Research Article 
Themes elicited during motivational interviewing to improve glycaemic control in adults with Type 1 diabetes mellitus
K. Ridge, J. Treasure, A. Forbes, S. Thomas and K. Ismail
Diabetic Medicine, 2012, 29(1), 148-152. DOI: 10.1111/j.1464-5491.2011.03384.x
Abstract
Aims To elicit the barriers and motivators to better diabetes self care in patients with Type 1 diabetes. Methods We obtained a purposive sample of 47 patients with Type 1 diabetes and persistent suboptimal glycaemic control from a randomized controlled trial of nurse-delivered psychological interventions. Each participant’s second session of motivational interviewing was analysed using content analysis. Results Four major themes emerged: emotions of living with Type 1 diabetes, perceived barriers to diabetes management, motivators for change and methods of coping. Increased assistance and support from family and healthcare teams, the prospect of improved emotional and physical well-being and feelings of success were described as factors that might motivate participants to practice more effective self care. Conclusions An enhanced awareness of the range of psychological concepts in diabetes may enable a better therapeutic relationship between clinicians and patients.
ASCI-ID: 109-412
Similar Articles
Glycaemic control and diabetes care utilization in young adults with Type 1 diabetes1
Diabetic Medicine, 2008, 25(8), 968-973.
The effect of the availability of inhaled insulin on glycaemic control in patients with Type 2 diabetes failing on oral therapy: the evaluation of Exubera® as a therapeutic option on insulin initiation and improvement in glycaemic control in clinical practice EXPERIENCE) trialDiabetic Medicine, 2008, 25(6), 662-670. DOI: 10.1111/j.1464-5491.2008.02438.x
Expenditure on diabetes treatments and achievement of glycaemic control: retrospective analysisDiabetic Medicine, 2008, 25(6), 738-742. DOI: 10.1111/j.1464-5491.2008.02429.x
Long-term efficacy and safety of insulin detemir compared to Neutral Protamine Hagedorn insulin in patients with Type 1 diabetes using a treat-to-target basal-bolus regimen with insulin aspart at meals: a 2-year, randomized, controlled trialDiabetic Medicine, 2008, 25(4), 442-449. DOI: 10.1111/j.1464-5491.2007.02407.x
The effect of biopsy-positive silent coeliac disease and treatment with a gluten-free diet on growth and glycaemic control in children with Type 1 diabetesDiabetic Medicine, 2009, 26(12), 1250-1254. DOI: 10.1111/j.1464-5491.2009.02859.x
Diabetes-specific emotional distress mediates the association between depressive symptoms and glycaemic control in Type 1 and Type 2 diabetesDiabetic Medicine, 2010, 27(7), 798-803. DOI: 10.1111/j.1464-5491.2010.03025.x
Telephone follow-up to improve glycaemic control in patients with Type 2 diabetes: systematic review and meta-analysis of controlled trialsDiabetic Medicine, 2010, 27(11), 1217-1225. DOI: 10.1111/j.1464-5491.2010.03113.x
Persistent individual tracking within overall improvement in HbA1c in a UK paediatric diabetes clinic over 15 yearsDiabetic Medicine, 2010, 27(11), 1284-1288. DOI: 10.1111/j.1464-5491.2010.03057.x
Anti-CD3 monoclonal antibody treatment in newly diagnosed Type 1 diabetes patients: a hypothetical modelling analysisDiabetic Medicine, 2010, 27(2), 189-196. DOI: 10.1111/j.1464-5491.2009.02902.x
Striving for the impossible dream: a community-based multi-practice collaborative model of diabetes managementDiabetic Medicine, 2010, 27(2), 197-202. DOI: 10.1111/j.1464-5491.2009.02907.x
Measurements of medication adherence in diabetic patients with poorly controlled HbA1cDiabetic Medicine, 2010, 27(2), 210-216. DOI: 10.1111/j.1464-5491.2009.02898.x
Economic impact of moderate weight loss in patients with Type 2 diabetes: The Fremantle Diabetes StudyDiabetic Medicine, 2011, 28(9), 1131-1135. DOI: 10.1111/j.1464-5491.2011.03314.x
Does serum 1,5-anhydroglucitol establish a relationship between improvements in HbA1c and postprandial glucose excursions? Supportive evidence utilizing the differential effects between biphasic insulin aspart 30 and insulin glargineDiabetic Medicine, 2008, 25(2), 200-205. DOI: 10.1111/j.1464-5491.2008.02384.x
Determinants of adiponectin levels in young people with Type 1 diabetesDiabetic Medicine, 2008, 25(3), 365-369. DOI: 10.1111/j.1464-5491.2007.02374.x
Children and young people with diabetes in Yorkshire: a population-based clinical audit of patient data 2005/2006Diabetic Medicine, 2008, 25(11), 1276-1282. DOI: 10.1111/j.1464-5491.2008.02583.x
Cognitive behavioural therapy (CBT) compared with blood glucose awareness training (BGAT) in poorly controlled Type 1 diabetic patients: long-term effects on HbA1c moderated by depression. A randomized controlled trialDiabetic Medicine, 2008, 25(11), 1337-1342. DOI: 10.1111/j.1464-5491.2008.02595.x
Severe hypoglycaemia and glycaemic control in Type 1 diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusionDiabetic Medicine, 2008, 25(7), 765-774. DOI: 10.1111/j.1464-5491.2008.02486.x
Clinical effectiveness of a brief educational intervention in Type 1 diabetes: results from the BITES (Brief Intervention in Type 1 diabetes, Education for Self-efficacy) trialDiabetic Medicine, 2008, 25(12), 1447-1453. DOI: 10.1111/j.1464-5491.2008.02607.x
Exenatide efficacy and safety: a systematic reviewDiabetic Medicine, 2009, 26(9), 837-846. DOI: 10.1111/j.1464-5491.2009.02790.x
Effects of a short-term improvement in glycaemic control on skin microvascular dysfunction in Type 1 and Type 2 diabetic patientsDiabetic Medicine, 2009, 26(9), 880-886. DOI: 10.1111/j.1464-5491.2009.02792.x
Adherence to a Mediterranean diet and glycaemic control in Type 2 diabetes mellitusDiabetic Medicine, 2009, 26(9), 900-907. DOI: 10.1111/j.1464-5491.2009.02798.x
Improvements in glycaemic control and cholesterol concentrations associated with the Quality and Outcomes Framework: a regional 2-year audit of diabetes care in the UKDiabetic Medicine, 2010, 27(3), 354-359. DOI: 10.1111/j.1464-5491.2010.02951.x
Prevalence of pain and association with quality of life, depression and glycaemic control in patients with diabetesDiabetic Medicine, 2010, 27(5), 578-584. DOI: 10.1111/j.1464-5491.2010.02971.x
Dose-dependent effects of the once-daily GLP-1 receptor agonist lixisenatide in patients with Type 2 diabetes inadequately controlled with metformin: a randomized, double-blind, placebo-controlled trialDiabetic Medicine, 2010, 27(9), 1024-1032. DOI: 10.1111/j.1464-5491.2010.03020.x
Predictors of glycaemic control in patients with Type 1 diabetes commencing continuous subcutaneous insulin infusion therapyDiabetic Medicine, 2010, 27(3), 339-347. DOI: 10.1111/j.1464-5491.2009.02925.x
The effect of extensive flooding in Hull on the glycaemic control of patients with diabetesDiabetic Medicine, 2011, 28(5), 519-524. DOI: 10.1111/j.1464-5491.2011.03228.x
Nateglinide provides tighter glycaemic control than glyburide in patients with Type 2 diabetes with prevalent postprandial hyperglycaemiaDiabetic Medicine, 2011, 28(5), 560-566. DOI: 10.1111/j.1464-5491.2010.03219.x
Blood glucose control and quality of health care in non-insulin-treated patients with Type 2 diabetes in Spain: a retrospective and cross-sectional observational studyDiabetic Medicine, 2011, 28(6), 731-740. DOI: 10.1111/j.1464-5491.2011.03258.x
Development and evaluation of a standardized registry for diabetes in pregnancy using data from the Northern, North West and East Anglia regional auditsDiabetic Medicine, 2011, 28(7), 797-804. DOI: 10.1111/j.1464-5491.2011.03259.x
Mobile phone support is associated with reduced ketoacidosis in young adultsDiabetic Medicine, 2011, 28(8), 1001-1004. DOI: 10.1111/j.1464-5491.2011.03302.x
Lower cardiorespiratory fitness in children with Type 1 diabetesDiabetic Medicine, 2011, 28(8), 1005-1007. DOI: 10.1111/j.1464-5491.2011.03271.x
Illness perceptions and glycaemic control in diabetes: a systematic review with meta-analysisDiabetic Medicine, 2011, 28(11), 1300-1310. DOI: 10.1111/j.1464-5491.2011.03298.x
Acute hepatic injury following treatment of a long-acting insulin analogue overdose necessitating urgent insulin depot excisionDiabetic Medicine, 2012, 29(2), 232-235. DOI: 10.1111/j.1464-5491.2011.03385.x
Effects of variations in duodenal glucose load on glycaemic, insulin, and incretin responses in type 2 diabetesDiabetic Medicine, 2012, 29(5), 604-608. DOI: 10.1111/j.1464-5491.2011.03496.x
Glycaemic control and weight 7 years after Dose Adjustment For Normal Eating (DAFNE) structured education in Type 1 diabetesDiabetic Medicine, 2012, 29(6), 807-812. DOI: 10.1111/j.1464-5491.2011.03525.x
Psychotherapy intervention to reduce depressive symptoms in patients with diabetic foot syndromeDiabetic Medicine, 2008, 25(2), 206-212. DOI: 10.1111/j.1464-5491.2007.02370.x
Patients’ perceptions and experiences of taking oral glucose-lowering agents: a longitudinal qualitative studyDiabetic Medicine, 2008, 25(4), 491-495. DOI: 10.1111/j.1464-5491.2008.02400.x
Understanding and beliefs of diabetes in the UK Bangladeshi populationDiabetic Medicine, 2009, 26(6), 636-640. DOI: 10.1111/j.1464-5491.2009.02741.x