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.