Problem solving interventions for diabetes self-management and control: A systematic review of the literature

AimsProblem solving is deemed a core skill for patient diabetes self-management education. The purpose of this systematic review is to examine the published literature on the effect of problem-solving interventions on diabetes self-management and disease control.Data sourcesWe searched PubMed and PsychINFO electronic databases for English language articles published between November 2006 and September 2012. Reference lists from included studies were reviewed to capture additional studies.Study selectionStudies reporting problem-solving intervention or problem solving as an intervention component for diabetes self-management training and disease control were included. Twenty-four studies met inclusion criteria.Data extractionStudy design, sample characteristics, measures, and results were reviewed.Data synthesisSixteen intervention studies (11 adult, 5 children/adolescents) were randomized controlled trials, and 8 intervention studies (6 adult, 2 children/adolescents) were quasi-experimental designs.ConclusionsStudies varied greatly in their approaches to problem-solving use in patient education. To date, 36% of adult problem-solving interventions and 42% of children/adolescent problem-solving interventions have demonstrated significant improvement in HbA1c, while psychosocial outcomes have been more promising. The next phase of problem-solving intervention research should employ intervention characteristics found to have sufficient potency and intensity to reach therapeutic levels needed to demonstrate change.