title: The role of resilience on psychological adjustment and physical health in patients with diabetes.
abstract: OBJECTIVE
  This study used a longitudinal design to investigate the buffering role of resilience on worsening HbA(1c) and self-care behaviours in the face of rising diabetes-related distress.
  
  
  METHODS
  A total of 111 patients with diabetes completed surveys and had their glycosylated haemoglobin (HbA(1c)) assessed at baseline and at 1-year follow-up. Resilience was defined by a factor score of self-esteem, self-efficacy, self-mastery and optimism. Diabetes-related distress and self-care behaviours were also assessed.
  
  
  RESULTS
  Baseline resilience, diabetes-related distress and their interaction predicted physical health (HbA(1c)) at 1 year. Patients with low, moderate and high resilience were identified. Those with low or moderate resilience levels showed a strong association between rising distress and worsening HbA(1c) across time (r=.57, .56, respectively). However, those with high resilience scores did not show the same associations (r=.08). Low resilience was also associated with fewer self-care behaviours when faced with increasing distress (r=-.55). These correlation coefficients remained significant after controlling for starting-points.
  
  
  CONCLUSIONS
  In patients with diabetes, resilience resources predicted future HbA(1c) and buffered worsening HbA(1c) and self-care behaviours in the face of rising distress levels.
authors.affiliation: Department of Psychology, University of Washington, Seattle, WA, USA. joyce.yi@seattlechildrens.org
authors.forename: Joyce P
authors.initials: JP
authors.lastname: Yi
authors.forename: Peter P
authors.initials: PP
authors.lastname: Vitaliano
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Smith
authors.forename: Jean C
authors.initials: JC
authors.lastname: Yi
authors.forename: Katie
authors.initials: K
authors.lastname: Weinger
mesh_terms: D000223:Adaptation, Psychological; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D012648:Self Care; D012649:Self Concept; D020377:Self Efficacy; D012720:Severity of Illness Index
chemical_list: D006442:Glycated Hemoglobin