Background
Aim
Methods/Design
Intervention
Implementation strategy 1: adaptation of clinical intervention
MPI | SMS | |
---|---|---|
Target group | Chronic patients with mild or non-severe major depression | Chronic patients with emotional distress and problems of daily functioning |
Providers | Research nurses not involved in usual care | Practice nurses providing usual chronic care |
Diagnostic approach | For research purposes. Using an extensive diagnostic interview, following strict psychiatric criteria | As part of daily care. Using simple tools, following a stepped care approach that fits the primary care setting |
Self-management support intervention | 1. cognitive therapy (reattribution) | 1. problem solving |
2. problem solving | 2. cognitive therapy (reattribution) |
Target group
Providers
Detection procedure
DFT ≤ 4 | DFT > 4 | |
---|---|---|
DS ≤ 3 | No indication | Watchful waiting |
DS > 3 | On the basis of the 4DSQ: | On the basis of the 4DSQ: |
Mild: watchful waiting | Mild: watchful waiting | |
Moderate: watchful waiting |
Moderate: self-management support by PN
| |
Severe: referral to GP | Severe: referral to GP |
Self-management support programme
Implementation strategy 2: involvement of regional GP organisation
Implementation strategy 3: financial support
Implementation strategy 4: training
Implementation strategy 5: registration system for SMS
Evaluation of the implementation process
Design
Variables and measurements
Cost evaluation
Data analysis
Clinical effect evaluation
Design
Sample size calculation
Patient recruitment
Measurements
Concept | Measurement | Items | Moment in time | |||
---|---|---|---|---|---|---|
3-monthly diabetes consultations during follow-up | T0 | T-4 | T-12 | |||
Primary outcome
| ||||||
Daily functioning | DFT | 1 | * | * |
*
| |
Secondary outcomes
| ||||||
Diabetes-related emotional distress | PAID | 20 | * | * |
*
| |
Mental health problems | PSYCHLOPS | 9 | *2
| *1
| * |
*
|
4DSQ | 50 | * | * | |||
Quality of life | SF-12 | 12 | * | * |
*
| |
Participation and autonomy | IPA | 32 + 9 | * | * |
*
| |
Job performance | SF-HLQ | 5 | * | * | * | |
Self-management knowledge and behaviour | PIH-NL | 12 | * | * |
*
| |
General self-efficacy | GSES-12 | 12 | * | * | * | |
Control over the disease | Average blood glucose level (HbA1c) | 1 | * | |||
Health care use | 5 | * | * | * | ||
Covariates
| ||||||
Patient demographics | Sex | 1 | * | |||
Age | 1 | * | ||||
Year of diagnosis | 1 | * | ||||
Treatment of diabetes | 1 | * | ||||
Marital status | 1 | * | ||||
Education | 1 | * | ||||
Practice nurse demographics | Age | 1 | * | |||
Training | 1 | * | ||||
Type of general practice(s) (one GP, two GPs, group, health centre) | 1 | * |