Transition readiness and coping styles in adolescents with type 1 diabetes.

ABSTRACT

PURPOSE: Although promoting positive coping and reducing negative coping improves health, little research has examined how types of coping relate to transition readiness in adolescents with type 1 diabetes (T1D). This study aimed to clarify the direct and indirect relations between coping style and transition readiness. We first examined which coping styles predict transition readiness in adolescents with T1D and then explored whether diabetes distress mediates the relation between disengagement coping and transition readiness. DESIGN AND METHODS: Using a cross-sectional observational design, 68 families with an adolescent with T1D were recruited during routine clinic appointments. Surveys on family demographics, coping styles, transition readiness, and diabetes distress were completed electronically. Medical information was extracted from electronic health records. RESULTS: Neither primary control, secondary control, nor disengagement coping had a direct significant association with transition readiness after controlling for HbA1c. There was a significant indirect effect of disengagement coping on transition readiness through greater diabetes distress (adolescent report ß = -0.13; 95% CI, LL = -0.27, UL = -0.02; parent report ß = -0.12; 95% CI, LL = -0.26, UL = -0.02). CONCLUSIONS: Coping style did not have a direct effect on transition readiness. However, disengagement coping was associated with diabetes distress, which in turn was significantly related to transition readiness. PRACTICE IMPLICATIONS Clinicians and researchers should consider incorporating coping strategies within transition readiness interventions to decrease distress and improve transition readiness. Disease-specific psychosocial screening may enhance routine diabetes transition education.