title: Daily stress variability, learned resourcefulness, regimen adherence, and metabolic control in type I diabetes mellitus: evaluation of a path model.
abstract: A model of daily stress and metabolic control in Type I diabetes was tested in which stress has dual effects upon glycemic level: (a) direct, through psychophysiological mechanisms, and (b) mediated, through regimen adherence. Learned resourcefulness was postulated to moderate both effects. Two approaches to measuring daily stress were also compared: stress mean and variability. Daily stress and adherence were measured in 62 adult diabetics on six occasions over 2 months, after which glycosylated hemoglobin levels were obtained. Stress had a direct association with metabolic control that was not mediated by adherence. Although learned resourcefulness failed to moderate this relationship, it did relate directly to metabolic control, in the unexpected direction. The variables combined to explain 37% of the variance in metabolic control. The utility of the intraindividual approach to daily stress measurement was supported.
authors.affiliation: Civitan International Research Center, University of Alabama, Birmingham 35294.
authors.forename: J E
authors.initials: JE
authors.lastname: Aikens
authors.forename: J L
authors.initials: JL
authors.lastname: Wallander
authors.forename: D S
authors.initials: DS
authors.lastname: Bell
authors.forename: J A
authors.initials: JA
authors.lastname: Cole
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006380:Helplessness, Learned; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010349:Patient Compliance / Q000523:psychology*; D012803:Sick Role; D013315:Stress, Psychological / Q000150:complications*
chemical_list: D001786:Blood Glucose