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在理解1型糖尿病青少年的感知应对效果方面,压力评估与二元应对之间的契合度。

The fit between stress appraisal and dyadic coping in understanding perceived coping effectiveness for adolescents with type 1 diabetes.

作者信息

Berg Cynthia A, Skinner Michelle, Ko Kelly, Butler Jorie M, Palmer Debra L, Butner Jonathan, Wiebe Deborah J

机构信息

Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA.

出版信息

J Fam Psychol. 2009 Aug;23(4):521-30. doi: 10.1037/a0015556.

Abstract

This study examined whether perceived coping effectiveness (PCE) was associated with better diabetes management and was higher when adolescents' dyadic coping was matched to shared stress appraisals. There were 252 adolescents with Type 1 diabetes who completed stress and coping interviews where they appraised mothers' and fathers' involvement in stress ownership (mine, indirectly shared, directly shared with parent), in coping (uninvolved, supportive, collaborative, or controlling), and rated their effectiveness in coping. Adolescents completed assessments of depressive symptoms (Children's Depression Inventory), self-care behaviors (Self-Care Inventory), and efficacy of disease management (Diabetes Self-Efficacy). Glycosylated hemoglobin levels were obtained from medical records. Higher PCE was associated with fewer depressive symptoms, self-care behaviors, and efficacy across age and, more strongly for older adolescents' metabolic control. Appraisals of support or collaboration from parents were more frequent when stressors were appraised as shared. PCE was enhanced when dyadic coping with mothers (but not fathers) was consistent with stress appraisals (e.g., shared stressors together with collaborative coping). Stress and coping is embedded within a relational context and this context is useful in understanding the coping effectiveness of adolescents.

摘要

本研究探讨了感知应对效能(PCE)是否与更好的糖尿病管理相关,以及当青少年的二元应对与共同的压力评估相匹配时,PCE是否更高。共有252名1型糖尿病青少年完成了压力与应对访谈,他们评估了父母在压力归属(我的、间接分担的、与父母直接分担的)、应对方式(不参与、支持、协作或控制)方面的参与情况,并对自己的应对效能进行了评分。青少年完成了抑郁症状评估(儿童抑郁量表)、自我护理行为评估(自我护理量表)以及疾病管理效能评估(糖尿病自我效能感量表)。糖化血红蛋白水平从医疗记录中获取。较高的PCE与各年龄段较少的抑郁症状、自我护理行为及效能相关,对年龄较大青少年的代谢控制影响更强。当压力源被评估为共同承担时,来自父母的支持或协作评估更为频繁。当与母亲(而非父亲)的二元应对与压力评估一致时(例如,共同的压力源与协作应对),PCE会增强。压力与应对嵌入在一种关系背景中,这种背景有助于理解青少年的应对效能。

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