Living with type 1 diabetes is challenging for Zambian adolescents: qualitative data on stress, coping with stress and quality of care and life

• DOI: 10.1186/s12902-015-0013-6
• Publication Date: 2015-04-17T00:25:19Z
• Authors: Given Hapunda; Amina Abubakar; Fons van de Vijver; Frans Pouwer
• Keywords: Quality of life; Male; Adolescent; Endocrinology, Diabetes and Metabolism; 610; Zambia; Social and Behavioral Sciences; Adolescents; Stress; 03 medical and health sciences; 0302 clinical medicine; Surveys and Questionnaires; Adaptation, Psychological; Medicine and Health Sciences; Humans; Child; Quality of Health Care; 360; Mental Disorders; Diabetes; 1. No poverty; Social Support; 3. Good health; Diabetes and Metabolism; 2712 Endocrinology; Diabetes Mellitus, Type 1; Caregivers; Socioeconomic Factors; Quality of Life; Female; Stress, Psychological; Research Article

Psychosocial problems are common in patients with diabetes. However, data on psychosocial issues affecting patients with diabetes in Zambia are scarce. The present study explored sources of stress, stress coping strategies, stigma and perceived quality of life and care as experienced by adolescents living with Type 1 Diabetes in Zambia.Semi-structured interviews were carried out. Three groups of participants involving adolescents with Type 1 Diabetes (n = 10), caregivers (n = 8) and health practitioners (n = 4) were interviewed. Transcripts were analyzed using a thematic approach.Stress was commonly reported by adolescents mainly stemming from social, psychological and physical sources. To deal with stress, adolescents often employed different coping strategies such as adapting, accepting and avoiding among others. Both internal factors (those relating to the patients themselves) and external factors (those related to the context of the patients') influenced the patients' quality of health care. In addition, low quality of life was an issue among adolescents and their families. Poor diet, low socioeconomic status and lack of medicine were factors affecting quality of health care.Stress was an issue affecting adolescents; the coping strategies employed were sometimes maladaptive such as avoiding injecting themselves to escape stress. Several aspects of quality of life were suboptimal in both adolescents and their families, such as stigmatization, short life expectancy, low socioeconomic status and poor social participation. Findings show that there is an urgent need for a strong response from all stakeholders (governments, patients, organizations and companies) to improve diabetes care and living conditions for young people with type 1 diabetes living in Zambia.