BEHAVIORAL ASPECTS OF DIABETES
The role of protective psychological factors, self-care behaviors, and HbA1c in young adults with type 1 diabetes
Philippa Loseby,
Kiralee Schache,
Alana Cavadino,
Simon Young,
Paul L. Hofman,
Anna Serlachius,
Philippa Loseby
Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorKiralee Schache
Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
Psychological Medicine, Counties Manukau Health, Auckland, New Zealand
Search for more papers by this authorAlana Cavadino
Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorSimon Young
North Shore Hospital, Waitemata District Health Board, Auckland, New Zealand
Search for more papers by this authorPaul L. Hofman
Liggins Institute, University of Auckland, Auckland, New Zealand
Search for more papers by this authorCorresponding Author
Anna Serlachius
Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
Correspondence
Anna Serlachius, Department of Psychological Medicine, School of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
Email: [email protected]
Search for more papers by this authorPhilippa Loseby,
Kiralee Schache,
Alana Cavadino,
Simon Young,
Paul L. Hofman,
Anna Serlachius,
Philippa Loseby
Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorKiralee Schache
Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
Psychological Medicine, Counties Manukau Health, Auckland, New Zealand
Search for more papers by this authorAlana Cavadino
Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorSimon Young
North Shore Hospital, Waitemata District Health Board, Auckland, New Zealand
Search for more papers by this authorPaul L. Hofman
Liggins Institute, University of Auckland, Auckland, New Zealand
Search for more papers by this authorCorresponding Author
Anna Serlachius
Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
Correspondence
Anna Serlachius, Department of Psychological Medicine, School of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
Email: [email protected]
Search for more papers by this authorAbstract
Objective
To investigate whether protective psychological factors in young adults with type 1 diabetes are associated with more optimal self-care behaviors and HbA1c, and to explore possible mediators between protective psychological factors and HbA1c.
Research design and methods
This cross-sectional study examined the associations between protective psychological factors (optimism, positive efficacy expectancies, and self-compassion), maladaptive psychological factors (depression, anxiety, and stress), self-care behaviors, and HbA1c in 113 young adults (17–25 years) with type 1 diabetes in Auckland, New Zealand. Pearson's correlations, multiple linear regressions, and multiple mediation analyses were used to examine associations and mediators.
Results
Higher positive efficacy expectancies (beliefs about coping with difficulties) were associated with more optimal HbA1c (β = −0.26, 95% CI: −1.99 to −0.45) and more optimal self-care behaviors (β = 0.33, 95% CI: 0.28 to 0.92) in the adjusted models. Higher levels of self-compassion were associated with more optimal self-care behaviors (β = 0.27, 95% CI: 0.09 to 0.43). Depression was associated with less optimal self-care behaviors (β = −0.35, 95% CI: −1.33 to −0.43) and stress was associated with less optimal HbA1c (β = 0.26, 95% CI: 0.27 to 1.21). Mediation results suggested that self-care behaviors mediated the relationship between all three of the protective psychological factors and more optimal HbA1c, and that lower stress also mediated the relationship between higher self-compassion and more optimal HbA1c.
Conclusions
This study adds to the emerging literature that protective psychological factors may play an adaptive role in improving health outcomes in young adults with type 1 diabetes. Interventions targeting protective psychological factors present a promising approach to optimizing wellbeing and self-care in youth with type 1 diabetes.
CONFLICT OF INTEREST
This research did not receive any specific funding. The authors report no conflict of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
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