10代の小児糖尿病患者のストレスと，飲酒・喫煙・食べて気をまぎらす対処行動―健康児との比較と縦断的変化

Stress and Coping Behavior of Drinking, Smoking and Eating with Diabetic Teenagers: Comparison with Healthy Teenagers, and Longitudinal Change

　本研究の目的は，1）10代の小児糖尿病患者と健康児のストレスと，飲酒，喫煙，食べて気をまぎらす対処行動を比較する，2）10代の小児糖尿病患者の飲酒，喫煙，食べて気をまぎらす対処行動の継続に関連する要因を明らかにすることである．外来受診中の10～18歳の小児糖尿病患者59名を対象に，1994年に日常生活と疾患に関するストレス，対処行動，療養行動について質問紙調査を行い，このうち51名に対し1995年に同様の調査を行った．また，小児糖尿病患者と性，年齢が一致する健康児59名を無作為に抽出し，日常生活に関するストレスと対処行動の調査を行った．その結果，「お酒を飲む」対処行動が健康児に有意に多く用いられていた．重回帰分析の結果，小児糖尿病患者では「お酒を飲む」対処行動は日常生活に関するストレスが高いこと，自分で積極的に問題に取り組む対処パターンが少ないこと，前年度の「お酒を飲む」対処行動の3変数が有意な変数として採択された．「たばこを吸う」対処行動は前年度の「たばこを吸う」対処行動のみが採択され，「食べて気をまぎらす」は，疾患に関するストレスが高いこと，自分で積極的に問題に取り組む対処パターンが多いことの2変数が採択された．これらの結果は，年齢が高くなることや友達のサポートを求める対処パターンが多いことが関連していた健康児の結果とは異なっていた．

　The purposes of this study were 1) to compare diabetic teenagers' stress and coping behaviors of drinking, smoking and eating with healthy teenagers', and 2) to predict factors that influence diabetic teenagers' coping behavior of drinking, smoking and eating. The subjects were 59 diabetic teenagers who visited the pediatric diabetic follow-up clinic of the University Hospital in Chiba city. They completed four questionnaires of daily stress, diabetic stress, coping and self-care behaviors in 1994. 51 out of 59 diabetic teenagers completed the same questionnaires again in 1995. 59 healthy teenagers who were picked out using random sampling matched by sex and age for diabetic subjects, completed two questionnaires of daily stress and coping in 1994. More healthy teen-agers than diabetic teenagers were using coping behavior of drinking significantly. Using multiple regression on 51 diabetic subjects, three factors; high daily stress, low `engaging in demanding activity', and coping behavior of drinking in 1994 were related with coping behavior of drinking in 1995. And only one factor of coping behavior of smoking in 1994 was positively related with coping behavior of smoking in 1995. High diabetic stress and high `engaging in demanding activity' were related with coping behavior of eating in 1995. The coping behavior of drinking and eating were influenced by stress in diabetic teenagers, but in healthy, they were influenced more by age and `Seeking friendly support'. The coping behaviors of smoking and drinking continued persistently both in 1994 and 1995.