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 hemoglobin (HbA 1c ) assessed at baseline and 1-year follow-up. Resilience was defined by a factor score of self-esteem, self-efficacy, self-mastery, and optimism. Diabetes-related distress and selfcare 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= â.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.Healthcare providers benefit from the knowledge and understanding of associations between psychosocial and physiological variables in patients with chronic illness. These associations can further inform treatment, prevention, and intervention protocols through a biopsychosocial perspective. In diabetes patients, a holistic view of disease can aid the prevention of a variety of debilitating physical complications that can result from consistently poor self-care behaviors and high glycosylated hemoglobin levels.One well-known correlate of poor glycemic control and self-care is diabetes-related psychological distress (Polonsky, Anderson, Lohrer, Welch, & Jacobson, 1995Weinger & Jacobson, 2001). Reducing diabetes-related distress has been successful through intensive, educational, or cognitive behavioral interventions (see Welch, Weinger, Anderson, & Polonsky, 2003, for review). Less is known about the personal factors that encourage successfully coping with rising levels of diabetes-related distress. Rising distress levels may accompany a diabetes patient at any stage of disease. For example, Shaban, Fosbury, Kerr, and Cavan (2006) report significant prevalence rates for moderate to severe depression and anxiety in type 1 patients living with diabetes for many years. Due to the extensive, daily nature of * Requests for reprints should be addressed to Joyce P. Yi, Ph.D., University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195 USA. jyi@u.washington.edu.
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Author ManuscriptBr J Health Psychol. Author manuscript; available in PMC 2010 July 8. diabetes self-care, feeling "burned out" or overwhelmed is a risk for patients at any stage of their disease. However, psycho...