Living with type 1 diabetes is challenging for Zambian adolescents: qualitative data on stress, coping with stress and quality of care and life.
BACKGROUND
Psychosocial problems are common in patients with diabetes. However, data on psychosocial issues affecting patients with diabetes in Zambia are scarce. The present study explored sources of stress, stress coping strategies, stigma and perceived quality of life and care as experienced by adolescents living with Type 1 Diabetes in Zambia.


METHODS
Semi-structured interviews were carried out. Three groups of participants involving adolescents with Type 1 Diabetes (n = 10), caregivers (n = 8) and health practitioners (n = 4) were interviewed. Transcripts were analyzed using a thematic approach.


RESULTS
Stress was commonly reported by adolescents mainly stemming from social, psychological and physical sources. To deal with stress, adolescents often employed different coping strategies such as adapting, accepting and avoiding among others. Both internal factors (those relating to the patients themselves) and external factors (those related to the context of the patients') influenced the patients' quality of health care. In addition, low quality of life was an issue among adolescents and their families. Poor diet, low socioeconomic status and lack of medicine were factors affecting quality of health care.


CONCLUSIONS
Stress was an issue affecting adolescents; the coping strategies employed were sometimes maladaptive such as avoiding injecting themselves to escape stress. Several aspects of quality of life were suboptimal in both adolescents and their families, such as stigmatization, short life expectancy, low socioeconomic status and poor social participation. Findings show that there is an urgent need for a strong response from all stakeholders (governments, patients, organizations and companies) to improve diabetes care and living conditions for young people with type 1 diabetes living in Zambia.
Department of Psychology, University of Zambia, P.O Box 32379, Lusaka, Zambia. given.hapunda@unza.zm.|Department of Culture Studies, Tilburg University, Tilburg, The Netherlands. given.hapunda@unza.zm.
Given
G
Hapunda
Department of Culture Studies, Tilburg University, Tilburg, The Netherlands. A.AbubakarAli@uvt.nl.|Department of Psychology, Lancaster University, Lancaster, UK. A.AbubakarAli@uvt.nl.|Neuroassessment Unit, Centre for Geographic Medicine Research, KEMRI-WTRP, Kilifi, Kenya. A.AbubakarAli@uvt.nl.
Amina
A
Abubakar
Department of Culture Studies, Tilburg University, Tilburg, The Netherlands. fons.vanvijver@uvt.nl.|Work Well Unit, North-West University, Potchefstroom, South Africa. fons.vanvijver@uvt.nl.|School of Psychology, University of Queensland, Brisbane, Australia. fons.vanvijver@uvt.nl.
Fons
F
van de Vijver
Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands. f.pouwer@uvt.nl.
Frans
F
Pouwer
D000223:Adaptation, Psychological; D000293:Adolescent; D017028:Caregivers / Q000523:psychology; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011787:Quality of Health Care; D011788:Quality of Life; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D015024:Zambia / Q000453:epidemiology