The role of resilience on psychological adjustment and physical health in patients with diabetes

Objective. This study used a longitudinal design to investigate the buffering role of resilience on worsening HbA(1c) and self-care behaviours in the face of rising diabetes-related distress. Method. A total of 111 patients with diabetes completed surveys and had their glycosylated haemoglobin (HbA(1c)) assessed at baseline and at 1-year follow-up. Resilience was defined by a factor score of self-esteem, self-efficacy, self-mastery and optimism. Diabetes-related distress and self-care behaviours were also assessed. Results. Baseline resilience, diabetes-related distress and their interaction predicted physical health (HbA(1c)) at 1 year. Patients with low, moderate and high resilience were identified. Those with low or moderate resilience levels showed a strong association between rising distress and worsening HbA(1c) across time (r = .57, .56, respectively). However, those with high resilience scores did not show the same associations (r = .08). Low resilience was also associated with fewer self-care behaviours when faced with increasing distress (r = -.55). These correlation coefficients remained significant after controlling for starting-points. Conclusion. In patients with diabetes, resilience resources predicted future HbA(1c) and buffered worsening HbA(1c) and self-care behaviours in the face of rising distress levels.