Rechenberg Kaitlyn, Whittemore Robin, Holland Margaret, Grey Margaret
Yale University School of Nursing, 400 West Campus Drive, Orange, CT 06577, United States.
Diabetes Res Clin Pract. 2017 Aug;130:1-8. doi: 10.1016/j.diabres.2017.05.003. Epub 2017 May 16.
Type 1 diabetes (T1D) is one of the most common chronic health conditions in adolescents in the United States. Adherence to the recommended treatment regimen has been reported as a source of stress for adolescents.
The purpose of this study was to examine the associations among general and diabetes-specific stress and glycemic control (HbA1c), self-management, and diabetes-specific quality of life (QOL) in adolescents with T1D.
A secondary analysis of baseline data (N=320) from a randomized controlled trial was conducted. Adolescents completed validated measures of general and diabetes-specific stress, self-management, and diabetes-specific QOL. HbA1c levels were obtained from medical records.
Over 50% of the sample scored at or above criteria for high general and diabetes-specific stress. Higher general and diabetes-specific stress was significantly associated with higher HbA1c, poorer self-management activities, and lower diabetes-specific QOL. Diabetes-specific stress accounted for a significant proportion of the variance in HbA1c, while general stress did not. General and diabetes-specific stress accounted for 40% of the variance in diabetes-specific QOL.
General and diabetes-specific stress are common in adolescents with T1D. Healthcare providers must be mindful of the sources of stress that adolescents with T1D face on a daily basis. General stress and diabetes-specific stress should be differentiated and may require different interventions to improve coping and outcomes.
1型糖尿病(T1D)是美国青少年中最常见的慢性健康问题之一。据报道,坚持推荐的治疗方案是青少年压力的一个来源。
本研究的目的是探讨T1D青少年中一般压力和糖尿病特异性压力与血糖控制(糖化血红蛋白)、自我管理及糖尿病特异性生活质量(QOL)之间的关联。
对一项随机对照试验的基线数据(N = 320)进行二次分析。青少年完成了关于一般压力和糖尿病特异性压力、自我管理及糖尿病特异性QOL的有效测量。糖化血红蛋白水平从医疗记录中获取。
超过50%的样本在一般压力和糖尿病特异性压力方面达到或超过高压力标准。较高的一般压力和糖尿病特异性压力与较高的糖化血红蛋白、较差的自我管理活动及较低的糖尿病特异性QOL显著相关。糖尿病特异性压力在糖化血红蛋白的变异中占很大比例,而一般压力则不然。一般压力和糖尿病特异性压力占糖尿病特异性QOL变异的40%。
一般压力和糖尿病特异性压力在T1D青少年中很常见。医疗保健提供者必须留意T1D青少年日常面临的压力源。应区分一般压力和糖尿病特异性压力,可能需要不同的干预措施来改善应对方式和结果。