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Coping Styles, Well-Being, and Self-Care Behaviors Among African Americans With Type 2 Diabetes

From the Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill (Dr Samuel-Hodge); University of Michigan, Department of Obstetrics and Gynecology (Dr Watkins); the Center for the Study of Health Disparities, Texas A & M University, College Station, Texas (Dr Rowell); and Duke University Medical Center, Center for Theology, Spirituality and Health (Dr Hooten).

Correspondence to Carmen D. Samuel-Hodge, PhD, MS, RD, University of North Carolina at Chapel Hill, Schools of Public Health and Medicine, Department of Nutrition, 1700 Martin Luther King Jr. Blvd, CB # 7426, Chapel Hill, NC 27599-7426 (Carmen_samuel{at}unc.edu).

Purpose

The purpose of this study was to describe how coping styles among African Americans with type 2 diabetes relate to diabetes appraisals, self-care behaviors, and health-related quality of life or well-being.

Methods

This cross-sectional analysis of baseline measures from 185 African Americans with type 2 diabetes enrolled in a church-based randomized controlled trial uses the theoretical framework of the transactional model of stress and coping to describe bivariate and multivariate associations among coping styles, psychosocial factors, self-care behaviors, and well-being, as measured by validated questionnaires.

Results

Among participants who were on average 59 years of age with 9 years of diagnosed diabetes, passive and emotive styles of coping were used most frequently, with older and less educated participants using more often passive forms of coping. Emotive styles of coping were significantly associated with greater perceived stress, problem areas in diabetes, and negative appraisals of diabetes control. Both passive and active styles of coping were associated with better diabetes self-efficacy and competence in bivariate analysis. In multivariate analysis, significant proportions of the variance in dietary behaviors and mental well-being outcomes (general and diabetes specific) were explained, with coping styles among the independent predictors. A positive role for church involvement in the psychological adaptation to living with diabetes was also observed.

Conclusions

In this sample of older African Americans with diabetes, coping styles were important factors in diabetes appraisals, self-care behaviors, and psychological outcomes. These findings suggest potential benefits in emphasizing cognitive and behavioral strategies to promote healthy coping outcomes in persons living with diabetes.

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