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01-06-2021 | Burnout Syndrome

Diabetes burnout among emerging adults with type 1 diabetes: a mixed methods investigation

Author: Vicki S. Helgeson

Published in: Journal of Behavioral Medicine | Issue 3/2021

Abstract

Feeling overwhelmed, exhausted, and frustrated by the daily demands of diabetes management has been referred to as diabetes burnout. The goal of the study was to develop a measure of diabetes burnout and to link this measure to psychological health and diabetes outcomes. Emerging adults with type 1 diabetes (n = 88, average age 27) completed an online questionnaire and an HbA1c assessment; a subset was interviewed by phone to obtain a more in-depth understanding of burnout. Exploratory factor analysis revealed three burnout domains: exhaustion, detachment, and powerlessness. Burnout was related to higher psychological distress, higher diabetes distress, and poorer diabetes outcomes. Burnout independently predicted higher HbA1c, independent of diabetes distress. Qualitative interviews revealed that participants defined burnout in terms of exhaustion and powerlessness and resolved burnout by acceptance and utilization of social resources. Prevention and intervention efforts might target resilience as a way to mitigate burnout.

Abdoli, S., Hessler, D. M., Vora, A., Smither, B., & Stuckey, H. (2019a). Experiences of diabetes burnout: A qualitative study among people with type 1 diabetes. American Journal of Nursing, 119(12), 22–31.CrossRef

Abdoli, S., Jones, D. H., Vora, A., & Stuckey, H. (2019b). Improving diabetes care: Should we reconceptualize diabetes burnout? Diabetes Educator, 45(2), 214–224. https://doi.org/10.1177/0145721719829066CrossRef

Abdoli, S., Hessler, D. M., Vora, A., Smither, B., & Stuckey, H. (2020a). Descriptions of diabetes burnout from individuals with type 1 diabetes: An analysis of YouTube videos. Diabetic Medicine, 37(8), 1344–1351. https://doi.org/10.1111/dme.14047CrossRefPubMed

Abdoli, S., Miller-Bains, K., Burr, E. M., Smither, B., Vora, A., & Hessler, D. M. (2020b). Burnout, distress, and depressive symptoms in adults with type 1 diabetes. Journal of Diabetes and Its Complications, 34(7), 107608. https://doi.org/10.1016/j.jdiacomp.2020.107608CrossRefPubMed

Arnett, J. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55(5), 469–480. https://doi.org/10.1037/0003-066X.55.5.469CrossRef

Bryden, K. S., Peveler, R. C., Stein, A., Neil, A., Mayou, R. A., & Dunger, D. B. (2001). Clinical and psychological course of diabetes from adolescence to young adulthood - A longitudinal cohort study. Diabetes Care, 24(9), 1536–1540. https://doi.org/10.2337/diacare.24.9.1536CrossRefPubMed

Celano, C. M., Beale, E. E., Moore, S. V., Wexler, D. J., & Huffman, J. C. (2013). Positive psychological characteristics in diabetes: A review. Current Diabetes Reports, 13(6), 917–929. https://doi.org/10.1007/s11892-013-0430-8CrossRefPubMed

Centers for disease control and prevention. (2019). Diabetes: Type 1. https://www.cdc.gov/diabetes/basics/type1.html

Collins, W. A., & Steinberg, L. (2007). Adolescent development in interpersonal context. In N. Eisenberg, W. Damon, & R. M. Lerner (Eds.), Handbook of child psychology (3rd ed., pp. 1003–1067). New Jersey: Wiley.

Costello, A. B., & Osborne, J. W. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research and Evaluation, 10, 7.

de Winter, J. C. F., Dodou, D., & Wieringa, P. A. (2009). Exploratory factor analysis with small sample sizes. Multivariate Behavioral Research, 44(2), 147–181. https://doi.org/10.1080/00273170902794206CrossRefPubMed

Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49(1), 71–75.CrossRef

Fisher, L., Polonsky, W. H., Hessler, D. M., Masharani, U., Blumer, I., Peters, A. L., et al. (2015). Understanding the sources of diabetes distress in adults with type 1 diabetes. Journal of Diabetes and Its Complications, 29(4), 572–577. https://doi.org/10.1177/2325160315570961CrossRefPubMedPubMedCentral

Fuligni, A. J., Eccles, J. S., Barber, B. L., & Clements, P. (2001). Early adolescent peer orientation and adjustment during high school. Developmental Psychology, 37(1), 28–36. https://doi.org/10.1037/0012-1649.37.1.28CrossRefPubMed

Greening, L., Stoppelbein, L., Konishi, C., Jordan, S. S., & Moll, G. (2007). Child routines and youths’ adherence to treatment for type 1 diabetes. Journal of Pediatric Psychology, 32, 437–447.CrossRef

Helgeson, V. S., Reynolds, K. A., Siminerio, L., Escobar, O., & Becker, D. (2008). Parent and adolescent distribution of responsibility for diabetes self-care: Links to health outcomes. Journal of Pediatric Psychology, 33(5), 497–508.CrossRef

Helgeson, V. S., Reynolds, K. A., Siminerio, L., Becker, D., & Escobar, O. (2014). Cognitive adaptation theory as a predictor of adjustment to emerging adulthood for youth with and without type 1 diabetes. Journal of Psychosomatic Research, 77, 484–491.CrossRef

Hoover, J. W. (1983). Patient burnout, and other reasons for noncompliance. The Diabetes Educator, 9(3), 41–43. https://doi.org/10.1177/014572178300900308CrossRefPubMed

Hunter, C. M. (2016). Understanding diabetes and the role of psychology in its prevention and treatment. American Psychologist, 71(7), 515–525. https://doi.org/10.1037/a0040344CrossRef

Kessler, R. C., Mickelson, K. D., Walters, E. E., Zhao, S., & Hamilton, L. (2004). Age and depression in the MIDUS survey. In O. G. Brim, C. D. Ryff & R. C. Kessler (Eds.), How healthy are we? A national study of well-being at midlife (pp. 227–251). Chicago, IL: The University of Chicago Press.

La Greca, A. M., Swales, T., Klemp, S., & Madigan, S. (1988). Self-care behaviors among adolescents with diabetes. Ninth Annual Sessions of the Society of Behavioral Medicine.

Larson, R. W., & Verma, S. (1999). How children and adolescents spend time across the world: Work, play, and developmental opportunities. Psychological Bulletin, 125(6), 701–736. https://doi.org/10.1037/0033-2909.125.6.701CrossRefPubMed

Lindström, C., Åman, J., & Norberg, A. L. (2011). Parental burnout in relation to sociodemographic, psychosocial and personality factors as well as disease duration and glycaemic control in children with type 1 diabetes mellitus. Acta Paediatrica, International Journal of Paediatrics, 100(7), 1011–1017. https://doi.org/10.1111/j.1651-2227.2011.02198.x.CrossRef

Lindström, C., Åman, J., Norberg, A. L., Forssberg, M., & Anderzén-Carlsson, A. (2017). “Mission Impossible”; the mothering of a child with type 1 diabetes—from the perspective of mothers experiencing burnout. Journal of Pediatric Nursing, 36, 149–156. https://doi.org/10.1016/j.pedn.2017.06.002.CrossRefPubMed

Lyons, S. K., Becker, D. J., & Helgeson, V. S. (2014). Transfer from pediatric to adult health care: Effects on diabetes outcomes. Pediatric Diabetes, 15(1), 10–17. https://doi.org/10.1111/pedi.12106CrossRefPubMed

Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Occupational Behaviour, 2, 99–113.CrossRef

Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). Maslach Burnout inventory manual (3rd ed.). California: Consulting Psychologists Press.

Oris, L., Luyckx, K., Rassart, J., Goubert, L., Goossens, E., Apers, S., et al. (2018). Illness identity in adults with a chronic illness. Journal of Clinical Psychology in Medical Settings, 25(4), 429–440. https://doi.org/10.1007/s10880-018-9552-0CrossRefPubMed

Polonsky, W. H. (1999). Diabetes burnout: What you can do when you can’t take it anymore. Arlington, VA: American Diabetes Association.

Polonsky, W. H., Fisher, L., Earles, J., Dudl, R. J., Lees, J., Mullan, J., & Jackson, R. A. (2005). Assessing psychosocial distress in diabetes. Diabetes Care, 28(3), 626–631.CrossRef

Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306CrossRef

Schmitt, A., Reimer, A., Kulzer, B., Icks, A., Paust, R., Roelver, K. M., et al. (2018). Measurement of psychological adjustment to diabetes with the diabetes acceptance scale. Journal of Diabetes and Its Complications, 32(4), 384–392. https://doi.org/10.1016/j.jdiacomp.2018.01.005CrossRefPubMed

Seligman, M. E. P. (1972). Learned helplessness. Annual Review of Medicine, 23, 407–412.CrossRef

Streiner, D. L. (1994). Figuring out factors: The use and misuse of factor analysis. Canadian Journal of Psychiatry, 39(3), 135–140. https://doi.org/10.1177/070674379403900303CrossRefPubMed

Talbot, F., Nouwen, A., Gingras, J., Gosselin, M., & Audet, J. (1997). The assessment of diabetes-related cognitive and social factors: The multidimensional diabetes questionnaire. Journal of Behavioral Medicine, 20(3), 291–311.CrossRef

Welch, G. W., Jacobson, A. M., & Polonsky, W. H. (1997). The problem areas in diabetes scale: An evaluation of its clinical utility. Diabetes Care, 20(5), 760–766. https://doi.org/10.2337/diacare.20.5.760CrossRefPubMed

Title: Diabetes burnout among emerging adults with type 1 diabetes: a mixed methods investigation
Author: Vicki S. Helgeson
Publication date: 01-06-2021
Publisher: Springer US
Keywords: Burnout Syndrome
Type 1 Diabetes
Published in: Journal of Behavioral Medicine / Issue 3/2021
Print ISSN: 0160-7715
Electronic ISSN: 1573-3521
DOI: https://doi.org/10.1007/s10865-020-00198-3

At a glance: The STEP trials

Springer Medicine

Diabetes burnout among emerging adults with type 1 diabetes: a mixed methods investigation

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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