Gratitude and Health in Type 1 Diabetes: A randomised controlled trial of a gratitude intervention to improve psychological and physical health in adolescents with type 1 diabetes
Year: 2017
Type: dissertation
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Background: Adolescents with type 1 diabetes (T1D) are at an increased risk for negative mental health outcomes due to having to manage a demanding chronic illness alongside navigating the developmental challenges of adolescence. Mental illness during adolescence increases the risk for poor glycaemic control and serious health complications later in life. It is therefore important to develop cost-effective and clinically usable interventions to protect against future psychological difficulties in adolescents with T1D. Several studies have shown gratitude interventions to be effective in improving depression and other psychological outcomes in adolescent populations. However, gratitude interventions have never been trialled in a paediatric population with a chronic illness. Aim: This study was a randomised controlled trial which aimed to examine whether a gratitude intervention could improve psychological and physical health compared to standard care for adolescents with T1D. Method: 80 adolescents (aged 10-16 years) with type 1 diabetes were recruited from paediatric and adolescent outpatient clinics run by Auckland District Health Board and randomized into the control group (standard care) or the intervention group (gratitude journal). Those in the intervention group wrote down three things to be grateful for in a journal on a daily basis for eight weeks. Sixty participants completed the baseline and follow-up assessments and were included in the analyses. The primary outcome measure was stress and the secondary outcome measures included depression, impact of diabetes (how much diabetes impacts a person’s life), gratitude, self-care behaviours, glycaemic control and parental stress. Independent t-tests were used to examine differences between the intervention and control groups at the eight week follow-up, and linear regression was used to examine what factors in the intervention group predicted psychological outcomes and glycaemic control at follow-up. Results: No significant differences were found between the intervention and control group at follow-up in any of the outcome measures (p>.05), providing little support for the effectiveness of gratitude journals in this sample. However, when examining sex differences, it was found that the gratitude intervention improved depression, impact of diabetes and gratitude for boys in the intervention group compared to boys in the control group (all p-values <.05). Furthermore, the linear regression analysis (including both boys and girls) found that gratitude at follow-up was a significant predictor of glycaemic control at follow-up in the intervention group, contributing to 15% of the variance in glycaemic control. Additionally, correlations at baseline for all participants showed that higher levels of gratitude were correlated with less stress, less impact of diabetes, improved self-care, less depression and less parental stress. Conclusion: This is the first study to examine the efficacy of a gratitude intervention for a paediatric population with a chronic illness, with results demonstrating that the intervention may be effective in improving psychological health for boys but not girls. This study would need to be replicated with a larger sample. A gratitude intervention is a promising, safe and clinically usable intervention for patient populations.
Author: Schache, Kiralee
Language: English
Subfield: Social Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2913293867