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Coping, Self-Management, and Adaptation in Adolescents with Type 1 Diabetes

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Adolescents with type 1 diabetes experience stress related to treatment management, feeling different from peers, and deciding to tell others about their diabetes.

Purpose

This study examined the relationship of stress reactivity and coping with self-management, quality of life, and metabolic control in an ethnically diverse sample of adolescents with type 1 diabetes.

Methods

Adolescents (n = 327) completed measures of coping and stress reactivity, self-management, and quality of life. Glycosylated hemoglobin data were collected from medical records.

Results

Low-income and minority status were related to lower levels of primary control coping (e.g., problem solving) and secondary control coping (e.g., acceptance), and higher levels of disengagement coping (e.g., avoidance). Self-management mediated the relationship between coping and stress reactivity with quality of life and metabolic control. Race/ethnicity and income moderated the relationship between coping and self-management goals.

Conclusions

Results indicate differences in coping related to income and race/ethnicity and demonstrate the impact of coping on self-management and health outcomes in adolescents with type 1 diabetes.

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References

  1. Liese AD. The burden of diabetes mellitus among US youth: Prevalence estimates from the SEARCH for Diabetes in Youth Study. Pediatrics. 2006; 118:1510–8.

    Article  PubMed  Google Scholar 

  2. ADA. Standards of medical care in diabetes - 2010. Diabetes Care. 2010; 33:S11–S61.

    Google Scholar 

  3. Greening L, Stoppelbein L, Konishi C, Jordan SS, Moll G. Child routines and youths’ adherence to treatment for type 1 diabetes. J Pediatr Psychol. 2007; 32:437–47.

    Article  PubMed  Google Scholar 

  4. Davidson M, Penney EA, Muller B, Grey M. Stressors and self-care challenges faced by adolescents living with type 1 diabetes. Appl Nurs Res. 2004; 17:72–80.

    PubMed  Google Scholar 

  5. Malik JA, Koot HM. Explaining the adjustment of adolescents with type 1 diabetes: Role of diabetes-specific and psychosocial factors. Diabetes Care. 2009; 32:774–9.

    Article  PubMed  Google Scholar 

  6. Hanson CL, Henggeler SW, Burghen GA. Social competence and parental support as mediators of the link between stress and metabolic control in adolescents with insulin-dependent diabetes mellitus. J Consult Clin Psych. 1987; 55:529–33.

    Article  CAS  Google Scholar 

  7. Compas BE, Connor-Smith JK, Saltzman H, Thomsen AH, Wadsworth ME. Coping with stress during childhood and adolescence: Progress, problems, and potential in theory and research. Psychol Bull. 2001; 127:87–127.

    Article  PubMed  CAS  Google Scholar 

  8. Graue M, Wentzel-Larsen T, Bru E, Hanestad BR, Sovik O. The coping styles of adolescents with type 1 diabetes are associated with degree of metabolic control. Diabetes Care. 2004; 27:1313–7.

    Article  PubMed  Google Scholar 

  9. Jacobson AM, Hauser ST, Lavori P, Wofsdorf JI, Herskowitz RD, Milley JE, et al. Adherence among children with insulin-dependent diabetes mellitus over a four-year longitudinal follow-up: I. The influence of patient coping and adjustment. J Pediatr Psychol. 1990; 15:511–26.

    Article  PubMed  CAS  Google Scholar 

  10. Delamater AM, Kurtz SM, Bubb J, White NH, Santiago JV. Stress and coping in relation to metabolic control of adolescents with type 1 diabetes. J Dev Behav Pediatr. 1987; 8:136–40.

    Article  PubMed  CAS  Google Scholar 

  11. Grey M, Cameron ME, Thurber FW. Coping and adaptation in children with diabetes. Nurs Res. 1991; 40:144–9.

    Article  PubMed  CAS  Google Scholar 

  12. Reid GJ, Dubow EF, Carey TC. Developmental and situational differences in coping among children and adolescents with diabetes. J Appl Dev Psychol. 1995; 16:529–54.

    Article  Google Scholar 

  13. Reid GJ, Dubow EF, Carey TC, Dura JR. Contribution of coping to medical adjustment and treatment responsibility among children and adolescents wtih diabetes. Dev Behav Pediatr. 1994; 15:327–35.

    Article  CAS  Google Scholar 

  14. Band EB, Weisz JR. Developmental differences in primary and secondary control coping and adjustment to juvenile diabetes. J Clin Child Psychol. 1990; 19:150–8.

    Article  Google Scholar 

  15. Hanson CL, Cigrang JA, Harris MA, Carle DL, Relyea G, Burghen GA. Coping styles in youth with insulin-dependent diabetes mellitus. J Consult Clin Psychol. 1989; 57:644–51.

    Article  PubMed  CAS  Google Scholar 

  16. Wiebe DJ, Berg CA, Korbel C, Palmer DL, Beveridge RM, Upchurch R, et al. Children’s appraisals of maternal involvement in coping with diabetes: Enhancing our understanding of adherence, metabolic control, and quality of life across adolescence. J Pediatr Psychol. 2005; 30:167–78.

    Article  PubMed  Google Scholar 

  17. Hood KK, Peterson CM, Rohan JM, Drotar D. Association between adherence and glycemic control in pediatric type 1 diabetes: A meta-analysis. Pediatrics. 2010; 124:1171–9.

    Article  Google Scholar 

  18. Gallegos-Macias AR, Macias SR, Kaufman E, Skipper B, Kalishman N. Relationship between glycemic control, ethnicity and socioeconomic status in Hispanic and white non-Hispanic youths with type 1 diabetes mellitus. Pediatr Diabetes. 2003; 4:19–23.

    Article  PubMed  Google Scholar 

  19. Delamater AM, Shaw KH, Applegate EB, Pratt IA, Eidson M, Lancelotta GX, et al. Risk for metabolic control problems in minority youth with diabetes. Diabetes Care. 1999; 22:700–5.

    Article  PubMed  CAS  Google Scholar 

  20. Wadsworth ME, Compas BE. Coping with family conflict and economic strain: The adolescent perspective. J Res Adolescence. 2002; 12:243–74.

    Article  Google Scholar 

  21. Connor-Smith JK, Compas BE, Wadsworth ME, Thomsen AH, Saltzman H. Responses to stress in adolescence: Measurement of coping and involuntary stress responses. J Consult Clin Psychol. 2000; 68:976–92.

    Article  PubMed  CAS  Google Scholar 

  22. Compas BE, Boyer MC, Stanger C, Colletti RB, Thomsen AH, Dufton LM, et al. Latent variable analysis of coping, anxiety/depression, and somatic symptoms in adolescents with chronic pain. J Consult Clin Psychol. 2006; 56:1132–42.

    Google Scholar 

  23. Kline RB. Principles and Practice of Structural Equation Modeling. 3 rd Ed. Guilford Press, New York, NY, 2011.

    Google Scholar 

  24. Vitaliano PP, Maiuro RD, Russo J, Becker J. Raw versus relative scores in the assessment of coping strategies. J Behav Med. 1987; 10:1–18.

    Article  PubMed  CAS  Google Scholar 

  25. Schilling LS, Dixon JK, Knafl KA, Lynn MR, Murphy K, Dumser S, et al. A new self-report measure of self-management of type 1 diabetes for adolescents. Nurs Res. 2009; 58:228–36.

    Article  PubMed  Google Scholar 

  26. Varni JW, Seid M, Kurtin PS. Pediatric health-related quality of life measurement technology: A guide for health care decision makers. J Clin Outcomes Manage. 1999; 6:33–40.

    Google Scholar 

  27. Browne MW, Cudeck R. Alternative ways of assessing model fit. In: Bollen KA, Long JS, (eds). Testing structural equation models. Sage, Newbury Park, CA, 1993, pp. 136–62.

    Google Scholar 

  28. Faulkner MS, Fritschi C, Quinn L, Hepworth JT. Cardiovascular risks in adolescents with diabetes from vulnerable populations. Home Health Care Manage Prac. 22:123–30.

  29. Skinner EA, Zimmer-Gembeck MJ. The development of coping. Annu Rev Psychol. 2007; 58:119–44.

    Article  PubMed  Google Scholar 

  30. Whittemore R, Jaser SS, Guo J, Grey M. A conceptual model of adaptation to type 1 diabetes. Nurs Outlook. 2010; 58:242–51.

    Article  PubMed  Google Scholar 

  31. Wadsworth ME, Raviv T, Santiago CD, Etter EM. Testing the adaptation to poverty-related stress model: Predicting psychopathology symptoms in families facing economic hardship. J Clin Child Adolesc Psychol. 2011; 40:646–57.

    Article  PubMed  Google Scholar 

  32. Luyckx K, Seiffge-Krenke I, Hampson S. Glycemic control, coping, and internalizing and externalizing symptoms in adolescents with type 1 diabetes: A cross-lagged, longitudinal approach Diabetes Care. 2010; 33:1424–9.

    Article  PubMed  Google Scholar 

  33. Skinner EA, Edge K, Altman J, Sherwood H. Searching for the structure of coping: A review and critique of the category systems for classifying ways of coping. Psychol Bull. 2003; 129:216–69.

    Article  PubMed  Google Scholar 

  34. Garcia C. Conceptualization and measurement of coping during adolescence: A review of the literature. J Nurs Scholarship. 2010; 42:166–85.

    Article  Google Scholar 

Download references

Acknowledgments

This research was supported by grant number R01-NR04009 from the National Institute of Nursing Research (PIs: Grey and Whittemore). Author Sarah S. Jaser was supported by awards from the National Institute of Diabetes and Digestive and Kidney Diseases (K23 NK088454) and the National Center for Research Resources (UL1 RR024139). The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official view of NIH. Clinical Trial Registry number: NCT00684658

Conflict of Interest Statement

The authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Yale University School of Nursing, 100 Church Street South, PO Box 9740, New Haven, CT, 06532, USA

    Sarah S. Jaser Ph.D., Robin Whittemore Ph.D., A.P.R.N., F.A.A.N., Sangchoon Jeon Ph.D. & Margaret Grey Dr.P.H., R.N., F.A.A.N.

  2. University of Arizona, Tucson, AZ, USA

    Melissa S. Faulkner D.S.N., R.N., F.A.A.N.

  3. The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Kathryn Murphy Ph.D., R.N.

  4. University of Miami, Coral Gables, FL, USA

    Alan Delamater Ph.D.

Authors
  1. Sarah S. Jaser Ph.D.
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  2. Melissa S. Faulkner D.S.N., R.N., F.A.A.N.
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  3. Robin Whittemore Ph.D., A.P.R.N., F.A.A.N.
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  4. Sangchoon Jeon Ph.D.
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  5. Kathryn Murphy Ph.D., R.N.
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  6. Alan Delamater Ph.D.
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  7. Margaret Grey Dr.P.H., R.N., F.A.A.N.
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Correspondence to Sarah S. Jaser Ph.D..

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Jaser, S.S., Faulkner, M.S., Whittemore, R. et al. Coping, Self-Management, and Adaptation in Adolescents with Type 1 Diabetes. ann. behav. med. 43, 311–319 (2012). https://doi.org/10.1007/s12160-012-9343-z

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  • DOI: https://doi.org/10.1007/s12160-012-9343-z

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