The mediating effect of coping styles and self-efficacy between perceived stress and satisfaction with QOL in Chinese adolescents with type 1 diabetes.

Aims: (a) To explore the effect of perceived stress on satisfaction with quality of life (QOL) among Chinese adolescents with type 1 diabetes (T1D); and (b) to determine if coping styles and self-efficacy are mediators of the association between perceived stress and satisfaction with QOL.

Background: Adolescents with T1D experience ongoing stress related to a complex treatment regimen and live with a condition that differentiates them from their peers. It is important to know how adolescents with T1D cope with the stress and what psychosocial attributes contribute to satisfaction with QOL.

Design: Cross-sectional study.

Methods: Data were collected from a sample of adolescents with T1D (N = 90) who had enrolled in a randomized control trial (baseline data) and a supplemental sample of N = 59 adolescents with T1D was recruited from a diabetes clinic from January 2016 - December 2016.

Results: The mean age of the participants was 13.91 years (range 8-20 years), the mean diabetes duration was 4.02 years. Approximately one-quarter of the sample exceeded the criterion score for perceived stress of 26, indicating stress sufficient to have a negative impact on physical and mental health. Adolescents with increased stress reported lower satisfaction with QOL compared with adolescents with less stress. Both externalization coping and self-efficacy were the mediators of the relationship between perceived stress and satisfaction with QOL.

Conclusions: Many Chinese adolescents with T1D reported elevated stress levels which was associated with decreased satisfaction with QOL. There is a need for culturally relevant interventions to improve coping by limiting the use of externalized coping styles and strengthening self-efficacy.