Defense Date

4-5-2019

Graduation Date

Spring 5-10-2019

Availability

One-year Embargo

Submission Type

dissertation

Degree Name

PhD

Department

Nursing

School

School of Nursing

Committee Chair

Linda M. Goodfellow

Committee Member

Jessica Devido

Committee Member

Fran R. Cogen

Keywords

Type 1 Diabetes, Mindfulness, HbA1c, Quality of Life, Mindfulness Bases Stress Reduction

Abstract

ABSTRACT

THE PHYSIOLOGICAL AND PSYCHOSOCIAL EFFECTS OF AN ONLINE MINDFULNESS BASED STRESS REDUCTION INTERVENTION ON ADOLESCENTS WITH TYPE 1 DIABETES

By

Denise E. Van Sant – Smith

Date: 4-5-2019

Dissertation Supervised by Linda Goodfellow, PhD, RN, FAAN

Background: Stress has been shown to increase glucose levels through a sympathetic physiological response resulting in a release of chemicals such as adrenalin and cortisol, a response which results in an even greater need for insulin. Adolescents with Type 1 Diabetes may not be able to change or decrease the amount of stress in their lives but they may be able to change the way they respond to the stress they experience. Mindfulness Based Stress Reduction (MBSR) has been shown to help practitioners change the way they respond to stress and perhaps reduce the psychosocial and physiological effects of stress.

Objectives: To determine if learning MBSR has an influence on psychosocial variables and the physiological variable of HbA1c in adolescents with Type 1 Diabetes and explore the relationships between those psychosocial variables and HbA1c in adolescents with Type 1 Diabetes.

Methods: This between group experimental design measured the effects of a 6-week, online/web-based instructional MBSR training module at three time points (pre intervention, immediately post intervention and 3 months post intervention) on adolescents with Type 1 Diabetes (N = 65) randomly assigned to either the Active Group or Control (Wait) group. The major dependent variables of Mindful Attention Awareness (MAAS-A), Diabetes Quality of Life (DQOLY) were measured at the three time points to examine the effects of MBSR on those variables. The dependent variable of HbA1c was measured at Time 1 and Time 3 to examine the effects of MBSR. Data Collected on Mindfulness, Quality of Life and HbA1c were correlated with MBSR training to examine their relationships. Prior to hypotheses testing, data collected on perceived stress and characteristics of the sample population were examined to ascertain any confounding variables.

Results: 65 individuals participated in the study. Mixed between-within subjects analysis of variance tests were used to determine the effects of MBSR over the two post intervention time points. There was a significant interaction effect of time with group assignment (Active or Control Group) on MAAS-A scores, Wilks’ Lambda = 0.44, F(2, 62) = 38.85, p = 0.000. There were also significant main effects on the score of time and group assignment for MAAS-A. There was a significant interaction effect of time with group on DQOLY scores, Wilks’ Lambda = 0.793, F(2, 62) = 8.08, p = 0.001. There was a significant main effect of time on DQOLY score Wilks’ Lambda = .73, F(2,62) = 11.18 p < 0.001. There was a significant interaction effect of time with group on HbA1c results, Wilks’ Lambda = 0.861, F(1, 63) = 10.13, p = 0.001.

Discussion: These findings suggest that learning MBSR may improve Mindful Attention Awareness, quality of life and lower HbA1c.

Key Words: adolescents with Type 1 Diabetes *diabetes quality of life * HbA1c *mindful attention * mindfulness

Language

English

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