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Relationships among stressful life events and physiological markers, treatment adherence, and psychosocial functioning among youth with type 2 diabetes.
Walders-Abramson, Natalie; Venditti, Elizabeth M; Ievers-Landis, Carolyn E; Anderson, Barbara; El Ghormli, Laure; Geffner, Mitchell; Kaplan, Joan; Koontz, Michaela B; Saletsky, Ron; Payan, Marisa; Yasuda, Patrice.
Afiliação
  • Walders-Abramson N; Department of Pediatrics, University of Colorado Denver and Children's Hospital Colorado, Aurora, CO.
  • Venditti EM; Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA.
  • Ievers-Landis CE; Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, OH.
  • Anderson B; Baylor College of Medicine, Houston, TX.
  • El Ghormli L; George Washington University Biostatistics Center, Rockville, MD. Electronic address: elghorml@bsc.gwu.edu.
  • Geffner M; Children's Hospital Los Angeles, Los Angeles, CA.
  • Kaplan J; Children's Hospital of Philadelphia, Philadelphia, PA.
  • Koontz MB; Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH.
  • Saletsky R; State University of New York Upstate Medical University, Syracuse, NY.
  • Payan M; George Washington University Biostatistics Center, Rockville, MD.
  • Yasuda P; Department of Pediatrics, Division of Endocrinology & Metabolism, Children's Hospital Los Angeles, Los Angeles CA.
J Pediatr ; 165(3): 504-508.e1, 2014 Sep.
Article em En | MEDLINE | ID: mdl-24948348
OBJECTIVE: To examine the relationships between stressful life events and physiological measures, adherence to prescribed oral medication regimens, depressive symptoms, and impaired quality of life (QoL) in adolescents with recent-onset type 2 diabetes (T2D). STUDY DESIGN: Data were collected from 497 ethnically diverse participants (66% female) in the final year of the Treatment Options for Type 2 Diabetes in Adolescents and Youth multicenter clinical trial. Exposure to 32 possible events over the previous year and rating of subsequent distress were collected by self-report and summarized as a major stressors score. This score was analyzed for relationship to glycemic control (hemoglobin A1c and treatment failure), body mass index, diagnosis of hypertension or triglyceride dyslipidemia, adherence to a prescribed oral medication regimen, presence of depressive symptoms, and impaired QoL. RESULTS: The total number of major stressful life events in the adolescents with T2D was calculated, with 33% reporting none, 67% reporting ≥ 1, 47% reporting ≥ 2, 33% reporting ≥ 3, and 20% reporting ≥ 4. There were no associations between the major stressors score and physiological measures or diagnosis of comorbidities. The odds of medication nonadherence increased significantly from those reporting ≥ 1 major stressor (OR, 1.58; P = .0265) to those reporting ≥ 4 major stressors (OR, 2.70; P = .0009). Significant odds of elevated depressive symptoms and impaired QoL were also found with increased reporting of major stressors. CONCLUSION: Exposure to major stressful life events is associated with lower adherence to prescribed oral medication regimens and impaired psychosocial functioning in adolescents with T2D.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Diabetes Mellitus Tipo 2 / Adesão à Medicação / Acontecimentos que Mudam a Vida Tipo de estudo: Clinical_trials / Etiology_studies Aspecto: Patient_preference Limite: Adolescent / Adult / Child / Female / Humans / Male Idioma: En Revista: J Pediatr Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Diabetes Mellitus Tipo 2 / Adesão à Medicação / Acontecimentos que Mudam a Vida Tipo de estudo: Clinical_trials / Etiology_studies Aspecto: Patient_preference Limite: Adolescent / Adult / Child / Female / Humans / Male Idioma: En Revista: J Pediatr Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos