Abstract
Objective: Examine coping as a mediator in the relationships of spiritual well-being to mental health in Black women with type 2 diabetes (T2DM). Methods: Using a cross-sectional design, data were collected from a convenience sample of 45 Black women with T2DM. Measures of coping strategies, spiritual well-being (religious and existential well-being), and mental health, as measured by diabetes-specific distress (DSED), were collected. Bivariate findings informed mediational, trivariate model development. Results: Religious well-being was significantly related to cognitive reframing (CR) coping strategies (p = 0.026) but not DSED (p = 0.751). Existential well-being was significantly related to CR (beta = 0.575, p < 0.001), direct assistance (DA) coping (beta = 0.368, p = 0.006) and DSED (beta = -0.338, p = 0.023). Although CR (beta = -0.305, p = 0.021) and DA (beta = -0.262, p = 0.041) had significant bivariate associations with DSED, the relationships were not significant when existential well-being was controlled. However, the relationship of existential well-being to DSED was mediated by specific CR and DA strategies that were associated with DSED to varying degrees -"I came up with a couple different solutions to the problem" (beta = 0.301, p = 0.049); "I came out of the experience better than I went in" (beta = 0.308, p=0.061); and "I talked to someone who could do something concrete about the problem" (beta = 0.272, p = 0.078). Conclusion: Findings indicate that diabetes care address spiritual well-being, both its religious and existential components, in Black women with T2DM. (Int'l. J. Psychiatry in Medicine 2010;40:439-459)