Children diagnosed with Type 1 diabetes face lifetime issues that will affect their health-related quality of life (HRQoL). These challenges require varied coping skills to manage the disease and a commitment to find ways to increase HRQoL. It was proposed that children’s general coping styles would be mediators in both the relation of family environment and children’s health-related quality of life and the relation of parental perceived social support and children’s health-related quality of life in children aged 8-16 with Type 1 diabetes. Age was also proposed to be a moderator in the relation of children’s coping to their health-related quality of life. Children aged 8 to 16 and their primary caregivers (N = 56) were recruited to participate in the study at a university hospital tertiary care clinic. Children completed the Pediatric Quality of Life Inventory 3.0 Diabetes Module for children and adolescents (PedsQL 3.0) and the Children’s Coping Strategies Checklist-Revision 1. Primary caregivers completed the PedsQL 3.0 for parents, the Family Environment Scale and the Multidimensional Scale of Perceived Social Support. Regression analyses were used to identify a model that explained the contribution of each factor to predict HRQoL. It was hypothesized that children’s active, distraction, and support-seeking general coping strategies would be mediators in the relation of family environment and parental perceived social support to children’s health-related quality of life and that children’s general avoidant coping strategies would not mediate either the relation of family environment or parental perceived social support to children’s health-related quality of life. Although children’s active, distraction, and support-seeking coping strategies were not found to mediate the relation of family environment to children’s health-related quality of life or the relation of parental perceive social support to health-related quality of life, children’s avoidant coping strategies were found to be a mediator in the relation of family environment to children’s health-related quality of life and in the relation of parental perceived social support to health-related quality of life. It was also hypothesized that children’s age would moderate the relation of children’s active, distraction, and support-seeking coping strategies to children’s health-related quality of life. Age moderated the relation of avoidant coping to HRQoL. Avoidant coping was negatively associated with HRQoL for the older children but the association was not significant for younger children. To facilitate a better health-related quality of life for children with Type 1 diabetes, therapists and healthcare professionals should identify ways to help parents feel more supported as they care for and create a more cohesive and low conflict family environment, which contributes to their children’s health-related quality of life. Additionally, therapists should work with children and their parents to increase children’s use of active, distraction, and support-seeking coping strategies, which are related to more positive outcomes compared to children’s use of avoidant coping strategies, which are related to less positive outcomes. / Ph. D. / This research study explored social and emotional climate in families, perception of parents’ social support, and children’s coping as factors that contribute to the health-related quality of life (HRQoL) in children aged 8 to 16 with Type 1 diabetes. One of the main goals of treatment for children diagnosed with Type 1 diabetes is preventing nerve, heart, and blood vessel damage from occurring in adulthood. When children are diagnosed with Type 1 diabetes, they face a lifetime issues that will affect their HRQoL. These challenges require children to develop skills to help them process both the expected and unexpected emotions and thoughts that occur while managing the disease and a commitment to find ways to increase HRQoL over the span of their lives. It was hypothesized that children with better social and emotional family climates or environments and more parental perceived social support would be able to more effectively cope and that better coping would be associated with more health-related quality of life. Effective forms of coping included three different strategies: active (e. g., use of positive restructuring of thoughts), distraction (e. g., use of physical release of emotion), and support-seeking (e. g., seeking support for managing feelings). Avoidant coping was also examined and included use of actions such as wishful thinking. Of note, the children’s coping measure used identified use general coping strategies and was not diabetes specific. Children with connected, expressive, and low conflict family climates and with parents who perceived themselves being supported more were lower in avoidant coping, which was related to more HRQoL for the children. How coping was associated with HRQoL was also predicted to be different when looking at older versus younger children. As children aged, their use of avoidant coping strategies increased and more avoidant coping was related to less HRQoL for older children but not for younger children. To facilitate a better health-related quality of life for children with Type 1 diabetes, therapists and healthcare professionals should identify ways to help parents feel more supported as they care for and create a more cohesive and low conflict family environment, which can contribute to their children’s health-related quality of life. Additionally, therapists should work with children and their parents to decrease children’s use of avoidant coping strategies, which are related to less positive outcomes.
| Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/84073 |
| Date | 16 July 2018 |
| Creators | Williams, Isha D. |
| Contributors | Adult Learning and Human Resource Development, Smith, Cynthia L., Dolbin-MacNab, Megan L., Finney, Jack W., Kim-Spoon, Jungmeen, Zvonkovic, Anisa |
| Publisher | Virginia Tech |
| Source Sets | Virginia Tech Theses and Dissertation |
| Detected Language | English |
| Type | Dissertation |
| Format | ETD, application/pdf |
| Rights | In Copyright, http://rightsstatements.org/vocab/InC/1.0/ |
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