Goal disturbance and coping in children with type I diabetes mellitus: relationships with health-related quality of life and A1C.
OBJECTIVE
Our first objective was to compare the health-related quality of life (HRQoL) of children with type 1 diabetes mellitus (8-12 years) with that of a healthy reference group, and to compare glycated hemoglobin (A1C) values of these children to recommended guidelines. Our second objective was to examine how goal disturbance and coping behaviour were related to HRQoL and A1C.


METHODS
Forty-three children, 8-12 years of age, completed a set of questionnaires that assessed generic and diabetes-specific HRQoL, goal disturbance and coping behaviour. Demographic and clinical characteristics were extracted from medical records.


RESULTS
Children with type 1 diabetes reported lower psychosocial HRQoL than healthy references (d=-0.48), especially on emotional functioning (d=-0.58). Goal disturbance was associated with lower generic HRQoL. Furthermore, the coping strategies avoidance, emotional reaction and wishful thinking were negatively associated with lower generic and disease-specific HRQoL (r ranged from -0.33 to -0.65), whereas acceptance was positively associated with disease-specific HRQoL (r=0.36). The average A1C was with 8.1% significantly above the recommended guidelines of 7.5%. Moreover, the coping strategies avoidance (r=0.31) and emotional reaction (r=0.32) were positively associated with higher blood glucose levels.


CONCLUSIONS
The psychosocial HRQoL of children with type 1 diabetes was affected, which was directly associated with the inability to reach personal goals (goal disturbance). An accepting coping strategy might solve these HRQoL problems and additionally improve A1C values.
Developmental Psychology, Tilburg University, Tilburg, The Netherlands; Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
Annika
A
van Bussel
Anke
A
Nieuwesteeg
Eef
E
Janssen
Hedwig
H
van Bakel
Bea
B
van den Bergh
Nienke
N
Maas-van Schaaijk
Roelof
R
Odink
Kathinka
K
Rijk
Esther
E
Hartman
D000223:Adaptation, Psychological / Q000502:physiology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006040:Goals; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011788:Quality of Life; D011795:Surveys and Questionnaires
D006442:Glycated Hemoglobin
A1C value; children; comportement d'adaptation; coping behaviour; diabète sucré de type 1; enfants; goal disturbance; health-related quality of life; perturbation des objectifs; qualité de vie liée à la santé; type 1 diabetes mellitus; valeur de l'HbA1c