Abstract
Background: Individuals with diabetes mellitus both have difficulty in solving problems in daily life and have similar difficulties with self-care regimens. We examined the effect of occupation-based intervention supported with problem-solving therapy of individuals with type 2 diabetes mellitus on participation and satisfaction of meaningful occupations, diabetes-related psychosocial self-efficacy, preferred coping strategies and individual well-being. Methods: This study was planned as a single-blind, randomized controlled study with 3-months’ follow-up involving sixty-seven adults with type 2 diabetes. The Canadian Occupational Performance Measure, the Diabetes Empowerment Scale, the Brief COPE and the Five-item World Health Organization Well-Being Index were used. The intervention was conducted in 6 modules, and each implemented about 60 minutes and for 1 session per week. The six modules included evaluations, diabetes education, and problem-solving therapy. The most important feature of the program is its focus on meaningful occupations for the person and provided an opportunity for the participants to apply problem-solving therapy through valued occupation. Differences between groups were analysed with the Mann Whitney U test, and the Friedman test was used to calculate group-time interaction differences (i.e. baseline, after six modules and after three months). Results: Individuals with type 2 diabetes mellitus in both groups identified the most significant meaningful activity problems in self-care as personal care. Significant improvement was reported in the intervention group when compared to the control group regarding the participation in meaningful occupation, the satisfaction of performance, psychological self-efficacy and well-being results (p<0.001) after the six modules and 3 months follow-up. The participants' use of the effective coping strategies, active coping and acceptance strategies, self-efficacy as revealed results showed improvement in favor of the intervention group (p<0.05). The intervention group showed significantly improving between measurements at baseline and after three months of modules except for ineffective coping style (p<0.001). Conclusions: The person-centred occupation-based problem-solving therapy encourages participation in meaningful occupations, positive effects on psychological self-efficacy, and improves effective coping styles and well-being of type 2 diabetes mellitus. Problem-solving therapies that incorporate individuals’ priorities via meaningful occupation could be used to supported to lead a meaningful life of individuals of type 2 diabetes mellitus. Trial Registration: ClinicalTrials.gov Identifier: NCT03783598. Retrospectively Registered. First Posted-December 21, 2018, Last Update Posted-February 18, 2020. Key words: Diabetes mellitus, Person-centred, Occupation-based, Problem-solving, Psychosocial self-efficacy, Coping, Well-being, Quality of life, Occupational therapy