Goal Disturbance and Coping in Children with Type I Diabetes Mellitus: Relationships with Health-Related Quality of Life and A1C

• Published in: Canadian journal of diabetes 2013-06, Vol.37 (3), p.169-174
• Main Authors: van Bussel, Annika, MSc, Nieuwesteeg, Anke, MSc, Janssen, Eef, MSc, van Bakel, Hedwig, PhD, van den Bergh, Bea, PhD, Maas-van Schaaijk, Nienke, PhD, Odink, Roelof, MD, Rijk, Kathinka, PhD, Hartman, Esther, PhD
• Format: Article
• Language: English
• Subjects: A1C value; Adaptation, Psychological - physiology; Child; children; comportement d'adaptation; coping behaviour; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - epidemiology; Diabetes Mellitus, Type 1 - psychology; diabète sucré de type 1; Endocrinology & Metabolism; enfants; Female; Glycated Hemoglobin A - analysis; goal disturbance; Goals; health-related quality of life; Humans; Male; Netherlands - epidemiology; Other; perturbation des objectifs; Quality of Life; qualité de vie liée à la santé; Surveys and Questionnaires; type 1 diabetes mellitus; valeur de l'HbA1c
• ISSN: 1499-2671; 2352-3840
• DOI: 10.1016/j.jcjd.2013.02.058

A b s t r a c t Objective Our first objective was to compare the health-related quality of life (HRQoL) of children with type 1 diabetes mellitus (8–12 years) with that of a healthy reference group, and to compare glycated hemoglobin (A1C) values of these children to recommended guidelines. Our second objective was to examine how goal disturbance and coping behaviour were related to HRQoL and A1C. Method Forty-three children, 8–12 years of age, completed a set of questionnaires that assessed generic and diabetes-specific HRQoL, goal disturbance and coping behaviour. Demographic and clinical characteristics were extracted from medical records. Results Children with type 1 diabetes reported lower psychosocial HRQoL than healthy references (d=−0.48), especially on emotional functioning (d=−0.58). Goal disturbance was associated with lower generic HRQoL. Furthermore, the coping strategies avoidance, emotional reaction and wishful thinking were negatively associated with lower generic and disease-specific HRQoL (r ranged from −0.33 to −0.65), whereas acceptance was positively associated with disease-specific HRQoL (r=0.36). The average A1C was with 8.1% significantly above the recommended guidelines of 7.5%. Moreover, the coping strategies avoidance (r=0.31) and emotional reaction (r=0.32) were positively associated with higher blood glucose levels. Conclusions The psychosocial HRQoL of children with type 1 diabetes was affected, which was directly associated with the inability to reach personal goals (goal disturbance). An accepting coping strategy might solve these HRQoL problems and additionally improve A1C values.