Yi Joyce P, Vitaliano Peter P, Smith Ronald E, Yi Jean C, Weinger Katie
Department of Psychology, University of Washington, Seattle, WA, USA.
Br J Health Psychol. 2008 May;13(Pt 2):311-25. doi: 10.1348/135910707X186994. Epub 2007 Mar 1.
This study used a longitudinal design to investigate the buffering role of resilience on worsening HbA(1c) and self-care behaviours in the face of rising diabetes-related distress.
A total of 111 patients with diabetes completed surveys and had their glycosylated haemoglobin (HbA(1c)) assessed at baseline and at 1-year follow-up. Resilience was defined by a factor score of self-esteem, self-efficacy, self-mastery and optimism. Diabetes-related distress and self-care behaviours were also assessed.
Baseline resilience, diabetes-related distress and their interaction predicted physical health (HbA(1c)) at 1 year. Patients with low, moderate and high resilience were identified. Those with low or moderate resilience levels showed a strong association between rising distress and worsening HbA(1c) across time (r=.57, .56, respectively). However, those with high resilience scores did not show the same associations (r=.08). Low resilience was also associated with fewer self-care behaviours when faced with increasing distress (r=-.55). These correlation coefficients remained significant after controlling for starting-points.
In patients with diabetes, resilience resources predicted future HbA(1c) and buffered worsening HbA(1c) and self-care behaviours in the face of rising distress levels.
本研究采用纵向设计，以调查面对日益增加的糖尿病相关困扰时，心理弹性对糖化血红蛋白（HbA1c）恶化及自我护理行为的缓冲作用。
共有111名糖尿病患者完成了调查，并在基线和1年随访时接受糖化血红蛋白（HbA1c）评估。心理弹性由自尊、自我效能感、自我掌控和乐观的因子得分定义。还评估了糖尿病相关困扰和自我护理行为。
基线心理弹性、糖尿病相关困扰及其交互作用可预测1年后的身体健康状况（HbA1c）。确定了低、中、高心理弹性的患者。低心理弹性或中等心理弹性水平的患者在随访期间，困扰增加与HbA1c恶化之间存在强关联（相关系数分别为0.57和0.56）。然而，高心理弹性得分的患者未表现出相同的关联（相关系数为0.08）。面对日益增加的困扰时，低心理弹性也与较少的自我护理行为相关（相关系数为 -0.55）。在控制起始点后，这些相关系数仍具有统计学意义。
在糖尿病患者中，心理弹性资源可预测未来的HbA1c，并在面对日益增加的困扰时缓冲HbA1c恶化及自我护理行为。
