Dimensions, application, and outcomes of person-centered self-management interventions for those living with type 2 diabetes: A scoping review.

OBJECTIVES: To explore which dimensions of the person-centered approach (PCA) are adopted in self-management interventions, how they are applied, and its outcomes. METHODS: A review team carried out a scoping review using the methodology of Arksey and O'Malley on diabetes mellitus type 2, person-centered care, and self-management. RESULTS: Of the 364 titles identified, 22 articles were included in this review. No study contained all five dimensions described by the person-centered framework. Some dimensions seemed difficult to assess, mainly having a sympathetic presence and engagement. The application of the five PCA dimensions are presented. Although the authors claimed their intervention to be person-centered, none used a specific tool to measure person-centered care in a holistic way. CONCLUSION: Although the guidelines recommend a PCA to professionals, there is a gap with practice, professionals having difficulty adopting and measuring this approach. PRACTICE IMPLICATIONS: Some strategies to facilitate the adoption of a PCA with people living with type 2 diabetes are proposed. These can help researchers and clinicians develop a PCA, by identifying the care delivery processes necessary to provide it. It seems important for researchers to measure whether their intervention is truly person-centered, using holistic tools and combining different methods (observation, questionnaire, interview).

A comparison of DSM-III and ICD-8 diagnoses for major affective disorders and the use of biological markers for depression.

The aims of the present study were to investigate the value of adding DSM-III diagnosis and Newcastle Scale Rating to the ICD-8 diagnosis currently used and to investigate the association between Dexamethasone Suppression Test (DST) and the Thyrotropine Releasing Hormone- Thyroid Stimulating Hormone (TRH-TSH) test and the three classification systems for depression. Twenty-six depressed in-patients were included, 17 women and 9 men, with a mean age of 51.5 years. Fourteen patients were psychotic depressed. DST and Newcastle Scale Rating were performed on 18 patients and TRH-TSH test was performed on 16 patients. The addition of DSM-III diagnosis on the 4-digit level did not have any value compared to the ICD-8 diagnosis. However, DSM-III diagnosis on the 5-digit level added important clinical information which corresponded better to Newcastle Scale scores and DST and TRH-TSH test results than ICD-8 diagnosis. The main advantage of the DSM-III classification of depression on the 5-digit level compared to ICD-8 concerns depression on the border between psychosis and neurosis. In clinical practice there is a risk of underestimating the severity of a depression if ICD-8/9 is used as the only criterion for severity. This may have tragic consequences for the patient. This study suggests that rating of the depression on the Newcastle Scale or provision of a DSM-III diagnosis on the 5-digit level are valuable assessment procedures of severity.

Memory deficits in young schizophrenics with normal general intellectual function.

The aim of the present study was to examine different dimensions of memory functioning in young schizophrenics with normal general intellectual abilities. Thirty-three patients with schizophrenia and 33 healthy controls were included in the study. The results suggest that immediate short-term memory is intact, though there emerged a working memory deficit in the schizophrenia group. Deficient encoding of verbal material was observed in some, but not in other, testing conditions. There also seemed to be a retrieval deficit for verbal material in schizophrenia, though no storage deficit was indicated. Impaired memory for non-verbal material was also revealed. These results occurred in a context of intact executive functioning as measured by the Wisconsin Card Sorting Test. The results indicate that temporal and frontal structures, as well as their interconnections, may be compromised in schizophrenia.