背景:高弹性青少年1型糖尿病已被证明可实现目标内的血糖结果并体验高质量的生活。本研究建立了青少年1型糖尿病的生态弹性模型。它旨在增加我们对复原力如何受到内部和环境生态因素的积极和消极影响的理解。
方法:这项横断面研究调查了来自11个省36个城市的460名1型糖尿病青少年,中国。参与者完成了关于韧性的自我报告问卷,家庭功能,同行支持,同伴压力,应对方式,和人口统计。对青少年进行标准糖化血红蛋白测试。采用结构方程模型对数据进行分析。
结果:1型糖尿病青少年的生态弹性模型是一个很好的模型,其弹性变化水平很高(62%)。家庭功能是最重要的弹性预测指标,其次是同行支持,积极应对,和同伴压力。此外,积极应对是家庭功能与韧性之间关系的中介。积极应对和同伴压力共同介导了同伴支持和韧性之间的关系。
结论:家庭功能,同伴关系,积极应对是相互关联的,这可能会共同影响韧性。研究结果为青少年1型糖尿病患者制定韧性促进干预措施提供了理论依据。这可能会在脆弱的发育期导致健康改善。
BACKGROUND: Highly resilient adolescents with type 1 diabetes have been proved to achieve within-target glycemic outcomes and experience high quality of life. The ecological resilience model for adolescents with type 1 diabetes was developed in this study. It aims to increase our understanding of how resilience is both positively and negatively affected by internal and environmental ecological factors.
METHODS: This cross-sectional study surveyed 460 adolescents with type 1 diabetes from 36 cities in 11 provinces,
China. Participants completed self-report questionnaires on resilience, family functioning, peer support, peer stress, coping style, and demographics. Standard glycated hemoglobin tests were performed on the adolescents. Structural equation modeling was applied to analyze the data.
RESULTS: The ecological resilience model for adolescents with type 1 diabetes was a good model with a high level of variance in resilience (62%). Family functioning was the most important predictor of resilience, followed by peer support, positive coping, and peer stress. Moreover, positive coping was the mediator of the relationship between family functioning and resilience. Positive coping and peer stress co-mediated the association between peer support and resilience.
CONCLUSIONS: Family functioning, peer relationships, and positive coping are interrelated, which may jointly influence resilience. The findings provide a theoretical basis for developing resilience-promotion interventions for adolescents with type 1 diabetes, which may lead to health improvements during a vulnerable developmental period.