Abstract
ObjectivesGroup care for individuals with diabetes is a recognized educational practice, but techniques from narrative medicine using of literary works have never been incorporated in these programs. We designed a new educational model (i.e. the Close Reading and Creative Writing program) of group care for individuals with diabetes incorporating close reading and creative writing in group education. A randomized trial was designed to evaluate this intervention. MethodsA total of 49 individuals with type 2 diabetes, aged <85 years and with >6 years of school education, were randomized to 2 different group care dynamics: (a) a “control group,” with a classical structured educational approach currently used at our institution; and (b) an “intervention group,” with introduction of literary texts, narrative skills, close reading and creative writing. Evaluation included anthropometric measures, glycated hemoglobin (A1C) and questionnaires for psychological evaluation. Individual A1C levels in the 6-year period before the trial were collected from clinical records. ResultsA significant reduction of A1C was observed in the intervention group, showing noninferiority in relation to the classical approach. A significant decrease in A1C was observed in relation to the 6 previous years. A significant increase in satisfaction with the therapist and group process was observed. ConclusionsThis is the first randomized trial designed to evaluate a group care intervention to manage type 2 diabetes using narrative techniques. The results suggest that this may be a useful model for more highly schooled individuals, and may represent an alternative for the educational process.
Highlights
Diabetes is a holistic experience comprised of psychological, intellectual, clinical, financial, cultural, spiritual, and social elements [1]
Group Care for individuals with diabetes is a recognized educational practice, but techniques from narrative medicine using of literary works have never been incorporated in these programs
A total of 49 individual with type 2 diabetes, aged 6 years school education were randomized to two different Group Care dynamics: (a) one “control group”, with a classical structured educational approach currently used in our institution and (b) an “intervention group”, with the introduction of literary texts, narrative skills, close reading and creative writing
Summary
Diabetes is a holistic experience comprised of psychological, intellectual, clinical, financial, cultural, spiritual, and social elements [1]. In recent years some published reports demonstrated beneficial effects of using narrative approach, patient centered, in diabetes and in other chronic diseases Examples of these are storytelling groups [21,22,23,24,25,26,27], photo stories [28,29], autobiographical narratives [30], artistic and creative expression [31]. This kind of approach has the potencial, as Gucciardi noted, to provide patients with a more active role in their health care, while allowing them to form strong bonds with peers who share similar disease-related experiences [22]. A randomized trial was designed to determine whether group dynamic strategies using narrative and reading produce the same positive outcomes as a conventional group approach
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