Delamater A M, Kurtz S M, Bubb J, White N H, Santiago J V
J Dev Behav Pediatr. 1987 Jun;8(3):136-40.
The purpose of this study was to determine whether measures of anxiety, stress, and means of coping with stress differ in diabetic adolescents in good, fair, and poor metabolic control. Trait anxiety, perceived daily stress, and coping responses to a recent stressful event were assessed in 27 adolescents with Type 1 diabetes mellitus. Information also was obtained regarding the type of stressful events that subjects referred to in completing the coping measure, as well as their appraisals of the events. Hemoglobin A1 (HbA1) obtained at the time of the study was used as a measure of antecedent metabolic control. Based upon their HbA1, patients were divided into three metabolic control subgroups: good control (M = 8.4%; n = 8), fair control (M = 10.9%; n = 9), and poor control (M = 13.3%; n = 10). Patients in these subgroups were similar with regard to age, disease duration, and socioeconomic status. Results indicated that the subgroups did not differ on the anxiety and stress measures; however, analyses of the coping data indicated that patients in poor control employed significantly more wishful thinking and avoidance/help-seeking than did patients in good metabolic control. Furthermore, the metabolic control subgroups differed in the type of stressful events reported and their appraisals of the stressful events. These results support the hypothesis that the ways in which individuals with diabetes appraise and cope with stress is related to their metabolic control. The findings are discussed in relation to methodological issues and treatment implications.
本研究的目的是确定焦虑、压力测量指标以及应对压力的方式在代谢控制良好、一般和较差的糖尿病青少年中是否存在差异。对27名1型糖尿病青少年的特质焦虑、感知到的日常压力以及对近期压力事件的应对反应进行了评估。还获取了有关受试者在完成应对措施时提及的压力事件类型以及他们对这些事件的评估的信息。将研究时获得的糖化血红蛋白（HbA1）用作先前代谢控制的指标。根据HbA1水平，患者被分为三个代谢控制亚组：良好控制组（M = 8.4%；n = 8）、一般控制组（M = 10.9%；n = 9）和较差控制组（M = 13.3%；n = 10）。这些亚组中的患者在年龄、病程和社会经济地位方面相似。结果表明，这些亚组在焦虑和压力测量指标上没有差异；然而，对应对数据的分析表明，代谢控制较差的患者比代谢控制良好的患者更多地采用了如意算盘思维和回避/寻求帮助的方式。此外，代谢控制亚组在报告的压力事件类型及其对压力事件的评估方面存在差异。这些结果支持了这样一种假设，即糖尿病患者评估和应对压力的方式与他们的代谢控制有关。将结合方法学问题和治疗意义对这些发现进行讨论。
