Control metabólico en pacientes diabéticos tipo 1 chilenos: Rol del estrés psicológico. Diabetes tipo 1: Rol del estrés psicológico
Palabras clave:
ESTRES PSICOLOGICO, CONTROL METABOLICO, ADOLESCENTES DIABETICOS TIPO 1.Resumen
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PROPOSITO: Determinar si diferentes dominios del estrés psicológico (estrés emocional, estrés con el médico, estrés con el tratamiento y estrés interpersonal) predicen el control metabólico de adolescentes diabéticos tipo 1. Identificar si diferentes dominios del estrés psicológico predicen la estabilidad del control metabólico.
MATERIAL Y METODO: Una muestra no probabilística e intencionada de 20 adolescentes diabéticos tipo 1 de la ciudad de Temuco (Medad = 15,15, D.S = 3.8) fueron estudiados por 1 año. Tres mediciones de hemoglobina glicosilada (HbA1c) y autorreportes de estrés fueron obtenidos con la Escala de Estrés para Diabéticos de Polonski.
RESULTADOS: Análisis de regresión múltiple jerárquica identificaron que tanto el estrés con el régimen de tratamiento (R2 = 0,505) y el estrés con el médico (R2 = 0,13) predijeron el control metabólico. Análisis de la varianza de medidas repetidas con factores intersujeto, identificaron que el control metabólico asumió una tendencia lineal negativa (F = 16,208; p ≤ 0,001; hp2 = 0,503; poder (1 - b) = 0,965). Diferencias estadísticamente significativas en el control metabólico fueron encontradas entre los adolescentes con alto y bajo estrés con el médico (F = 4,729; p ≤ 0,05; hp2 = 0,228; poder (1 - b) = 0,533), y entre los adolescentes con alto y bajo estrés con el tratamiento (F = 9,804; p ≤ 0,01; hp2 = 0,380; poder (1 - b) = 0,836).
CONCLUSION: Atención debe ser puesta a los niveles de estrés entre adolescentes diabéticos. Diferentes dominios del estrés psicológico predijeron trayectorias del control metabólico de adolescentes diabéticos tipo 1.
Palabras claves: Estrés psicológico, control metabólico, adolescentes diabéticos tipo 1.
ABSTRACT.
PURPOSE:
To determine whether different psychological stress factors (emotional burden, physician-related distress, regimen-related distres, diabetes-related interpersonal distress) predict the metabolic control of adolescents with type 1 diabetes, and whether these factors predict the metabolic control stability / non-estability.
MATERIALS AND METHODS: An intentional sample (n = 20) of type 1 diabetic adolescents was followed-up for a year (Mage = 15.15; S.D = 3.8) Three HbA1c exams were performed and a stress self-report was obtained with the Polonsky’ Diabetes Distress Scale.
RESULTS: Hierarchical multiple regression identified two factors (regimen-related distress R2 = 0.505; and physician-related distress R2 = 0.13) predicting the metabolic control. Within subject ANOVA with blocking factors, shows that the metabolic control assumed a negative linear trend (F = 16,208; p ≤ 0,001; hp2 = 0,503; power (1 - b) = 0,965). There were differences statistically significant in the metabolic control between adolescents with high and low scores on the physician-related distress (F = 4,729; p ≤ 0,05; hp2 = 0,228; power (1 - b) = 0,533) and those with high and low scores on the regimen-related distress factor (F = 9,804; p ≤ 0,01; hp2 = 0,380; power (1 - b) = 0,836).
CONCLUSION: Stress levels in type 1 diabetic adolescents deserve attention. Different psychological stress factors predicting metabolic control trajectories in type 1 diabetic adolescents were found.
Key words: Psychological stress, metabolic control, type 1 diabetics adolescents.