Seyed Reza Mazlom - Evidence Based Care Research Centre, Department of Medical-Surgical Nursing, School of Nursing & Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Seyedjavad Hoseini - MS in Pediatric Nursing, School of Nursing & Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Hamid Reza Behnam Vashani - Evidence Based Care Research Centre, Instuctor of Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Seyedmohsen Asghari Nekah - Assistant Professor, School of Education and Psychology, Mashhad University of Ferdowsi, Mashhad, Iran

Background: Self-efficacy is a crucial factor in controlling adolescents with insulin-dependent diabetes mellitus (IDDM). Subsequently the negative behavioral reactions such as aggression adversely affect on self-efficacy. Therefore, interventions are essential to reduce the aggression and to improve the self- efficacy in these patients. Aim: To determine the efficacy of the modified aggression replacement training program on self-efficacy of adolescents with insulin-dependent diabetes. Methods: In this clinical trial, 70 adult subjects with IDDM who were referred to Parsian Diabetes clinic of Mashhad in 2014 were divided into two groups of intervention and control. The intervention program, including three aspects including: anger control training, social skills training and moral reasoning training was performed in five sessions, each 1.5-2 hours. A five-day interval was between the sessions and each group consisted of 8-10 individuals. The self-management standard questionnaire of insulin-dependent diabetes management self-efficacy scale (IDMSE) was filled before the intervention and two months afterwards. Data were analyzed using SPSS version 11.5 with paired and Independent t-tests. Results: In this study, 38.5 and 61.5 percent of the subjects were boys and girls, respectively with total mean age of 15.9±2. The self-efficacy of the subjects before the intervention was not significantly different within the groups (p=0/57). Nevertheless in post-intervention assessment, the self-efficacy of the Intervention group significantly increased (49.0±11.1) compared to the control group (33.7±5.5) (p<0.001). Conclusion: Our findings revealed the modified aggression replacement training programs can be effective in improving the self-efficacy of adolescents with insulin-dependent diabetes mellitus. Therefore, the implementation of the program is recommended as part of comprehensive treatment programs for management of IDDM.

Aggression replacement training, Self-efficacy, Adolescent, Insulin-dependent diabetes