Self-regulation and collaborative coping with Type 1 Diabetes over the life span

 描述(申请人提供)：2013年，近300万美国人患有1型糖尿病，其中85%是成年人。由于应对糖尿病是在社会背景下进行的，恋爱伴侣可能在糖尿病管理中扮演着重要角色。然而，关于成年人在整个成年期如何应对1型糖尿病的管理以及浪漫伴侣的作用，人们知之甚少。在年轻人和中年人面临相互竞争的工作和家庭压力的情况下，浪漫伴侣的合作参与(共同应对糖尿病的挑战)可能会促进日常糖尿病的管理，对于可能擅长合作但认知和身体储备减少的老年人来说可能特别重要。这项拟议的研究应用成人寿命的视角来研究与青年、中年和老年糖尿病管理有关的压力源，以及浪漫伴侣可能通过协作应对过程促进糖尿病管理的方式。这项研究采用了多方法、多地点、为期6个月的纵向设计，将检查协作过程、压力、糖尿病管理和痛苦。一人患有1型糖尿病的250对夫妇将完成基线访谈、14天的每日日记和6个月的随访评估。在目标1中，我们将确定1型糖尿病患者一生中经历的日常压力源，这些压力源与较差的糖尿病管理和痛苦有关。夫妇们将完成一份基于网络的14天每日日记，以评估日常压力源、糖尿病依从性、情绪和血糖。应激源内容的定性分析将揭示干扰不同年龄糖尿病日常管理的一般应激源和糖尿病应激源。在目标2中，我们研究了每天和六个月内与更好的糖尿病管理和更低的痛苦相关的协作过程，以及这些过程在整个生命周期中是否具有不同的重要性。检查了多个协作过程：评估疾病是共享的，当应激源出现时协作应对，以及讨论当前糖尿病问题时的视频行为交互。在目标3中，我们使用对执行功能的行为和自我报告评估来检验协作过程是否对执行功能低下的个体特别有益。这项拟议的研究采用了一种创新的多方法方法来研究1型糖尿病终生管理的社会背景，这具有为1型糖尿病成人及其伴侣提供适合发展的量身定做的干预措施的巨大潜力。

 DESCRIPTION (provided by applicant): In 2013, nearly three million Americans were living with type 1 diabetes, with 85% of these individuals being adults. As coping with diabetes occurs in a social context, romantic partners likely play an important role in diabetes management. However, little is known about how adults cope with type 1 diabetes management throughout adulthood and the role of romantic partners. Collaborative involvement by romantic partners (jointly coping with challenges of diabetes) may facilitate daily diabetes management in the face of competing work and family pressures among young and middle-aged adults and may be especially important for older adults who may be adept at collaboration but experiencing reduced cognitive and physical reserves. The proposed study applies an adult life-span perspective to examine the stressors that are linked to diabetes management during young, middle-aged, and older adulthood and the ways that romantic partners may facilitate diabetes management across time through collaborative coping processes. The study employs a multi-method, multisite, 6-month longitudinal design that will examine collaborative processes, stress, diabetes management, and distress. Two-hundred and fifty couples across the life span where one person has type 1 diabetes will complete a baseline interview, a 14-day daily diary, and a 6-month follow-up assessment. In Aim 1 we will identify the daily stressors experienced by individuals across the life span with type 1 diabetes that are linked to poorer diabetes management and distress. Couples will complete a web-based 14-day daily diary to assess daily stressors, diabetes adherence, mood, and blood glucose. Qualitative analysis of stressor content will reveal the general and diabetes stressors that interfere with daily diabetes management at different ages. In Aim 2 we examine the collaborative processes associated with better diabetes management and lower distress both daily and across six months and whether these processes are differentially important across the life span. Multiple collaborative processes are examined: appraisals that the illness is shared, collaborative coping when stressors arise, and video-recorded behavioral interactions when discussing a current diabetes problem. In Aim 3 we examine whether collaborative processes are especially beneficial for individuals with low executive function, using behavioral and self-report assessments of executive functioning. The proposed study takes an innovative multi-method approach to the social context of type 1 diabetes management over the life span, which has great potential for informing developmentally appropriate tailored interventions for adults with type 1 diabetes and their partners.