Associations of Coping Strategies With Glycemic and Psychosocial Outcomes Among Adolescents With Type 1 Diabetes Experiencing Diabetes Distress.

IF 3.6 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY
Emma Straton, Kashope Anifowoshe, Hailey Moore, Randi Streisand, Sarah S Jaser
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Abstract

Background: Many adolescents with type 1 diabetes experience diabetes distress which is associated with suboptimal glycemic and psychosocial outcomes. The ways in which adolescents respond to diabetes distress may serve as a risk or protective factor for these outcomes, but few studies have examined the coping strategies adolescents use to manage diabetes distress.

Purpose: To examine the association of coping strategies with glycemic and psychosocial outcomes among adolescents experiencing diabetes distress.

Methods: Participants included 198 adolescents with elevated diabetes distress who completed baseline data for a randomized controlled trial (Mage = 15.3 ± 1.4, 58% female, 58% non-Hispanic White, MA1c = 9.1 ± 2.1%). Adolescents reported on their use of coping strategies related to diabetes stressors, including primary control engagement coping (e.g., problem-solving), secondary control engagement coping (e.g., positive thinking), and disengagement coping (e.g., avoidance). Adolescents also completed measures of diabetes distress, quality of life, and resilience. HbA1c data were extracted from electronic medical records and at-home kits.

Results: Higher use of primary control engagement coping was associated with better glycemic and psychosocial outcomes. Secondary control engagement coping was associated with better psychosocial outcomes but not glycemic outcomes. Greater use of disengagement coping strategies was associated with poorer glycemic and psychosocial outcomes. All associations were significant after adjusting for adolescent sex, age, race/ethnicity, and continuous glucose monitor use.

Conclusions: These results build on prior findings by including a more diverse sample of adolescents and highlight the value of promoting engagement coping strategies and discouraging the use of disengagement coping strategies among adolescents experiencing diabetes distress.

Clinical trial information: NCT03845465.

应对策略与 1 型糖尿病青少年血糖和社会心理结果的关系。
背景:许多患有1型糖尿病的青少年都有糖尿病困扰,这与血糖和社会心理状况不理想有关。青少年应对糖尿病困扰的方式可能是导致这些结果的风险或保护因素,但很少有研究探讨青少年为控制糖尿病困扰而采取的应对策略:参与者包括198名糖尿病症状加重的青少年,他们完成了随机对照试验的基线数据(Mage = 15.3 ± 1.4,58%为女性,58%为非西班牙裔白人,MA1c = 9.1 ± 2.1%)。青少年报告了他们使用的与糖尿病压力相关的应对策略,包括主要控制参与应对(如解决问题)、次要控制参与应对(如积极思考)和脱离应对(如逃避)。青少年还完成了糖尿病困扰、生活质量和适应能力的测量。HbA1c数据来自电子病历和家庭工具包:结果:更多使用初级控制参与应对与更好的血糖和社会心理结果相关。二级控制参与应对与更好的社会心理结果有关,但与血糖结果无关。更多地使用脱离应对策略与较差的血糖和社会心理结果有关。在对青少年的性别、年龄、种族/民族和连续血糖监测仪的使用情况进行调整后,所有相关性都很明显:这些结果以先前的研究结果为基础,纳入了更多样化的青少年样本,并强调了在经历糖尿病困扰的青少年中推广参与应对策略和阻止使用脱离应对策略的价值:NCT03845465。
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来源期刊
Annals of Behavioral Medicine
Annals of Behavioral Medicine PSYCHOLOGY, MULTIDISCIPLINARY-
CiteScore
7.00
自引率
5.30%
发文量
65
期刊介绍: Annals of Behavioral Medicine aims to foster the exchange of knowledge derived from the disciplines involved in the field of behavioral medicine, and the integration of biological, psychosocial, and behavioral factors and principles as they relate to such areas as health promotion, disease prevention, risk factor modification, disease progression, adjustment and adaptation to physical disorders, and rehabilitation. To achieve these goals, much of the journal is devoted to the publication of original empirical articles including reports of randomized controlled trials, observational studies, or other basic and clinical investigations. Integrative reviews of the evidence for the application of behavioral interventions in health care will also be provided. .
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