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J Clin Psychol Med Settings. 2018 Mar;25(1):55-65. doi: 10.1007/s10880-017-9527-6.

The Role of Affect and Coping in Diabetes Self-Management in Rural Adults with Uncontrolled Diabetes and Depressive Symptoms.

Author information

1
Health Service Research and Development Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital, 3000 Bruce (B) Downs Boulevard (116A), Tampa, FL, 33612, USA. shannon.miles@va.gov.
2
Department of Psychiatry & Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, 33620, USA. shannon.miles@va.gov.
3
VA South Central Mental Illness Research, Education and Clinical Center, Michael E DeBakey VA Medical Center (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX, 77030, USA. shannon.miles@va.gov.
4
VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX, 77030, USA.
5
Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN, USA.
6
Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
7
VA South Central Mental Illness Research, Education and Clinical Center, Michael E DeBakey VA Medical Center (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX, 77030, USA.
8
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.

Abstract

Many patients with diabetes have poorly controlled blood sugar levels and remain at risk for serious diabetes complications, despite access to effective diabetes treatments and services. Using the transactional model of stress and coping framework, the study investigated the contributions of affect (Positive and Negative Affect Schedule) and coping (maladaptive and adaptive coping from the Brief Cope) on diabetes self-management behaviors, namely diet and exercise. One hundred seventy-eight rural adults with uncontrolled diabetes and moderate depressive symptoms completed the measures. Multiple regression analyses demonstrated that positive affect and negative affect were significantly associated with diet and exercise, even after adjusting for diabetes severity, illness intrusiveness, and diabetes knowledge. However, two path analyses clarified that adaptive coping mediated the relationships between affect (positive and negative) and self-management behaviors (diet and exercise). Comprehensive diabetes treatments that include self-management support can assist patients in recognition and use of adaptive emotion-focused coping skills.

KEYWORDS:

Affect; Coping; Diabetes; Rural

PMID:
29332264
DOI:
10.1007/s10880-017-9527-6
[Indexed for MEDLINE]

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