressure reduced by 7.91 mm Hg, p = .05; d = .85). They also reported significant improvements in emotional health. Our small sample limits the generalizability of our findings but our results provide preliminary evidence of feasibility, which supports further exploration of the efficacy and effectiveness of mindfulness-based interventions for indigenous people with T2DM.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Adler, A. I., Stratton, I. M., Neil, H. A. W., Yudkin, J. S., Matthews, D. R., Cull, C. A., et al. (2000). Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. British Medical Journal, 321, 412–419. CrossRefPubMedCentralPubMed
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143.
Barnes, P. M., Adams, P. F., & Powell-Griner, E. (2010). Health characteristics of the American Indian or Alaska Native adult population: United States, 2004–2008. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
Campbell, T. S., Labelle, L. E., Bacon, S. L., Faris, P., & Carlson, L. E. (2012). Impact of mindfulness-based stress reduction (MBSR) on attention, rumination and resting blood pressure in women with cancer: a waitlist-controlled study. Journal of Behavioral Medicine, 35(3), 262–271. CrossRefPubMed
Canadian Diabetes Association. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. (2013). Clinical practice guidelines for the prevention and management of diabetes in Canada. Canadian Journal of Diabetes, 37(suppl 1), S1–S216.
Eberth, J., & Sedlmeier, P. (2012). The effects of mindfulness meditation: a meta-analysis. Mindfulness, 3(3), 174–189. CrossRef
First Nations Centre. (2007). OCAP: Ownership, Control, Access and Possession. Sanctioned by the First Nations Information Governance Committee. National Aboriginal Health Organization: Assembly of First Nations. Ottawa.
French, L. A. (2004). Alcohol and other drug addictions among Native Americans: The movement toward tribal-centric treatment programs. Alcoholism Treatment Quarterly, 22, 81–91. CrossRef
Goldstein, D. J. (1992). Beneficial health effects of modest weight loss. International Journal of Obesity and Related Metabolic Disorders, 16, 397–415. PubMed
Greeson, J. M. (2008). Mindfulness research update: 2008. Complementary Health Practice Review, 14(1), 10–18.
Hartmann, M., Kopf, S., Kircher, C., Faude-Lang, V., Djuric, Z., Augstein, F., et al. (2012). Sustained Effects of a Mindfulness-Based Stress-Reduction Intervention in Type 2 Diabetic Patients Design and first results of a randomized controlled trial (the Heidelberger Diabetes and Stress-Study). Diabetes Care, 35(5), 945–947. CrossRefPubMedCentralPubMed
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press.
Hoyle, R. H. (Ed.). (1999). Statistical strategies for small sample research. Incorporated: Sage Publications.
Hughes, J. W., Fresco, D. M., van Dulmen, M., Carlson, L. E., Josephson, R., & Myerscough, R. (2010). Mindfulness-based stress reduction for prehypertension. Psychosomatic Medicine, 71(3), 23.
International Diabetes Foundation. (2011). Diabetes Atlas (5th ed.). Brussels, Belgium: International Diabetes Foundation.
Ismail, K., Winkley, K., & Rabe-Hesketh, S. (2004). Systematic review and meta-analysis of randomised controlled trials of psychological interventions to improve glycaemic control in patients with type 2 diabetes. The Lancet, 363(9421), 1589–1597. CrossRef
Iwasaki, Y., Bartlett, J., & O’Neil, J. (2003). An examination of stress among Aboriginal women and men with diabetes in Manitoba, Canada. Ethnicity and Health, 9(2), 189–212. CrossRef
Iwasaki, Y., Bartlett, J., & O’Neil, J. (2005). Coping with stress among Aboriginal women and men with diabetes in Winnipeg, Canada. Social Science & Medicine, 60, 977–988. CrossRef
Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the Wisdom of your body and mind to face stress, pain, and illness. New York: Dell Publishing.
Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion.
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156.
Kabat-Zinn, J., Wheeler, E., Light, T., Skillings, A., Scharf, M. J., Cropley, T. G., et al. (1998). Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosomatic Medicine, 60, 625–632. CrossRefPubMed
Lloyd, C., Smith, J., & Weinger, K. (2005). Stress and diabetes: a review of the links. Diabetes Spectrum, 18(2), 121–127. CrossRef
Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales. Sydney: Psychology Foundation.
Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 71(1), 31–40. CrossRef
Mallinson, S. (2002). Listening to respondents: a qualitative assessment of the Short-Form 36 Health Status Questionnaire. Social Science & Medicine, 54(1), 11–21. CrossRef
Markovic, T. P., Jenkins, A. B., & Campbell, L. V. (1998). The determinants of glycemic responses to diet restriction and weight loss in obesity and NIDDM. Diabetes Care, 21(687), 694.
McCabe, G. (2007). The healing path: A culture and community-derived indigenous therapy model. Psychotherapy: Theory, Research, Practice, Training, 44, 148–160. CrossRef
McCabe, G. (2008). Mind, body, emotions, and spirit: reaching to the ancestors for healing. Counselling Psychology Quarterly, 21, 143–152. CrossRef
McIntyre, M. (1996). Counseling and Native healing. Asian Journal of Counseling, 19, 87–100.
National Institute of Diabetes and Digestive and Kidney Diseases. (2006). Report on closing the disparity between hemoglobin A1c treatment guidelines and practice. Bethesda: National Institutes of Health.
Rosenzweig, S., Reibel, D. K., Greeson, J. M., Edman, J. S., Jasser, S. A., McMearty, K. D., et al. (2007). Mindfulness-based stress reduction is associated with improved glycemic control in type-2 diabetes mellitus: A pilot study. Alternative Therapies in Health and Medicine, 13(5), 36–38. PubMed
Salmon, P., Sephton, S., Weissbecker, I., Hoover, K., Ulmer, C., & Studts, J. L. (2004). Mindfulness meditation in clinical practice. Cognitive Behavioral Practice, 11(4), 434–446. CrossRef
Santorelli, S. & Kabat-Zinn, J. (2009). Mindfulness-Based Stress Reduction professional training resource manual. Center for Mindfulness in Medicine, Health Care, and Society, Division of Preventative and Behavioral Medicine, Department of Medicine, University of Massachusetts.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York, NY: The Guilford Press.
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33. PubMed
Shigaki, C. L., Glass, B., & Schopp, L. H. (2006). Mindfulness-based stress reduction in medical settings. Journal of Clinical Psychology in Medical Settings, 13(3), 209–216. CrossRef
Sibthorpe, B. M., Bailie, R. S., Brady, M. A., Ball, S. A., Sumner-Dodd, P., & Hall, W. D. (2002). The demise of a planned randomised controlled trial in an urban Aboriginal medical service. The Medical Journal of Australia, 176(6), 273. PubMed
Statistics Canada (1993). 1991 Aboriginal peoples survey: language, tradition, health, lifestyle and social issues. Ottawa: Statistics Canada; Cat. No. 89–533.
Vallejo, Z., & Amaro, H. (2009). Adaptation of mindfulness-based stress reduction program for addiction relapse prevention. The Humanistic Psychologist, 37, 192–206. CrossRef
van Son, J., Nyklíček, I., Pop, V. J., Blonk, M. C., Erdtsieck, R. J., Spooren, P. F., et al. (2013). The Effects of a Mindfulness-Based Intervention on Emotional Distress, Quality-of-Life, and HbA1c in Outpatients With Diabetes (DiaMind) A randomized controlled trial. Diabetes Care, 36(4), 823–830. CrossRefPubMedCentralPubMed
Vibe M.de, Hammerstrøm K, Kowalski K, Bjørndal A. (2010). Mindfulness Based Stress Reduction (MBSR) for improving health and social functioning in adults. Campbell Library of Systematic Reviews.
Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 health survey: Manual and interpretation guide. Boston: The Health Institute, New England Medical Centre.
White, P., Smith, S. M., & O’Dowd, T. (2005). The role of the family in adult chronic illness: A review of the literature on type 2 diabetes. Irish Journal of Psychology, 26(1–2), 9–15. CrossRef
- Feasibility of a Mindfulness-Based Intervention for Aboriginal Adults with Type 2 Diabetes
Lisa C. Dreger
- Springer US