The aim of this investigation was to determine the contributions of coping behaviors used at diagnosis to medical (metabolic control) and psychosocial adjustment (self-perceived competence; adjustment) 1 year later. A total of 89 children (8 to 14 years of age; 48% male; 59% White) received follow-up quarterly from diabetes diagnosis to 1 year later. Findings indicated that, in general, although metabolic control worsened over the first year, psychosocial status and coping behaviors were stable. Boys had worse metabolic control than girls. Multiple regression analysis indicated that self-worth at 1 year postdiagnosis was associated with less use of spirituality (beta = -.44), more use of humor (beta = .28), and more positive self-care (beta = .28); and self-care was less likely to be positive in older children (r = .32). These variables accounted for 47% of the variance (39% adjusted) in general self-worth when entry self-worth was controlled. Poorer overall adjustment at 1 year postdiagnosis was associated with more use of avoidance behaviors (beta = -.47) and poorer self-care (beta = -.71); and more use of avoidance was associated with older age. These variables accounted for 62% of the variance (58% adjusted) in adjustment when adjustment at diagnosis was controlled. Poorer metabolic control was associated with more use of avoidance (beta = .30) and female gender (beta = .39), and avoidance behaviors were more common in older children (beta = .12). This model predicted 33% of the variance (25% adjusted) in metabolic control 1 year after diagnosis.

Adaptation, Psychological↗

PubMedDate not supplied

Mothers with multiple sclerosis and their children: effects of fatigue and exacerbations on maternal support.

BACKGROUND: Mothers with multiple sclerosis (MS) often face fatigue and episodic exacerbations during their child-rearing years. These problems affect their support of their children, including physical affection. Children, depending on their age and gender, may or may not understand the changes. OBJECTIVES: To increase knowledge about mothers with MS concerning the relationship of fatigue and functional status to the perception of physical affection with their children, their perceptions of physical affection with their children in relation to exacerbation of their symptoms and the age and gender of their children, and the children's perceptions of their mothers' physical affection in relation to the children's age and gender and exacerbations in their mothers' symptoms. METHOD: Thirty-five mothers with relapsing-remitting MS and a child of each mother were studied, using interviews and questionnaires. RESULTS: Functional status and fatigue were not significant predictors of physical affection during an exacerbation. When the mothers' symptoms were stable, perceptions of mothers and children with respect to maternal physical affection were similar. Significant changes were reported in both the mothers' perceptions of their physical affection and the children's perceptions of their mothers' physical affection during exacerbations. There was a significant difference between the perceptions of the mothers and children regarding the magnitude of that change. Mothers significantly underestimated changes in their physical affection. CONCLUSIONS: Physical affection was selected as an important aspect of family functioning that could be affected by characteristics of illness, including exacerbations, fatigue, and functional status. However, fatigue and functional status did not explain the perception of physical affection during an exacerbation.

Activities of Daily Living↗

PubMedDate not supplied

Coping and adaptation in children with diabetes.

The purpose of this study was to investigate the influence of age, coping behavior, and self-care on psychological, social, and physiologic adaptation in preadolescents and adolescents with diabetes. Children (N = 103) with insulin-dependent diabetes mellitus (IDDM) between 8 and 18 years of age and their parents participated in the study. Findings indicated that preadolescent children were significantly less depressed, less anxious, coped in more positive ways, had fewer adjustment problems, and were in better metabolic control than their adolescent counterparts. Age and secondary sexual development were related to psychosocial adaptation and metabolic control of the diabetes. Further, those who coped by avoiding their problems and who were more depressed were the most likely to have problems in both adjustment and metabolic control with 56% of the variance in metabolic control explained by the variables studied. These findings indicate that preadolescents and adolescents cope differently with a chronic illness, and that interventions should be designed to identify and help those with inappropriate coping styles.

Adaptation, Psychological↗

PubMedDate not supplied

The content of ethical problems experienced by persons with AIDS.

The purpose of this research was to describe and examine the basic nature (essences) and content (subject-matter) of ethical problems involving AIDS that are experienced by persons with AIDS (PWAs). The participants were 25 PWAs and 5 significant others, the latter included to provide contextual understanding. During audiotaped interviews, the PWAs described 45 different ethical problems from which emerged a three-component basic nature and 10 content categories. This paper reports the content categories. The findings provide understanding of the content of PWAs' ethical problems and suggest the importance of ethical listening as an independent nursing intervention.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Initial adaptation in children with newly diagnosed diabetes and healthy children.

A cohort of children with newly diagnosed diabetes (n = 68) from four diabetes treatment centers in northeastern states were compared with a cohort of healthy peers (n = 40) 6 weeks following the diagnosis of diabetes in the ill children. Instruments used included the Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), Coping Inventory (COPE), Child & Adolescent Adjustment Profile (CAAP), and Self Perception Profile for Children (SPPC). Results indicated no demographic differences between the two groups and no differences in scores on CDI, STAIC-state anxiety, and all subscales of the CAAP and SPPC. However, the children with diabetes were reported to demonstrate less withdrawal (11.6 +/- 3.0 versus 12.4 +/- 2.3) than their healthy peers and were more likely to cope by ventilating feelings (19.7 +/- 2.0 versus 18.7 +/- 2.2). Parents reported that children with IDDM were less healthy (p < .001). These data suggest a less severe initial psychologic response to diabetes than might be expected and that there are differences in coping patterns among children with IDDM and children without chronic illness.

Adaptation, Psychological↗