Psychosocial Adjustment to Diabetes: An Integrative Model for Glycemic Control and Quality of Life
Open Access
- Author:
- Renosky, Ronda J.
- Graduate Program:
- Biobehavioral Health
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- March 03, 2010
- Committee Members:
- Jan Ulbrecht, Dissertation Advisor/Co-Advisor
Jan Ulbrecht, Committee Chair/Co-Chair
Linda Ann Wray, Committee Chair/Co-Chair
Frank Martin Ahern, Committee Member
Brandon B Hunt, Committee Member - Keywords:
- diabetes
psychosocial adjustment
quality of life
glycemic control
psychosocial adaptation
sense of coherence - Abstract:
- AIM: This study examined relationships among psychosocial predictors of diabetes-specific quality of life (DM-QOL) and glycemic control, through an integrative framework of psychosocial adjustment to chronic illness, which was anchored in the Self-Regulation Model and stress and coping theories. METHODS: A sample of 111 adults with diabetes (DM), ages 21 to 81, completed questionnaires that measured components of adjustment (illness representations, sense of coherence, psychological distress, chronic illness resources, and obstacles to diabetes management), as well as their quality of life; HbA1c levels were determined by blood samples. Hierarchical regression analyses tested the association of the adjustment-related variables to glycemic control and DM-QOL. RESULTS: DM-QOL was significantly associated with type of DM and illness representations. Adults with better DM-QOL attributed fewer symptoms to diabetes, believed diabetes to have fewer negative consequences and to be unpredictable/cyclical, and had fewer emotional reactions to their experiences. The effect of illness representations on DM-QOL was partially mediated by psychological distress. The model significantly explained 69.8% of the variance in DM-QOL, with 49.9% explained by adjustment-related variables. Better glycemic control was significantly associated with older age, type 2 DM, no insulin use, more comorbid illnesses, and greater use of resources. The model significantly explained 48.7% of the variance in glycemic control, with 33.6% due to demographic and/or disease variables and 15.1% to adjustment-related variables. CONCLUSION: The relationships found among psychosocial variables, DM-QOL, and glycemic control supported the framework of adjustment to chronic illness. This approach further clarifies the psychosocial determinants of these two important diabetes outcomes and informs future conceptualizations of diabetes management.