وقتی راجع به نقش روان شناسی در بیماران مبتلا به دیابت صحبت می کنیم اولین تصویری که به ذهن می آید تصویر کسی است که در مطب نشسته است و در مورد مشکلات مربوط به دیابت با مشاور صحبت می کند اما این کلیشه با تغییر علوم رفتاری و روان شناسی و آگاهی بیشتر ما از دیابت رنگ باخته است و روش جدیدی در مشاوره روان شناسانه با بیماران دیابتی در پیش گرفته می شود
When one thinks of the role of psychology in diabetes or other types of
health care, the image that comes to mind is that of a patient discussing
emotional dif®culties with a therapist or counsellor in a mental health
setting. This stereotype, based on a referral system for behavioural health
care, was generally accurate for many years. Today, however, the face of
psychology and behavioural science in diabetes is changing, spurred on by
both the development of brief behavioural interventions and the information
technology revolution1±3.
Both the range of issues addressed by psychology and the modalities of
intervention have expanded signi®cantly. Psychologists and other health
professionals are increasingly involved in diabetes care. In some instances,
they are part of multidisciplinary teams providing direct patient care in
medical of®ces. In other cases, they supervise practice innovations, design
computer-assisted intervention programmes or instruct other health profes-
sionals in behaviour change principles and strategies.
There is an important need for psychologists to be more involved in the
diabetes care that takes place in medical of®ces, for three primary reasons.
First, many patients will not or cannot avail themselves of psychological
Psychology in Diabetes Care. Edited by Frank J. Snoek and T. Chas Skinner.
# 2000 John Wiley & Sons Ltd.
Psychology in Diabetes Care, Edited by: Frank J. Snoek & T. Chas Skinner
Copyright # 2000 John Wiley & Sons, Ltd
ISBNs: 0-471-97703-9 (Hardback); 0-470-84656-9 (Electronic)
assistance offered via the traditional referral system. Patients frequently have
many barriers to following through on referrals, including cost, lack of
familiarity with behavioural science, convenience and time commitment
required, and anticipated stigma associated with `seeing a shrink'. Second,
the quality of care provided for diabetes patients in most medical settings is
substantially suboptimal4±6. Almost all population-based studies of the level
of recommended `best practices' received by patients have revealed much
lower than desired rates of clinical services and screening measures4,5. The
rates of preventive services, and especially lifestyle change interventions, are
even lower5,6. Third, patient-centred, motivational interviewing, and patient
activation=empowerment approaches have consistently been found to
produce bene®cial effects, yet such strategies are seldom employed in
either primary care or specialty endocrinological settings. Thus, there is a
compelling need and great opportunity for the application of behavioural
science in medical of®ce settings.