Psychological Flexibility Among Youth with Type 1 Diabetes: Relating Patterns of Acceptance, Adherence, and Stress to Adaptation

Abstract

Psychological flexibility, a complex concept encompassing both acceptance and action related factors, has been identified as a target for intervention for diabetes management. Research suggests acceptance, self-management, and stress, all factors that influence psychological flexibility, have an impact on adaptation to type 1 diabetes (T1D) by youth independently. However, yet to be explored is individually varying patterns of these variables and how they may relate to diabetes adaptation outcomes. The present study aimed to establish individual variations of patterns of these factors to derive profiles of psychological flexibility, and examine their relations to the adaptation outcomes of glycemic control and health-related quality of life. Youth (N = 162, aged 12-17 years) with T1D completed the Acceptance and Action Diabetes Questionnaire, Diabetes Stress Questionnaire, Self-Care Inventory, and Pediatric Quality of Life-Diabetes Module. Hemoglobin A values were abstracted from medical records. Latent profile analysis yielded three profiles: High Acceptance & Adherence/Low Stress, Low Acceptance/Moderate Adherence & Stress, and Low Acceptance & Adherence/High Stress. The High Acceptance & Adherence/Low Stress group displayed significantly higher health-related quality of life and lower HbA compared to other groups. Fluid psychological variables, such as acceptance and diabetes stress, and adherence behaviors may be salient targets to increase psychological flexibility for individual psychosocial interventions aimed at improving adaptation to type 1 diabetes in youth.

Clinical and Subclinical Distress, Quality of Life, and Psychological Well‐Being after Cardiac Rehabilitation

“…Indeed, it could be hypothesised that high distress patients, who seem to show the lowest levels of contentment and the poorest cardiac outcomes in the survival analysis, could benefit from interventions aimed to promote acceptance and adaptation to stressful conditions, thus enhancing psychological flexibility. The latter, indeed, was found to be highly related to quality of life and adaptation in different medical settings, especially among patients with chronic conditions (Wicksell, Olsson, & Hayes, ; Kamody et al., ).…”

Adherence to dietary recommendations in diabetes mellitus: disease acceptance as a potential mediator

“…In the case of adherence to dietary recommendations, the issue is more complicated, as important psychological functions of eating have to be considered as well. 27 , 28 …”

“…Therefore, this study focuses on the role of acceptance of one’s own disease, as this topic has received significantly less attention in the literature. 28 – 30 …”

“…These observations are consistent with other authors’ reports. 28 – 30 It should be noted that one important paper, in particular, emphasizing the significance of patient’s adequate psychological attitude, was published by DuBois et al 30 They prepared a 12-week positive psychology intervention for a group of 15 diabetic patients. DuBois et al 30 demonstrated that adequate psychological intervention in diabetic patients was beneficial not only for their psychological functioning but also for their physical well-being.…”

Adolescentes Com Diabetes Mellitus Tipo 1: Estresse, Coping E Adesão Ao Tratamento

“…Neste estudo, os adolescentes buscaram o suporte para a expressão e a regulação emocional, bem como para a solução de problemas, principalmente, nos pais, em Deus, irmãos e nos amigos. Esses resultados são positivos, pois o suporte social é apontado como um fator de proteção, contribuindo principalmente para o controle metabólico, manejo da doença e adesão ao tratamento [7][8]26 .…”