青少年 1 型糖尿病患者经历糖尿病困扰时，应对策略与血糖和心理社会结局的相关性。
Associations of Coping Strategies With Glycemic and Psychosocial Outcomes Among Adolescents With Type 1 Diabetes Experiencing Diabetes Distress.
机构信息
Children's National Hospital Division of Psychology and Behavioral Health, Washington, DC, USA.
Vanderbilt University Medical Center Department of Pediatrics, Nashville, TN, USA.
出版信息
Ann Behav Med. 2024 Aug 7;58(9):628-633. doi: 10.1093/abm/kaae028.
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.
背景
许多 1 型糖尿病青少年经历着糖尿病困扰，这与血糖控制不佳和心理社会结局相关。青少年应对糖尿病困扰的方式可能成为这些结局的风险或保护因素，但很少有研究检查青少年用于管理糖尿病困扰的应对策略。
目的
研究应对策略与经历糖尿病困扰的青少年的血糖和心理社会结局之间的关联。
方法
参与者包括 198 名糖尿病困扰程度较高的青少年，他们完成了一项随机对照试验的基线数据（Mage = 15.3 ± 1.4，58%女性，58%非西班牙裔白人，MA1c = 9.1 ± 2.1%）。青少年报告了与糖尿病应激源相关的应对策略的使用情况，包括主要控制参与应对（例如，解决问题）、次要控制参与应对（例如，积极思考）和脱离应对（例如，回避）。青少年还完成了糖尿病困扰、生活质量和适应力的测量。HbA1c 数据从电子病历和家庭检测试剂盒中提取。
结果
更高的主要控制参与应对与更好的血糖和心理社会结局相关。次要控制参与应对与更好的心理社会结局相关，但与血糖结局无关。更多使用脱离应对策略与更差的血糖和心理社会结局相关。所有关联在调整青少年性别、年龄、种族/民族和连续血糖监测器使用后仍然显著。
结论
这些结果在之前的研究基础上增加了更多样化的青少年样本，强调了在经历糖尿病困扰的青少年中促进参与应对策略和抑制脱离应对策略的价值。
临床试验信息
NCT03845465。
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