目的：

以青少年1型糖尿病患者为研究对象，确定心理韧性与患者健康指标的关联；找寻影响患者心理韧性水平的关键变量，描述患者心理韧性的产生条件和作用过程；尝试构建青少年1型糖尿病患者心理韧性模型，在该模型指导下开发以心理韧性为切入点的健康干预方案，并初步验证方案的可行性。

方法：

第一部分量性研究使用横断面研究设计，便利抽取172例于2017年7月至2019年1月在江苏省南京市某三级甲等医院内分泌科门诊及病房常规复诊或参加该院举办的公益活动的青少年1型糖尿病患者。使用青少年糖尿病优势与韧性量表、糖尿病自我管理行为评定量表、5条目糖尿病痛苦量表、接受胰岛素治疗患者生活质量量表和一般情况问卷收集患者心理韧性、自我管理、糖尿病痛苦、生活质量、人口社会学和疾病相关资料。从医疗记录中调取患者近3个月的糖化血红蛋白，若无记录，则按照标准化流程采用高效液相色谱测定法检测。使用分层回归模型分析心理韧性与青少年1型糖尿病患者血糖控制、糖尿病痛苦和生活质量的关系，使用内嵌于SPSS 22.0的PROCESS宏程序检验自我管理在心理韧性和患者健康相关结局间的中介和调节作用。

第二部分量性研究使用横断面研究设计，便利抽取360例于2019年2月至2020年8月在江苏省南京市某三级甲等医院和儿童医院内分泌科门诊及病房常规复诊或参加由两所医院举办的公益活动的青少年1型糖尿病患者。使用青少年糖尿病优势与韧性量表、家庭亲密度和适应性量表、感知同伴支持量表、糖尿病特异性压力测量问卷、简易应对方式问卷和一般情况问卷收集患者心理韧性、家庭功能、同伴支持、同伴压力、应对方式、人口社会学和疾病相关资料。患者糖化血红蛋白的获取方法同第一部分。采用多元线性逐步回归模型分析人口社会学和疾病特征与青少年1型糖尿病患者心理韧性的关联，使用结构方程模型确定家庭功能、同伴支持、同伴冲突和应对方式对心理韧性的作用路径。

第三部分质性研究采用诠释现象学研究方法，在开展第二部分研究的过程中有目的地招募15名青少年1型糖尿病患者，实施面对面访谈。患者访谈和资料分析同步进行，按照Benner分析法的步骤分析资料，直至主题饱和。

第四部分研究是根据第一部分至第三部分研究结果构建青少年1型糖尿病患者心理韧性模型。基于心理韧性模型开发以心理韧性为切入点的健康干预方案，并通过专家会议法修改方案。对8名青少年1型糖尿病患者实施完善后的干预方案，评价方案的可行性。

结果：

第一部分量性研究结果：（1）172例青少年1型糖尿病患者的平均年龄为15.8 ± 3.6岁，平均糖化血红蛋白为8.0 ± 2.2%。（2）本研究中青少年1型糖尿病患者心理韧性平均值为41.4 ± 9.7。（3）分层回归分析结果显示，在控制人口学和疾病变量后，心理韧性与生活质量（β = 0.317, P < 0.001）呈正相关，与糖尿病痛苦（β = -0.273, P < 0.001）和糖化血红蛋白（β = -0.233, P = 0.002）间存在负向关联。（4）自我管理在心理韧性与血糖控制间起完全中介作用，在心理韧性与糖尿病痛苦和生活质量的关联中起调节作用。

第二部分量性研究结果：（1）360例青少年1型糖尿病患者的平均年龄为14.0 ± 3.3岁，平均糖化血红蛋白为8.1 ± 2.0%。（2）青少年1型糖尿病患者心理韧性的主要预测因子包括家庭亲密度与适应度、同伴支持、同伴压力和积极应对方式，上述4个变量共解释心理韧性变异的63%，其中家庭亲密度与适应度（β = 0.538, P < 0.001）、同伴支持（β = 0.149, P = 0.019）和积极应对方式（β = 0.250, P < 0.001）与患者心理韧性有正向关联。同伴压力（β = -0.163, P < 0.001）与心理韧性呈负相关。（3）积极应对方式在家庭功能和心理韧性间起部分中介作用，中介效应值为0.135，占家庭功能对心理韧性总效应的22.3%。（4）积极应对方式和同伴压力在同伴支持和心理韧性关系间起多重中介作用，中介效应值为0.151，占同伴支持对心理韧性总效应的50.34%。

第三部分质性研究结果：（1）15例青少年1型糖尿病患者的年龄为12.3-19.4岁，糖化血红蛋白为5.8-11.6%。（2）青少年1型糖尿病患者需要承受疾病管理负担、身体健康威胁、外在形象改变和情感社会孤立，上述压力源是心理韧性产生的必要前提。（3）青少年1型糖尿病患者心理韧性的作用过程为：患者动态评估压力源的严重性，在不同情境下采取情绪应对或问题解决应对来维持正常生活。其中情绪应对策略包括认知重构和情绪调节，问题解决应对包括营造外周安全环境、增强对疾病掌控感和主动寻求他人帮助。（4）心理韧性对青少年1型糖尿病患者的积极作用包括对未来充满希望、抗挫折能力增强，以及自我价值感提升。（5）青少年1型糖尿病患者心理韧性受到个体内部特征和外部环境资源的双重影响。保护性因素包括乐观、开朗、高自我效能感、内部归因和遇事冷静等内部优势，以及家庭资源、朋友和病友支持、医护支持和传统文化等外部资源；危险因素包括性格内向、不善交际、不喜倾诉等个人特质，以及家庭冲突、同学压力、医护同理心缺乏和传统文化等外部威胁。

第四部分模型构建及干预开发结果：（1）青少年1型糖尿病患者心理韧性模型由压力源、内外部影响因素、韧性过程和健康结局四部分组成，涵盖心理韧性的产生、发展和结果。（2）心理韧性训练项目共计6次干预，每次90分钟，既强调心理韧性的培养和提升，又关注自我管理知识的传递和补充。（3）心理韧性训练项目的可行性、真实性和可接受性均较高，6/8的参与者完成了所有的干预内容。

结论：

青少年1型糖尿病患者心理韧性与其血糖控制、心理健康和生活质量呈正相关，且该关联不受人口社会学和疾病特征的影响。自我管理在心理韧性与健康结局间发挥中介或调节作用。青少年患者心理韧性产生的前提条件是承受疾病相关压力，其韧性水平受到个体特征、家庭、同伴、医护和文化因素的多重影响。

青少年1型糖尿病患者心理韧性模型包括压力源、影响因素、韧性过程和健康结局四部分，可指导临床护理人员将提高心理韧性纳入糖尿病患者健康管理中。基于该模型开发的心理韧性训练项目可行性高，能够为今后在更大范围推广该项目以及应用到其他慢性病的患者管理中提供科学依据。

Aims:

To determine the relationship between resilience and health indicators among adolescents with type 1 diabetes; Besides, to explore the key variables that affect the resilience and to describe the process of resilience emergence and action; Moreover, to construct a resilience model for adolescents with type 1 diabetes. Finally, to develop the health intervention with resilience as the entry point, and initially verify the feasibility of the intervention.

Methods:

The first part of the study was a cross-sectional study. One hundred and seventy-two adolescents were recruited from the outpatient and inpatient in Endocrinology departments of a Public Hospital in Nanjing or from patients who participated in public welfare activities organized by the hospital through convenience sampling from July 2017 to January 2019. Adolescents’ resilience, self-management, diabetes distress, and quality of life were measured by the Diabetes Strengths and Resilience Measure for Adolescents, Diabetes Behavior Rating Scale, Problem Areas in Diabetes Scale-5, Insulin Therapy Related Quality of Life Measure, and General Condition Questionnaire, respectively. Demographic and disease-related characteristics were investigated by a self-designed information sheet. Patients’ glycosylated hemoglobin for the last 3 months was collected from medical records. If no relevant data were available, glycosylated hemoglobin was measured at the central laboratory of the site utilizing the High performance liquid chromatography. The association between resilience and glycemic control, diabetes distress, and quality of life was analyzed by the hierarchical regression model. The mediating and moderating effects of self-management on the association between resilience and glycemic control, diabetes distress, and quality of life were examined by the Process macro version 3.3 for SPSS 22.0.

 The second part of the study was also a cross-sectional study. A total of 360 adolescents were recruited from the outpatient and inpatient in the Endocrinology departments of a Public Hospital and a Children’s Hospital in Nanjing, or from patients who participated in public welfare activities organized by two hospitals through convenience sampling from February 2019 to August 2020. The Diabetes Strengths and Resilience Measure for Adolescents, Family Adaptability and Cohesion Evaluation Scales Ⅱ, Perceived Peer Support Scale, Diabetes Stress Questionnaire for Youths, Simplified Coping Style Questionnaire, and General Condition Questionnaire were administered to measure adolescents’ resilience, family function, peer support, peer stress, respectively, in addition to the demographic and disease-related characteristics. The patient’s glycosylated hemoglobin was obtained in the same way mentioned in the first part of this study. Multiple linear regression models were performed to explore the effects of demographic and disease characteristics on resilience among adolescents with Type 1 diabetes. The structural equation model was conducted to detect the effects of family function, peer support and stress, and coping styles on resilience.  

The third part of the study was a qualitative study with the hermeneutical phenomenological design. Face-to-face interviews were conducted with 15 adolescents with Type 1 diabetes, who were recruited purposefully during the process of second part of this study. Interviews and data analysis were carried out simultaneously, and the data were analyzed according to the suggestion of Benner. The new interview was unnecessary when the topic was saturated.

The fourth part of the study was to construct resilience model among padolescents with Type 1 diabetes  based on the quantitative and qualitative findings. The health intervention with resilience as the entry point was developed under the guidance of the resilience model and was improved through the expert meeting. We evaluated the feasibility of the intervention by conducting it with 8 adolescents with Type 1 diabetes.

Results:

Part I: (1) A total of 172 adolescents (average age: 15.8 ± 3.6 years) with Type 1 diabetes participated in this study. The average glycosylated hemoglobin was 8.0 (SD: 2.2%). (2) The average score of resilience among the participants was 41.44 (SD: 9.36). (3) The results of the hierarchical regression analysis showed that higher resilience was positively correlated with better quality of life (β = 0.317, P < 0.001), less diabetes distress (β = -0.273, P < 0.001) and lower glycosylated hemoglobin (β = -0.233, P = 0.002) after controlling for relevant demographic and disease variables. (4) Self-management completely mediated the association between resilience and glycemic control and moderated the correlation between resilience and diabetes distress, and quality of life.

Part II: (1) A total of 360 adolescents (average age: 14.0 ± 3.3 years) with Type 1 diabetes participated in this study. The average glycosylated hemoglobin was 8.1 (SD: 2.0%). (2) The main predictors of resilience among adolescents with Type 1 diabetes included family adaptability and cohesion, peer support, peer stress, and positive coping styles. The above 4 variables explained 63% of the variation in resilience. Family adaptability and cohesion (β = 0.538, P < 0.001), peer support (β = 0.149, P = 0.019), and active coping (β = 0.250, P < 0.001) had positive associations with resilience, while peer stress (β = -0.163, P < 0.001) was negatively associated with resilience. (3) Active coping partially mediated the association between family functioning and resilience, with a mediating effect of 0.135, which accounted for 22.3% of the total effect of family functioning on resilience. (4) The association between peer support and resilience was mediated by actively coping and peer stress. The mediating effects were 0.151, accounting for 50.34% of the total effect of peer support on resilience.

Part III: (1) The age and glycosylated hemoglobin of the 15 adolescents with Type 1 diabetes ranged from 12.3 to 19.4 years old and 5.8% to 11.6%, respectively. (2) Adolescents with type 1 diabetes need to be faced with the burden of disease management, physical health threats, changes in their body image, and emotional and social isolation. These stressors were necessary prerequisites for the generation of resilience. (3) The resilience process was described as the following: the adolescents with Type 1 diabetes dynamically evaluated the severity of the stressor and adopted emotional coping or problem-solving coping in different situations to maintain a normal life. Emotional coping strategies included cognitive restructuring and emotional regulation, and problem-solving coping included creating a safe peripheral environment, enhancing the sense of control, and actively seeking help from others. (4) The resilient adolescents with Type 1 diabetes were hopeful about the future and had high levels of frustration resistance, and self-worth. (5) The resilience of those adolescents was affected by both the internal characteristics and external environmental resources. Protective factors included personal strengths (e.g., optimism, cheerfulness, high self-efficacy, internal attribution, and calmness) and external resources (e.g., family resources, peer support, medical support, and traditional culture). Risk factors included personal traits such as introversion, poor communication, as well as unwillingness to talk, and external threats such as family conflict, classmate pressure, lack of empathy among medical staff, as well as traditional culture.

Part IV: (1) The resilience model of adolescents with Type 1 diabetes consists of four parts: stressors, internal and external influencing factors, resilience process, and health outcomes and the model described the generation, development, and outcomes of resilience. (2) The Adolescents Resilience Training Program for patients with Type 1 diabetes was developed with a total of 6 sessions, each of which lasted for 90 minutes. The program focuses not only on the transmission of self-management knowledge but also on the promotion of resilience. (3) The feasibility, authenticity, and acceptability of the Adolescents Resilience Training Program were high, and 6/8 of the participants completed all models of intervention.

Conclusions:

The resilience was positively correlated with better glycemic control, mental health, and quality of life among adolescents with Type 1 diabetes, and these associations were not affected by demographic and disease variables. Self-management played a mediating or mediating role between resilience and health outcomes. The prerequisite for the generation of resilience among adolescents was to undergo disease-related stress, and the level of resilience was affected by individual characteristics, family, peer, medical care, and cultural factors.

The resilience model of adolescent patients with Type 1 diabetes includes four parts—stressors, influencing factors, resilience process, and health outcome—which can guide clinical nurses to integrate resilience promotion into diabetes health management. The Adolescents Resilience Training Program is feasible and can provide evidence and suggestions for promoting this intervention in the clinical as well as applying it to the management of patients with other chronic diseases.

第一章 文献综述 1
1.1 心理韧性概念 1
1.2 心理韧性研究的起源和发展历程 2
1.3 心理韧性的理论研究 3
1.3.1 挑战与威胁的生物心理社会模型 3
1.3.2 心理韧性的生态模型 4
1.3.3 心理韧性框架 5
1.3.4 儿童时期慢性疾病适应模型 7
1.4 心理韧性的测量 9
1.4.1 CD-RISC心理韧性量表 9
1.4.2 成人心理韧性量表 9
1.4.3 青少年心理韧性量表 10
1.4.4 儿童青少年心理韧性量表 10
1.4.5 青少年糖尿病优势与韧性量表 10
1.5 心理韧性的实证研究 11
1.5.1 心理韧性与个体健康关系 11
1.5.2 心理韧性的影响因素 11
1.5.3 心理韧性促进健康的作用机制 13
1.5.4 以心理韧性为切入点的健康干预方案 14
1.6 国内外青少年1型糖尿病患者的主要健康问题 16
1.6.1 疾病控制不佳 16
1.6.2 心理行为问题显著 16
1.6.3 社会适应不佳 17
1.7 心理韧性在青少年1型糖尿病患者中的应用研究现状 17
1.7.1 心理韧性与青少年1型糖尿病患者健康指标关系 17
1.7.2 青少年1型糖尿病患者心理韧性的影响因素 18
1.7.3 青少年1型糖尿病患者心理韧性的干预研究 19
1.8 研究进展小结 25
第二章 前言 26
2.1 研究背景 26
2.2 科学问题、研究内容和目的 27
2.2.1 科学问题和研究内容 27
2.2.2 研究目的 28
2.3 研究意义 28
2.4 操作性定义 29
2.5 研究的概念框架 30
第三章 心理韧性与青少年1型糖尿病患者血糖控制及心身健康的关系研究 32
3.1 研究目的 32
3.2 研究方法 32
3.2.1 研究对象 32
3.2.2 抽样方法及样本量 32
3.2.3 评价指标与研究工具 32
3.2.4 资料收集方法 35
3.2.5 资料的统计分析 35
3.2.6 质量控制 36
3.2.7 伦理考量 37
3.3 研究结果 37
3.3.1 青少年1型糖尿病患者心理韧性现状 37
3.3.2 心理韧性与健康指标的关联 39
3.3.3 心理韧性与健康指标的关联机制--自我管理的中介与调节效应 45
3.4 讨论 54
3.4.1 青少年1型糖尿病患者的心理韧性得分情况 54
3.4.2 青少年1型糖尿病患者心理韧性是血糖控制的独立预测因子 55
3.4.3 青少年1型糖尿病患者心理韧性是糖尿病痛苦的独立预测因子 57
3.4.4 青少年1型糖尿病患者心理韧性是生活质量的独立预测因子 58
3.5 小结 60
第四章 基于内外环境的青少年1型糖尿病患者心理韧性影响因素研究 61
4.1 研究目的 61
4.2 研究方法 61
4.2.1 研究的概念框架 61
4.2.2 研究对象 62
4.2.3 抽样方法及样本量 62
4.2.4 评价指标与研究工具 62
4.2.5 资料收集 64
4.2.6 资料的统计分析 65
4.2.7 质量控制和伦理考量 66
4.3 研究结果 66
4.3.1 人口社会学和疾病变量与青少年1型糖尿病患者心理韧性的关联 66
4.3.2 家庭功能、同伴因素和应对方式与心理韧性的相关性分析 72
4.3.3 心理韧性影响因素测量模型的验证性因子分析 73
4.3.4 心理韧性影响因素结构方程模型建立 79
4.4 讨论 86
4.4.1 社会人口学特征与青少年1型糖尿病患者心理韧性的关联 86
4.4.2 家庭功能、同伴因素和个体应对方式与心理韧性的关联 87
4.5 小结 90
第五章 青少年1型糖尿病患者心理韧性体验的质性研究 91
5.1 研究目的 91
5.2 研究方法 91
5.2.1 研究对象 91
5.2.2 抽样方法和样本量 91
5.2.3 资料收集 92
5.2.4 资料整理与分析 93
5.2.5 质量控制 94
5.2.6 伦理考量 95
5.3 研究结果 95
5.3.1 受访者一般资料 95
5.3.2 青少年1型糖尿病患者病程中的心理韧性体验 97
5.3.3 青少年1型糖尿病患者心理韧性的影响因素 107
5.4 讨论 115
5.4.1 青少年1型糖尿病患者心理韧性的诱发条件 115
5.4.2 青少年1型糖尿病患者心理韧性的作用过程及结果 116
5.4.3 青少年1型糖尿病患者心理韧性的影响因素 118
5.5 小结 120
第六章 青少年1型糖尿病患者心理韧性模型构建及应用 122
6.1 研究目的 122
6.2 青少年1型糖尿病患者心理韧性模型的建立 122
6.2.1 模型建立的方法 122
6.2.2 结果 122
6.3 以心理韧性为切入点的青少年1型糖尿病患者健康干预方案的开发 127
6.3.1 基于青少年1型糖尿病患者心理韧性模型开发干预方案 127
6.3.2 专家小组会议确定干预方案 129
6.4 以心理韧性为切入点的青少年1型糖尿病患者健康干预方案的可行性分析 132
6.4.1 研究对象 132
6.4.2 研究方法 132
6.4.3 研究结果 135
6.5 讨论 141
6.5.1 青少年1型糖尿病患者心理韧性模型对临床护理的启示 141
6.5.2 青少年1型糖尿病患者心理韧性训练项目可行性高 143
第七章 结论与展望 146
7.1 全文总结 146
7.2 创新性 146
7.3 局限和展望 147
参考文献 148
附录 169
附录A 调查问卷 169
表A.1 一般情况调查表 169
表A.2 青少年糖尿病优势与韧性量表 170
表A.3 糖尿病自我管理行为评定量表（使用胰岛素泵的青少年版本） 171
表A.4 糖尿病自我管理行为评定量表（使用胰岛素笔的青少年版本） 173
表A.5 5条目糖尿病痛苦量表 175
表A.6 接受胰岛素治疗患者生活质量量表 176
表A.7 家庭亲密度与适应性量表 178
表A.8 感知同伴支持量表 180
表A.9 糖尿病特异性压力测量问卷--同伴压力维度 181
表A.10 简易应对方式问卷 182
附录B 青少年1型糖尿病患者心理韧性训练项目干预材料 183
致谢 185
北京大学学位论文原创性声明和使用授权说明 186
学位论文答辩委员会名单 187
个人简历、在读期间科研成果简介 188

[1] Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diabetes [J]. The Lancet, 2014, 383(9911): 69-82.

[2] Bjerg L, Hulman A, Charles M, et al. Clustering of microvascular complications in Type 1 diabetes mellitus [J]. Journal of diabetes and its complications, 2018, 32(4): 393-399.

[3] Livingstone SJ, Levin D, Looker HC, et al. Estimated Life Expectancy in a Scottish Cohort With Type 1 Diabetes, 2008-2010 [J]. JAMA, 2015, 313(1): 37-44.

[4] Heald AH, Livingston M, Fryer A, et al. Route to improving Type 1 diabetes mellitus glycaemic outcomes: real‐world evidence taken from the National Diabetes Audit [J]. Diabetic medicine, 2018, 35(1): 63-71.

[5] Mcguire HC, Ji L, Kissimova-Skarbek K, et al. Type 1 diabetes mellitus care and education in China: The 3C study of coverage, cost, and care in Beijing and Shantou [J]. Diabetes research and clinical practice, 2017, 129: 32-42.

[6] Ersig AL, Tsalikian E, Coffey J, et al. Stressors in Teens with Type 1 Diabetes and Their Parents: Immediate and Long-Term Implications for Transition to Self-Management [J]. Journal of pediatric nursing, 2016, 31(4): 390-396.

[7] Buchberger B, Huppertz H, Krabbe L, et al. Symptoms of depression and anxiety in youth with type 1 diabetes: A systematic review and meta-analysis [J]. Psychoneuroendocrinology, 2016, 70: 70-84.

[8] De Souza MA, Freire De Freitas RWJ, De Lima LS, et al. Health-related quality of life of adolescents with type 1 diabetes mellitus [J]. Revista latino-americana de enfermagem, 2019, 27: e3210-e3210.

[9] Hilliard ME, Harris MA, Weissberg-Benchell J. Diabetes Resilience: A Model of Risk and Protection in Type 1 Diabetes [J]. Current diabetes reports, 2012, 12(6): 739-748.

[10] 杨婧, 王詠, 宋莉莉. 心理韧性的神经机制研究进展 [J]. 神经解剖学杂志, 2019, 35(1): 88-92.

[11] Kim GM, Lim JY, Kim EJ, et al. Resilience of patients with chronic diseases: A systematic review [J]. Health & Social Care in the Community, 2019, 27(4): 797-807.

[12] Cal SF, Cal SF, Sá LRD, et al. Resilience in chronic diseases: A systematic review [J]. Cogent Psychology, 2015, 2(1): 1024928.

[13] Christie D, Thompson R, Sawtell M, et al. Effectiveness of a structured educational intervention using psychological delivery methods in children and adolescents with poorly controlled type 1 diabetes: a cluster-randomized controlled trial of the CASCADE intervention [J]. BMJ open diabetes research & care, 2016, 4(1): 1-14.

[14] Powers MA, Richter SA, Ackard DM, et al. Diabetes Distress Among Persons With Type 1 Diabetes [J]. The Diabetes educator, 2017, 43(1): 105-113.

[15] Lazarus RS. From psychological stress to the emotions: A history of changing outlooks [J]. Annual review of psychology, 1993, 44(1): 1-21.

[16] Richardson GE, Neiger BL, Jensen S, et al. The resiliency model [J]. Health education, 1990, 21(6): 33-39.

[17] Masten AS. Ordinary Magic: Resilience Processes in Development [J]. The American psychologist, 2001, 56(3): 227-238.

[18] Ungar M. Resilience across Cultures [J]. British Journal of Social Work, 2008, 38(2): 218-235.

[19] Hornor G. Resilience [J]. Journal of pediatric health care, 2017, 31(3): 384-390.

[20] "Vulnerable But Invincible: A Longitudinal Study of Resilient Children and Youth", Emmy E. Werner "and" Ruth S. Smith (Book Review) [M]. Roslyn Heights, N.Y; Libra Publishers. 1982: 247.

[21] Richardson GE. The metatheory of resilience and resiliency [J]. Journal of Clinical Psychology, 2002, 58(3): 307-321.

[22] Ludolph P, Kunzler AM, Stoffers-Winterling J, et al. Interventions to Promote Resilience in Cancer Patients [J]. Deutsches ?rzteblatt international, 2019, 116(51-52): 865-872.

[23] Vreeman RC, Nyandiko WM, Marete I, et al. Evaluating a patient-centred intervention to increase disclosure and promote resilience for children living with HIV in Kenya [J]. AIDS, 2019, 33 Suppl 1: S93-S101.

[24] Highland KB, Schoomaker A, Rojas W, et al. Benefits of the Restorative Exercise and Strength Training for Operational Resilience and Excellence Yoga Program for Chronic Low Back Pain in Service Members: A Pilot Randomized Controlled Trial [J]. Archives of physical medicine and rehabilitation, 2018, 99(1): 91-98.

[25] Blascovich J, Tomaka J. The Biopsychosocial Model of Arousal Regulation [J]. Advances in experimental social psychology, 1996, 28(C): 1-51.

[26] Schotte CK, Van Den Bossche B, De Doncker D, et al. A biopsychosocial model as a guide for psychoeducation and treatment of depression [J]. Depress Anxiety, 2006, 23(5): 312-324.

[27] Mescouto K, Olson RE, Hodges PW, et al. A critical review of the biopsychosocial model of low back pain care: time for a new approach? [J]. Disability and rehabilitation, 2020, 1-15.

[28] lvarez AS, Pagani M, Meucci P. The clinical application of the biopsychosocial model in mental health: a research critique [J]. American journal of physical medicine & rehabilitation, 2012, 91(13 Suppl 1): S173-S180.

[29] Ungar M. Social Ecologies and Their Contribution to Resilience [M]. New York, NY; Springer New York. 2011: 13-31.

[30] Hamby S, Grych J, Banyard V. Resilience Portfolios and Poly-Strengths: Identifying Protective Factors Associated With Thriving After Adversity [J]. Psychology of violence, 2018, 8(2): 172-183.

[31] Oshri A, Duprey EB. Growth patterns of future orientation among maltreated youth: A prospective examination of the emergence of resilience [J]. 2018, 54(8): 1456-1471.

[32] 张婷. 基于社会生态系统理论的乳腺癌患者心理韧性保护性因素的研究 [D]. 安徽医科大学, 2015.

[33] Kumfer KL. Factors and processes contributing to resilience: The resilience framework // Glantz&J. L. Johnson (Eds), Resilience and development: Positive life adaptation [M]. New York: Kluwer Academic, 1999:179-224.

[34] Li C, Lu H, Qin W, et al. Resilience and Its Predictors Among Chinese Liver Cancer Patients Undergoing Transarterial Chemoembolization [J]. Cancer Nurs, 2019, 42(5): e1-e9.

[35] Luo D, Lin Z, Shang XC, et al. "I can fight it!": A qualitative study of resilience in people with inflammatory bowel disease [J]. International journal of nursing sciences, 2019, 6(2): 127-133.

[36] Grey M, Cameron ME, Thurber FW. Coping and Adaptation in Children with Diabetes [J]. Nursing research, 1991, 40(3): 144-148.

[37] Roy SC, Corliss CP. The Roy Adaptation Model: theoretical update and knowledge for practice [J]. NLN publications, 1993, 15-2548: 215-229.

[38] Pollock SE. Human Responses to Chronic Illness: Physiologic and Psychosocial Adaptation [J]. Nursing research, 1986, 35(2): 90-97.

[39] Whittemore R, Jaser S, Guo J, et al. A conceptual model of childhood adaptation to type 1 diabetes [J]. Nursing outlook, 2010, 58(5): 242-251.

[40] Guo J, Whittemore R, Jeon S, et al. Diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life over time in Chinese youth with type 1 diabetes [J]. J Clin Nurs, 2015, 24(9-10): 1258-1268.

[41] Windle G, Bennett KM, Noyes J. A methodological review of resilience measurement scales [J]. Health and Quality of Life Outcomes, 2011, 9(1): 8.

[42] Hilliard ME, Iturralde E, Weissberg-Benchell J, et al. The Diabetes Strengths and Resilience Measure for Adolescents With Type 1 Diabetes (DSTAR-Teen): Validation of a New, Brief Self-Report Measure [J]. Journal of Pediatric Psychology, 2017, 42(9): 995-1005.

[43] Connor KM, Davidson JRT. Development of a new resilience scale: The Connor‐Davidson Resilience Scale (CD‐RISC) [J]. Depression and Anxiety, 2003, 18(2): 76-82.

[44] Yu X, Zhang J. Factor Analysis and Psychometric Evaluation of the Connor-Davidson Resilience Scale (CD-RISC) with Chinese People[J]. Social behavior and personality, 2007, 35(1): 19-30.

[45] Wagnild GM, Young HM. Development and psychometric evaluation of the Resilience Scale [J]. Journal of nursing measurement, 1993, 1(2): 165-178.

[46] Hjemdal O, Friborg O, Stiles TC, et al. A New Scale for Adolescent Resilience: Grasping the Central Protective Resources Behind Healthy Development [J]. Measurement and evaluation in counseling and development, 2006, 39(2): 84-96.

[47] Stratta P, Riccardi I, Di Cosimo A, et al. A Validation Study of the Italian Version of the Resilience Scale for Adolescents (READ): Resilience Scale for Adolescents Italian Validation [J]. Journal of community psychology, 2012, 40(4): 479-485.

[48] Hjemdal O, Vogel PA, Solem S, et al. The relationship between resilience and levels of anxiety, depression, and obsessive–compulsive symptoms in adolescents [J]. Clinical psychology and psychotherapy, 2011, 18(4): 314-321.

[49] Ungar M, Liebenberg L. Assessing Resilience Across Cultures Using Mixed Methods: Construction of the Child and Youth Resilience Measure [J]. Journal of Mixed Methods Research, 2011, 5(2): 126-149.

[50] 向小平, 田国秀, 王曦影, 等. 儿童青少年抗逆力测量中文版在北京青少年中的适用性研究 [J]. 中国青年研究, 2014, 5: 5-10.

[51] Xu J, Luo D, Zhu M, et al. Translation and its Psychometric Characteristic of the Diabetes Strengths and Resilience Measure among Chinese Adolescents with type 1 Diabetes [J]. Journal of pediatric nursing, 2020, 50: e2-e7.

[52] Rosenberg AR, Syrjala KL, Martin PJ, et al. Resilience, health, and quality of life among long‐term survivors of hematopoietic cell transplantation [J]. Cancer, 2015, 121(23): 4250-4257.

[53] Hopkins KD, Shepherd CCJ, Taylor CL, et al. Relationships between psychosocial resilience and physical health status of Western Australian urban Aboriginal youth [J]. PloS one, 2015, 10(12): e0145382.

[54] Anyan F, Hjemdal O. Adolescent stress and symptoms of anxiety and depression: Resilience explains and differentiates the relationships [J]. Journal of Affective Disorders, 2016, 203: 213-220.

[55] Popa-Velea O, Diaconescu L, Jidveian Popescu M, et al. Resilience and active coping style: Effects on the self-reported quality of life in cancer patients [J]. The International Journal of Psychiatry in Medicine, 2017, 52(2): 124-136.

[56] Mathias K, Pandey A, Armstrong G, et al. Outcomes of a brief mental health and resilience pilot intervention for young women in an urban slum in Dehradun, North India: A quasi-experimental study [J]. International journal of mental health systems, 2018, 12(1): 47.

[57] Chow KM, Tang WKF, Chan WHC, et al. Resilience and well-being of university nursing students in Hong Kong: A cross-sectional study [J]. BMC Medical Education, 2018, 18(1): 13-18.

[58] 杨雪岭, 崔梓天, 赵静波, 等. 大学生心理韧性、心理症状与自杀风险的关系 [J]. 中国健康心理学杂志, 2013, 21(9): 1408-1412.

[59] Eisenberg N, Valiente C, Fabes RA, et al. The Relations of Effortful Control and Ego Control to Children's Resiliency and Social Functioning [J]. Developmental psychology, 2003, 39(4): 761-776.

[60] Chung JOK, Li WHC, Cheung AT, et al. Relationships among resilience, depressive symptoms, self-esteem, and quality of life in children with cancer [J]. Psycho-oncology, 2020, online ahead of print.

[61] Kim M, Kim K, Kim J-S. Impact of resilience on the health-related quality of life of adolescents with a chronic health problem: A structural equation?approach: Resilience and health-related quality of life of adolescents [J]. Journal of advanced nursing, 2019, 75(4): 801-811.

[62] Olsson CA, Bond L, Burns JM, et al. Adolescent resilience: a concept analysis [J]. Journal of adolescence, 2003, 26(1): 1-11.

[63] Werner EE. Stress and protective factors in children's lives // Nicol (Ed.), longitudinal studies in child psychology and psychiatry [M]. New York: John Wiley and Sons, 1985.

[64] Rutter M. Epidemiological-longitudinal approaches to the study of development // Collins (Ed). The concept of development. The Minnesota Symposia on Child Psychology (Vol. 15) [M]. Hillsdale: NJ: Lawrence Erlbaum, 1982.

[65] Terrill AL, Molton IR, Ehde DM, et al. Resilience, age, and perceived symptoms in persons with long-term physical disabilities [J]. Journal of Health Psychology, 2016, 21(5): 640-649.

[66] Kim DH, Yoo IY. Factors associated with resilience of school age children with cancer [J]. Journal of Paediatrics and Child Health, 2010, 46(7-8): 431-436.

[67] 谭萍, 石朝凯. 三峡移民家庭大学生心理韧性水平及影响因素 [J]. 职业与健康, 2019, 35(02): 246-249.

[68] 葛秀杰, 李春玉. 延边地区汉族留守儿童心理韧性状况及其影响因素调查研究 [J]. 延边大学医学学报, 2013, 36(2): 119-124.

[69] Gao Y, Yuan L, Pan B, et al. Resilience and associated factors among Chinese patients diagnosed with oral cancer [J]. BMC cancer, 2019, 19(1): 447.

[70] Zhang T, Li H, Liu A, et al. Factors promoting resilience among breast cancer patients: a qualitative study [J]. Contemporary Nurse, 2018, 54(3): 293-303.

[71] Seiler A, Jenewein J. Resilience in Cancer Patients [J]. Frontiers in Psychiatry, 2019, 10: 208.

[72] Alvord MK, Grados JJ. Enhancing Resilience in Children: A Proactive Approach [J]. Professional psychology, research and practice, 2005, 36(3): 238-245.

[73] Lansing AH, Berg CA. Topical review: Adolescent self-regulation as a foundation for chronic illness self-management [J]. Journal of pediatric psychology, 2014, 39(10): 1091-1096.

[74] Murphy LK, Bettis AH, Gruhn MA, et al. Resilience in Adolescents with Cancer: Association of Coping with Positive and Negative Affect [J]. Journal of developmental and behavioral pediatrics, 2017, 38(8): 646-653.

[75] Berszán L. Positive Coping And Resilience: Questions and Conclusions Drawn From A Longitudinal Study [J]. European journal of mental health, 2017, 12(2): 187-203.

[76] Aizpurua-Perez I, Perez-Tejada J. Resilience in women with breast cancer: A systematic review [J]. European journal of oncology nursing, 2020, 49: 101854-101854.

[77] Lee S, Kim S, Young Choi J. Coping and Resilience of Adolescents With Congenital Heart Disease [J]. The Journal of cardiovascular nursing, 2014, 29(4): 340-346.

[78] 潘允康. 社会变迁中的家庭: 家庭社会学 [M]. 天津: 天津社会科学院出版社, 2019.

[79] Harris MA, Greco P, Wysocki T, et al. Adolescents with diabetes from single-parent, blended, and intact families: Health-related and family functioning [J]. Families, Systems and Health, 1999, 17(2): 181-196.

[80] Wysocki T, Nansel TR, Holmbeck GN, et al. Collaborative Involvement of Primary and Secondary Caregivers: Associations with Youths' Diabetes Outcomes [J]. Journal of Pediatric Psychology, 2009, 34(8): 869-881.

[81] Luo D, Xu JJ, Cai X, et al. The effects of family functioning and resilience on self‐management and glycaemic control among youth with type 1 diabetes [J]. Journal of clinical nursing, 2019, 28(23-24): 4478-4487.

[82] J K-C, T.E M, A C, et al. Genetic and Environmental Processes in Young Childrens Resilience and Vulnerability to Socioeconomic Deprivation [J]. Child Development, 2004, 75(3): 651-668.

[83] Anthony EK. Cluster Profiles of Youths Living in Urban Poverty: Factors Affecting Risk and Resilience [J]. Social Work Research, 2008, 32(1): 6-17.

[84] Horner SD, Rew L, Brown A. Risk-Taking Behaviors Engaged in By Early Adolescents While on School Property [J]. Issues in Comprehensive Pediatric Nursing, 2012, 35(2): 90-110.

[85] Delgado MY, Nair RL, Updegraff KA, et al. Discrimination, Parent–Adolescent Conflict, and Peer Intimacy: Examining Risk and Resilience in Mexican‐Origin Youths' Adjustment Trajectories [J]. Child Development, 2019, 90(3): 894-910.

[86] Cohen S. Psychological stress, immunity, and physical disease // Sternberg R, Fiske F, Foss D. (Eds.), Scientists Making a Difference: The Greatest Living Behavioral and Brain Scientists Talk about Their Most Important Contributions [M]. New York: Cambridge University Press, 2016.

[87] Dantzer R, Cohen S, Russo SJ, et al. Resilience and immunity [J]. Brain Behavior and Immunity, 2018, 74: 28-42.

[88] Skrove M, Romundstad P, Indredavik MS. Resilience, lifestyle and symptoms of anxiety and depression in adolescence: the Young-HUNT study [J]. Social Psychiatry and Psychiatric Epidemiology, 2013, 48(3): 407-416.

[89] Stewart AL, Stewart AL, Hays RD, et al. Long-term functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the medical outcomes study [J]. Journal of Clinical Epidemiology, 1994, 47(7): 719-730.

[90] Mehravar F, Mansournia MA, Holakouie-Naieni K, et al. Associations between diabetes self-management and microvascular complications in patients with type 2 diabetes [J]. Epidemiology and health, 2016, 38: e2016004.

[91] Wang RH, Hsu HC, Kao CC, et al. Associations of changes in psychosocial factors and their interactions with diabetes distress in patients with type 2 diabetes: a longitudinal study [J]. Journal of advanced nursing, 2017, 73(5): 1137-1146.

[92] Yi JP, Vitaliano PP, Smith RE, et al. The role of resilience on psychological adjustment and physical health in patients with diabetes [J]. British Journal of Health Psychology, 2008, 13(2): 311-325.

[93] Park ERPDMPH, Traeger LPD, Vranceanu A-MPD, et al. The Development of a Patient-Centered Program Based on the Relaxation Response: The Relaxation Response Resiliency Program (3RP) [J]. Psychosomatics, 2013, 54(2): 165-174.

[94] Gillham JE, Hamilton J, Freres DR, et al. Preventing Depression Among Early Adolescents in the Primary Care Setting: A Randomized Controlled Study of the Penn Resiliency Program [J]. Journal of Abnormal Child Psychology, 2006, 34(2): 195-211.

[95] Bond FW, Dryden W. Handbook of brief cognitive behaviour therapy [M]. Chichester;New York, NY;: Wiley, 2002.

[96] 巴赫, 莫兰, 方双虎, 等. 接受与实现疗法: 理论与实务[M]. 重庆: 重庆大学出版社, 2011.

[97] Loprinzi CE, Prasad K, Schroeder DR, et al. Stress Management and Resilience Training (SMART) Program to Decrease Stress and Enhance Resilience Among Breast Cancer Survivors: A Pilot Randomized Clinical Trial [J]. Clinical Breast Cancer, 2011, 11(6): 364-368.

[98] Vranceanu A-M, Merker VL, Plotkin SR, et al. The relaxation response resiliency program (3RP) in patients with neurofibromatosis 1, neurofibromatosis 2, and schwannomatosis: results from a pilot study [J]. Journal of Neuro-Oncology, 2014, 120(1): 103-109.

[99] Mccann TV, Songprakun W, Stephenson J. Effectiveness of a Guided Self-help Manual in Strengthening Resilience in People Diagnosed with Moderate Depression and Their Family Caregivers in Thailand: A Randomised Controlled Trial [J]. Issues in Mental Health Nursing, 2017, 38(8): 655-662.

[100] Hood KK, Hood KK, Iturralde E, et al. Preventing Diabetes Distress in Adolescents With Type 1 Diabetes: Results 1 Year After Participation in the STePS Program [J]. Diabetes care, 2018, 41(8): 1623-1630.

[101] Li X, Harrison SE, Fairchild AJ, et al. A randomized controlled trial of a resilience-based intervention on psychosocial well-being of children affected by HIV/AIDS: Effects at 6- and 12-month follow-up [J]. Social Science & Medicine, 2017, 190: 256-264.

[102] Ye ZJ, Liang MZ, Qiu HZ, et al. Effect of a multidiscipline mentor-based program, Be Resilient to Breast Cancer (BRBC), on female breast cancer survivors in mainland China—A randomized, controlled, theoretically-derived intervention trial [J]. Breast Cancer Research and Treatment, 2016, 158(3): 509-522.

[103] Donze JR, Tercyak KP. The Survivor Health and Resilience Education (SHARE) Program: Development and Evaluation of a Health Behavior Intervention for Adolescent Survivors of Childhood Cancer [J]. Journal of Clinical Psychology in Medical Settings, 2006, 13(2): 161-168.

[104] Chiang JL, Chiang JL, Maahs DM, et al. Type 1 Diabetes in Children and Adolescents: A Position Statement by the American Diabetes Association [J]. Diabetes care, 2018, 41(9): 2026-2044.

[105] Sherr JL, Tauschmann M, Battelino T, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes technologies [J]. Pediatric Diabetes, 2018, 19(S27): 302-325.

[106] Warner J, Morris S. The National Paediatric Diabetes Audit [J]. Practical diabetes (2011), 2014, 31(6): 257-261.

[107] 刘媛, 刘超. 1型糖尿病青少年儿童心理行为问题研究进展 [J]. 国际内分泌代谢杂志, 2015, 35(1): 63-65.

[108] 王爱华 朱逞 洪宝瑟 张. 1型糖尿病儿童情绪障碍对照研究 [J]. 中国实用儿科杂志, 2008, 23(4): 281-283.

[109] 吴庆秋 吴娟 王雅蓉 何. 宁夏地区1型糖尿病儿童及青少年患者生命质量调查分析 [J]. 宁夏医学杂志, 2017, 39(10): 907-909.

[110] Verchota G, Sawin KJ. Testing Components of a Self-Management Theory in Adolescents With Type 1 Diabetes Mellitus [J]. Nursing research, 2016, 65(6): 487-495.

[111] Mcguire HC, Ji L, Ji Y, et al. Type 1 diabetes mellitus care and education in China: The 3C study of coverage, cost, and care in Beijing and Shantou [J]. Diabetes research and clinical practice, 2017, 129: 32-42.

[112] Chilton R, Pires-Yfantouda R. Understanding adolescent type 1 diabetes self-management as an adaptive process: A grounded theory approach [J]. Psychology & health, 2015, 30(12): 1486-1504.

[113] Jaacks LM, Liu W, Ji L, et al. Type 1 diabetes stigma in China: A call to end the devaluation of individuals living with a manageable chronic disease [J]. Diabetes research and clinical practice, 2014, 107(2): 306-307.

[114] Brazeau A-S, Nakhla M, Wright M, et al. Stigma and its association with glycemic control and hypoglycemia in adolescents and young adults with type 1 diabetes: Cross-sectional study [J]. Journal of medical Internet research, 2018, 20(4): e151.

[115] Nishio I, Chujo M. Structure of resilience among japanese adult patients with type 1 diabetes: A qualitative study [J]. Yonago acta medica, 2017, 60(1): 1-8.

[116] Murillo M, Bel J, Pérez J, et al. Health-related quality of life (HRQOL) and its associated factors in children with Type 1 Diabetes Mellitus (T1DM) [J]. BMC pediatrics, 2017, 17(1): 16.

[117] 王婧, 郭佳, 王瑶, 等. 儿童青少年1型糖尿病患者生活质量总体满意度的影响因素调查研究 [J]. 中国全科医学, 2013, 16(9C): 3221-3224.

[118] 王旭梅, 张琳琪, 王艳红, 等. 1型糖尿病患儿生存质量的调查分析 [J]. 中国实用护理杂志, 2013, 29(28): 64-66.

[119] Winsett RP, Stender SR, Gower G, et al. Adolescent self-efficacy and resilience in participants attending A diabetes camp [J]. Pediatric nursing, 2010, 36(6): 293-297.

[120] Hilliard ME, Hagger V, Hendrieckx C, et al. Strengths, risk factors, and resilient outcomes in adolescents with type 1 diabetes: Results from diabetes MILES Youth-Australia [J]. Diabetes care, 2017, 40(7): 849-855.

[121] Santos FRM, Bernardo V, Gabbay MaL, et al. The impact of knowledge about diabetes, resilience and depression on glycemic control: A cross-sectional study among adolescents and young adults with type 1 diabetes [J]. Diabetology and metabolic syndrome, 2013, 5(1): 55.

[122] Perfect MM, Jaramillo E. Relations Between Resiliency, Diabetes-Related Quality of Life, and Disease Markers to School-Related Outcomes in Adolescents With Diabetes [J]. School psychology quarterly, 2012, 27(1): 29-40.

[123] Helgeson VS, Reynolds KA, Siminerio LM, et al. Cognitive adaptation theory as a predictor of adjustment to emerging adulthood for youth with and without type 1 diabetes [J]. Journal of psychosomatic research, 2014, 77(6): 484-491.

[124] Perna L, Mielck A, Lacruz ME, et al. The association between resilience and diabetic neuropathy by socioeconomic position: Cross-sectional findings from the KORA-Age study [J]. Journal of Health Psychology, 2015, 20(9): 1222-1228.

[125] Santos FRM, Bernardo V, Gabbay MaL, et al. The impact of knowledge about diabetes, resilience and depression on glycemic control: A cross-sectional study among adolescents and young adults with type 1 diabetes [J]. Diabetology and Metabolic Syndrome, 2013, 5(1): 55.

[126] Yi-Frazier JP, Yaptangco M, Semana S, et al. The association of personal resilience with stress, coping, and diabetes outcomes in adolescents with type 1 diabetes: Variable- and person-focused approaches [J]. Journal of Health Psychology, 2015, 20(9): 1196-1206.

[127] Vesco AT, Feldman MA, Evans MA, et al. Parent-adolescent dyadic diabetes distress: Associations with A1c and diabetes-related strengths [J]. Families, Systems and Health, 2018, 36(3): 357-367.

[128] Lukács A, Mayer K, Sasvári P, et al. Health‐related quality of life of adolescents with type 1 diabetes in the context of resilience [J]. Pediatric Diabetes, 2018, 19(8): 1481-1486.

[129] Lo F-S, Hsu H-Y, Chen B-H, et al. Factors affecting health adaptation of Chinese adolescents with type 1 diabetes: A path model testing [J]. Journal of Child Health Care, 2016, 20(1): 5-16.

[130] Jaser SS, White LE. Coping and resilience in adolescents with type 1 diabetes [J]. Child: Care, Health and Development, 2011, 37(3): 335-342.

[131] Huston SA, Blount RL, Heidesch T, et al. Resilience, emotion processing and emotion expression among youth with type 1 diabetes [J]. Pediatric diabetes, 2016, 17(8): 623-631.

[132] Rosenberg AR, Yi-Frazier JP, Eaton L, et al. Promoting resilience in stress management: A pilot study of a novel resilience-promoting intervention for adolescents and young adults with serious illness [J]. Journal of Pediatric Psychology, 2014, 40(9): 992-999.

[133] Yi-Frazier JP, Cochrane K, Whitlock K, et al. Trajectories of acute diabetes-specific stress in adolescents with type 1 diabetes and their caregivers within the first year of diagnosis [J]. Journal of pediatric psychology, 2018, 43(6): 645-653.

[134] Lord JH, Rumburg TM, Jaser SS. Staying positive: Positive affect as a predictor of resilience in adolescents with type 1 diabetes [J]. Journal of Pediatric Psychology, 2014, 40(9): 968-977.

[135] Rohan JM, Huang B, Pendley JS, et al. Predicting health resilience in pediatric type 1 diabetes: A test of the resilience model framework [J]. Journal of Pediatric Psychology, 2014, 40(9): 956-967.

[136] David M, Nancy A, Jean M, et al. Epidemiology of Type 1 Diabetes [J]. Endocrinology and metabolism clinics of North America, 2010, 39(3): 481-497.

[137] Danaei G, Lu Y, Singh GM, et al. Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment [J]. Lancet Diabetes & Endocrinology, The, 2014, 2(8): 634-647.

[138] Kilpatrick ES, Rigby AS, Atkin SL. Insulin resistance, the metabolic syndrome, and complication risk in type 1 diabetes: "Double diabetes" in the diabetes control and complications trial [J]. Diabetes care, 2007, 30(3): 707-712.

[139] Jacobson AM, Braffett BH, Cleary PA, et al. The long-term effects of type 1 diabetes treatment and complications on health-related quality of life: A 23-year follow-up of the diabetes control and complications/ epidemiology of diabetes interventions and complications cohort [J]. Diabetes care, 2013, 36(10): 3131-3138.

[140] Pambianco G, Costacou T, Ellis D, et al. The 30-year natural history of type 1 diabetes complications: The Pittsburgh epidemiology of diabetes complications study experience [J]. Diabetes , 2006, 55(5): 1463-1469.

[141] International diabetes federation. IDF Diabetes Atlas (9th ed.) [EB/OL]. [2019-11]. https://diabetesatlas.org/en/

[142] 翁建平. 中国1型糖尿病研究现况及未来展望[J]. 广东医学, 2012, 33(18): 2699-2702.

[143] Karvonen M, Grp DP, Group DP, et al. Incidence and trends of childhood Type 1 diabetes worldwide 1990-1999 [J]. Diabetic Medicine, 2006, 23(8): 857-866.

[144] Q&A: Key points for IDF Diabetes Atlas 2017 [J]. Diabetes research and clinical practice, 2018, 135:235-236.

[145] 苏夜阳, 刘纪. 中国1型糖尿病的社会成见：请停止对这种可控慢性病患者的歧视 [J]. 中国糖尿病杂志, 2015, 23(3): 195-197.

[146] Buchberger B, Huppertz H, Krabbe L, et al. Symptoms of depression and anxiety in youth with type I diabetes: A systematic review and meta-analysis [J]. Psychoneuroendocrinology, 2016, 70: 70-84.

[147] Liu F, Guan Y, Li X, et al. Different Effects of Structured Education on Glycemic Control and Psychological Outcomes in Adolescent and Adult Patients with Type 1 Diabetes: A Systematic Review and Meta-Analysis [J]. International journal of endocrinology, 2020, 2020: 9796019-9796013.

[148] Winkley K, Upsher R, Stahl D, et al. Psychological interventions to improve self-management of type 1 and type 2 diabetes: a systematic review [J]. Health technology assessment, 2020, 24(28): I-232.

[149] Hanson CL, Henggeler SW, Burghen GA. Social Competence and Parental Support as Mediators of the Link Between Stress and Metabolic Control in Adolescents With Insulin-Dependent Diabetes Mellitus [J]. Journal of consulting and clinical psychology, 1987, 55(4): 529-533.

[150] Stewart M, Reid G, Mangham C. Fostering children's resilience [J]. Journal of pediatric nursing, 1997, 12(1): 21-31.

[151] Wallander JL, Wallander JL, Varni JW, et al. The social environment and the adaptation of mothers of physically handicapped children [J]. Journal of pediatric psychology, 1989, 14(3): 371-387.

[152] Herrman H, Stewart DE, Diaz-Granados N, et al. What is resilience? [J]. Canadian journal of psychiatry Revue canadienne de psychiatrie, 2011, 56(5): 258-265.

[153] Fang X, Vincent W, Calabrese SK, et al. Resilience, stress, and life quality in older adults living with HIV/AIDS [J]. Aging & mental health, 2015, 19(11): 1015-1021.

[154] Qiu C, Shao D, Yao Y, et al. Self-management and psychological resilience moderate the relationships between symptoms and health-related quality of life among patients with hypertension in China [J]. Quality of life research, 2019, 28(9): 2585-2595.

[155] 叶增杰, 刘秋婵, 梁木子, 等. 心理韧性模型在乳腺癌患者中的构建及应用 [J]. 医学与哲学, 2016, 37(24): 75-79.

[156] 周杨. 急性白血病化疗患者心理韧性与生活质量的关系及干预效果研究 [D]; 郑州大学 , 2016.

[157] 谢勇琼, 高金姣. 自我效能、家庭关怀及应对方式对2型糖尿病足患者心理韧性水平的影响 [J]. 临床护理杂志, 2018, 17(4): 2-4.

[158] WHO.Global Accelerated Action for the Health of Adolescents (AA-HA!): guidance to support country implementation. Geneva; 2017.

[159] Bowes L, Jaffee SR. Biology, Genes, and Resilience: Toward a Multidisciplinary Approach [J]. Trauma, violence & abuse, 2013, 14(3): 195-208.

[160] Grad FP. The preamble of the constitution of the World Health Organization [J]. Bulletin of the World Health Organization, 2002, 80(12): 981-982.

[161] Olson DH, Russell CS, Sprenkle DH. Circumplex Model of Marital and Family Systems: Vl. Theoretical Update [J]. Family process, 1983, 22(1): 69-83.

[162] Sokol R, Fisher E. Peer Support for the Hardly Reached: A Systematic Review [J]. American journal of public health (1971), 2016, 106(7): e1-e8.

[163] Baum A. Stress, Intrusive Imagery, and Chronic Distress [J]. Health psychology, 1990, 9(6): 653-675.

[164] Beutler LE, Harwood TM, Kimpara S, et al. Coping style [J]. Journal of clinical psychology, 2011, 67(2): 176-183.

[165] Faul F, Erdfelder E, Lang A-G, et al. GPower 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences [J]. Behavior research methods, 2007, 39(2): 175-191.

[166] Beaton DE, Bombardier C, Guillemin F, et al. Guidelines for the process of cross-cultural adaptation of self-report measures [J]. Spine, 2000, 25(24): 3186-3191.

[167] Iannotti RJ, Nansel TR, Schneider S, et al. Assessing Regimen Adherence of Adolescents With Type 1 Diabetes [J]. Diabetes care, 2006, 29(10): 2263-2267.

[168] Zhu J, Zhu J, Xu J, et al. Cross-cultural adaption and psychometric properties of the Chinese version of the Diabetes Behavior Rating Scale: a pilot study [J]. Science China Life Sciences, 2018, 61(3): 310-317.

[169] Mcguire BE, Morrison TG, Hermanns N, et al. Short-form measures of diabetes-related emotional distress: the Problem Areas in Diabetes Scale (PAID)-5 and PAID-1 [J]. Diabetologia, 2010, 53(1): 66-69.

[170] Nicolucci A, Kovacs Burns K, Holt RIG, et al. Diabetes Attitudes, Wishes and Needs second study (DAWN2?): Cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes [J]. Diabetic Medicine: Journal of Diabetes UK, 2013, 30(7): 767-777.

[171] Ishii H, Yamamoto T, Ohashi Y. Development of insulin therapy related quality of life measure (ITR-QOL) [J]. Tonyōbyō, 2001, 44(1): 9-15.

[172] 刘维维, 赵秋利. 接受胰岛素治疗患者的生活质量量表的信效度研究 [J].中华护理杂志, 2009, 44(9): 849-851.

[173] 新版基本公共卫生服务“菜单”公布 [J]. 中国卫生人才, 2017, 5: 4.

[174] 陈声林, 支涤静, 沈水仙, 等. 上海儿童1型糖尿病的经济负担 [J]. 中国慢性病预防与控制, 2001, 9(1): 17-28.

[175] 徐汉辉. 家庭成员共同决定--儒家家庭本位思想在临床决定中的体现, 医学与哲学杂志社第七届建构中国生命伦理学研讨会论文集, 2013:67-72.

[176] Castens?e‐Seidenfaden P, Teilmann G, Kensing F, et al. Isolated thoughts and feelings and unsolved concerns: adolescents’ and parents’ perspectives on living with type 1 diabetes – a qualitative study using visual storytelling [J]. Journal of clinical nursing, 2017, 26(19-20): 3018-3030.

[177] Main A, Wiebe DJ, Croom AR, et al. Associations of parent-adolescent relationship quality with type 1 diabetes management and depressive symptoms in Latino and Caucasian youth [J]. Journal of pediatric psychology, 2014, 39(10): 1104-1114.

[178] 凌萍, 章燕, 骆斯慧, 等. 青少年儿童1型糖尿病患者血糖达标相关因素分析 [J]. 中华医学杂志, 2018, 98(46): 3762-3766.

[179] Joseph JJ, Golden SH. Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus: Role of cortisol in stress, depression, and diabetes [J]. Annals of the New York Academy of Sciences, 2017, 1391(1): 20-34.

[180] Spencer-Segal JL, Akil H. Glucocorticoids and resilience [J]. Hormones and behavior, 2019, 111: 131-134.

[181] Ruiz-Robledillo N, De Andrés-García S, Pérez-Blasco J, et al. Highly resilient coping entails better perceived health, high social support and low morning cortisol levels in parents of children with autism spectrum disorder [J]. Research in developmental disabilities, 2014, 35(3): 686-695.

[182] Joseph DN, Whirledge S. Stress and the HPA axis: Balancing homeostasis and fertility [J]. International journal of molecular sciences, 2017, 18(10): 2224.

[183] Maniam J, Antoniadis C, Morris MJ. Early-life stress, HPA axis adaptation, and mechanisms contributing to later health outcomes [J]. Frontiers in endocrinology, 2014, 5: 73.

[184] Faye C, Mcgowan JC, Denny CA, et al. Neurobiological Mechanisms of Stress Resilience and Implications for the Aged Population [J]. Current neuropharmacology, 2018, 16(3): 234-270.

[185] Santos FRM, Sigulem D, Areco KCN, et al. Hope matters to the glycemic control of adolescents and young adults with type 1 diabetes [J]. Journal of health psychology, 2015, 20(5): 681-689.

[186] Kubzansky LD, Sparrow D, Vokonas P, et al. Is the glass half empty or half full? A prospective study of optimism and coronary heart disease in the normative aging study [J]. Psychosomatic medicine, 2001, 63(6): 910-916.

[187] Scheier MF, Matthews KA, Owens JF, et al. Optimism and rehospitalization after coronary artery bypass graft surgery [J]. Archives of internal medicine, 1999, 159(8): 829-835.

[188] Giltay EJ, Kamphuis MH, Kalmijn S, et al. Dispositional optimism and the risk of cardiovascular death: The Zutphen Elderly Study [J]. Archives of internal medicine (1960), 2006, 166(4): 431-436.

[189] Springfield S, Qin F, Hedlin H, et al. Resilience and CVD-protective Health Behaviors in Older Women: Examining Racial and Ethnic Differences in a Cross-Sectional Analysis of the Women's Health Initiative [J]. Nutrients, 2020, 12(7): 2107.

[190] Perna L, Perna L, Mielck A, et al. Socioeconomic position, resilience, and health behaviour among elderly people [J]. International journal of public health, 2012, 57(2): 341-349.

[191] Noghan N, Akaberi A, Pournamdarian S, et al. Resilience and therapeutic regimen compliance in patients undergoing hemodialysis in hospitals of Hamedan, Iran [J]. Electronic physician, 2018, 10(5): 6853-6858.

[192] Yao J, Wang H, Yin X, et al. The association between self-efficacy and self-management behaviors among Chinese patients with type 2 diabetes [J]. PloS one, 2019, 14(11): e0224869.

[193] Gonzalez JS, Tanenbaum ML, Commissariat PV. Psychosocial factors in medication adherence and diabetes self-management: Implications for research and practice [J]. Am Psychol, 2016, 71(7): 539-551.

[194] Rivera-Hernandez M. Depression, self-esteem, diabetes care and self-care behaviors among middle-aged and older Mexicans [J]. Diabetes research and clinical practice, 2014, 105(1): 70-78.

[195] Weissberg‐Benchell J, Antisdel‐Lomaglio J. Diabetes‐specific emotional distress among adolescents: feasibility, reliability, and validity of the problem areas in diabetes‐teen version [J]. Pediatric diabetes, 2011, 12(4pt1): 341-344.

[196] Esbitt SA, Tanenbaum ML, Gonzalez JS. Disentangling Clinical Depression from Diabetes-Specific Distress: Making Sense of the Mess We’ve Made [M]. London; Springer London. 2012: 27-46.

[197] Fisher L, Gonzalez JS, Polonsky WH. The confusing tale of depression and distress in patients with diabetes: a call for greater clarity and precision [J]. Diabetic medicine, 2014, 31(7): 764-772.

[198] Hagger V, Hendrieckx C, Sturt J, et al. Diabetes Distress Among Adolescents with Type 1 Diabetes: a Systematic Review [J]. Curr Diab Rep, 2016, 16(1): 9.

[199] 张红梅, 傅荣, 张宁. 青少年1型糖尿病患者糖尿病相关心理痛苦的研究进展 [J]. 中华现代护理杂志, 2020, 26(8): 1115-1120.

[200] Wang Y, Chen X, Gong J, et al. Relationships Between Stress, Negative Emotions, Resilience, and Smoking: Testing a Moderated Mediation Model [J]. Substance use & misuse, 2016, 51(4): 427-438.

[201] Wang Y, Chen X. Stress and alcohol use in rural Chinese residents: A moderated mediation model examining the roles of resilience and negative emotions [J]. Drug and alcohol dependence, 2015, 155: 76-82.

[202] Gloria CT, Steinhardt MA. Relationships Among Positive Emotions, Coping, Resilience and Mental Health [J]. Stress and health, 2016, 32(2): 145-156.

[203] Tuohy E, Rawdon C, Gallagher P, et al. Children and young people's experiences and perceptions of self-management of type 1 diabetes: A qualitative meta-synthesis [J]. Health psychology open, 2019, 6(2): 2055102919877105.

[204] Whittemore R, Jaser SS, Jeon S, et al. An Internet Coping Skills Training Program for Youth With Type 1 Diabetes: Six-Month Outcomes [J]. Nursing research, 2012, 61(6): 395-404.

[205] Guo J, Whittemore R, Grey M, et al. Diabetes self‐management, depressive symptoms, quality of life and metabolic control in youth with type 1 diabetes in China [J]. Journal of Clinical Nursing, 2013, 22(1-2): 69-79.

[206] Cafero?lu Z, ?nan? N, Hatipo?lu N, et al. Health-Related Quality of Life and Metabolic Control in Children and Adolescents with Type 1 Diabetes Mellitus [J]. Journal of clinical research in pediatric endocrinology, 2016, 8(1): 67-73.

[207] Nieuwesteeg A, Pouwer F, Van Der Kamp R, et al. Quality of life of children with type 1 diabetes: a systematic review [J]. Current diabetes reviews, 2012, 8(6): 434-443.

[208] Vanstone M, Rewegan A, Brundisini F, et al. Patient perspectives on quality of life with uncontrolled type 1 diabetes mellitus: A systematic review and qualitative meta-synthesis [J]. Ontario health technology assessment series, 2015, 15(17): 1-29.

[209] Simón-Saiz MJ, Fuentes-Chacón RM, Garrido-Abejar M, et al. Influence of resilience on health-related quality of life in adolescents [J]. Enfermería clínica, 2018, 28(5): 283-291.

[210] Nishio I, Chujo M. Self-stigma of patients with type 1 diabetes and their coping strategies [J]. Yonago acta medica, 2017, 60(3): 167-173.

[211] Kalomo EN, Jun JS, Lee K, et al. HIV stigma, resilience and depressive symptoms among older adults living with HIV in rural Namibia [J]. African journal of AIDS research: AJAR, 2020, 19(3): 198-205.

[212] Kwon T. Social stigma, ego-resilience, and depressive symptoms in adolescent school dropouts [J]. Journal of adolescence, 2020, 85: 153-163.

[213] Self-stigma, resilience, perceived quality of social relationships, and psychological distress among Filipina domestic helpers in Hong Kong: A mediation model [J]. Stigma and health, 2020, online ahead of print.

[214] Ma X, Wang Y, Hu H, et al. The impact of resilience on prenatal anxiety and depression among pregnant women in Shanghai [J]. Journal of affective disorders, 2019, 250: 57-64.

[215] Kuo C, Mathews C, Giovenco D, et al. Acceptability, Feasibility, and Preliminary Efficacy of a Resilience-Oriented Family Intervention to Prevent Adolescent HIV and Depression: A Pilot Randomized Controlled Trial [J]. AIDS education and prevention, 2020, 32(1): 67.

[216] Nishio I, Chujo M. Qualitative analysis of the resilience of adult Japanese patients with type 1 diabetes [J]. Yonago acta medica, 2016, 59(3): 196-203.

[217] Al-Khaledi M, Al-Dousari H, Al-Dhufairi S, et al. Diabetes Self-Management: A Key to Better Health-Related Quality of Life in Patients with Diabetes [J]. Medical principles and practice, 2018, 27(4): 323-331.

[218] Cunningham AT, Crittendon DR, White N, et al. The effect of diabetes self-management education on HbA1c and quality of life in African-Americans: A systematic review and meta-analysis [J]. BMC health services research, 2018, 18(1): 367.

[219] Kline P. The handbook of psychological testing [M]. London;New York: Routledge, 1993.

[220] 易丹辉, 李静萍. 结构方程模型及其应用 [M]. 北京: 北京大学出版社, 2019.

[221] Olson DH. Circumplex Model of Marital and Family Systems [J]. Journal of family therapy, 2000, 22(2): 144-167.

[222] 沈其杰, 费立鹏. “家庭亲密度和适应性量表”和“家庭环境量表”的初步评价 [J]. 中国心理卫生杂志, 1991, 5(5): 198-202.

[223] Pihlaskari AK, Wiebe DJ, Troxel NR, et al. Perceived Peer Support and Diabetes Management From Adolescence Into Early Emerging Adulthood [J]. Health psychology, 2018, 37(11): 1055-1058.

[224] Delamater AM, Pati?o‐Fernández AM, Smith KE, et al. Measurement of diabetes stress in older children and adolescents with type 1 diabetes mellitus [J]. Pediatric diabetes, 2013, 14(1): 50-56.

[225] 解亚宁. 简易应付方式量表信度和效度的初步研究 [J]. 中国临床心理学杂志, 1998, 006(2): 114-115.

[226] 方菁, 王雅婷, 肖水源, 等. 简易应对方式问卷在青少年中的信效度检验 [J]. 中国临床心理学杂志, 2018, 26(5): 905-909.

[227] Becker J-M, Klein K, Wetzels M. Hierarchical Latent Variable Models in PLS-SEM: Guidelines for Using Reflective-Formative Type Models [J]. Long range planning, 2012, 45(5-6): 359-394.

[228] Kleinbaum DG. Applied regression analysis and other multivariable methods [M]. 3rd ed. Pacific Grove: Duxbury Press, 1998.

[229] 吴明隆. 问卷统计分析实务: SPSS操作与应用 [M]. 重庆: 重庆大学出版社, 2010.

[230] Guo J, Yang J, Wiley J, et al. Perceived stress and self‐efficacy are associated with diabetes self‐management among adolescents with type 1 diabetes: A moderated mediation analysis [J]. Journal of advanced nursing, 2019, 75(12): 3544-3553.

[231] Doe E. An analysis of the relationships between peer support and diabetes outcomes in adolescents with type 1 diabetes [J]. Journal of health psychology, 2018, 23(10): 1356-1366.

[232] Singh R, Mahato S, Singh B, et al. Resilience In Nepalese Adolescents: Socio-Demographic Factors Associated With Low Resilience [J]. Journal of multidisciplinary healthcare, 2019, 12: 893-902.

[233] Lohan A, Morawska A, Mitchell A. A systematic review of parenting interventions for parents of children with type 1 diabetes [J]. Child : care, health & development, 2015, 41(6): 803-817.

[234] Vesco AT, Jedraszko AM, Garza KP, et al. Continuous Glucose Monitoring Associated With Less Diabetes-Specific Emotional Distress and Lower A1c Among Adolescents With Type 1 Diabetes [J]. Journal of diabetes science and technology, 2018, 12(4): 792-799.

[235] Karges B, Schwandt A, Heidtmann B, et al. Association of Insulin Pump Therapy vs Insulin Injection Therapy With Severe Hypoglycemia, Ketoacidosis, and Glycemic Control Among Children, Adolescents, and Young Adults With Type 1 Diabetes [J]. JAMA, 2017, 318(14): 1358-1366.

[236] Li X, Wu Z, Liu Y, et al. Resilience and Associated Factors among Mainland Chinese Women Newly Diagnosed with Breast Cancer [J]. PloS one, 2016, 11(12): e0167976.

[237] Ahern NR, Ark P, Byers J. Resilience and coping strategies in adolescents [J]. Paediatric nursing, 2008, 20(10): 32-36.

[238] Jaser SS, White LE. Coping and resilience in adolescents with type 1 diabetes: Coping and resilience in adolescents with T1D [J]. Child : care, health & development, 2011, 37(3): 335-342.

[239] Folkman S, Lazarus RS. If It Changes It Must Be a Process: Study of Emotion and Coping During Three Stages of a College Examination [J]. Journal of personality and social psychology, 1985, 48(1): 150-170.

[240] Folkman S, Lazarus RS. Coping as a Mediator of Emotion [J]. Journal of personality and social psychology, 1988, 54(3): 466-475.

[241] Guo X. Coping as a Mediator Between Parental Attachment and Resilience: An Examination of Differential Effects Between Chinese Adolescents From Single Parent Families Versus Those From Intact Families [J]. Psychological reports, 2019, 122(2): 506-524.

[242] Balmer GM, Pooley JA, Cohen L. Psychological resilience of Western Australian police officers: relationship between resilience, coping style, psychological functioning and demographics [J]. Police practice & research, 2014, 15(4): 270-282.

[243] Thompson G, Mcbride RB, Hosford CC, et al. Resilience Among Medical Students: The Role of Coping Style and Social Support [J]. Teaching and learning in medicine, 2016, 28(2): 174-182.

[244] 史梦薇, 赵守盈. 儒家思想与压力应对：应激研究的本土心理学视角 [J]. 南京师大学报社会科学版, 2014, 2: 117-122.

[245] Han J, Liu J-E, Xiao Q. Coping strategies of children treated for leukemia in China [J]. European journal of oncology nursing : the official journal of European Oncology Nursing Society, 2017, 30: 43-47.

[246] Berlin KS, Hains AA, Kamody RC, et al. Differentiating peer and friend social information-processing effects on stress and glycemic control among youth with type 1 diabetes [J]. Journal of pediatric psychology, 2015, 40(5): 492-499.

[247] Daniel TLS, Rachel CFS, Merrick J. Positive youth development: Social connectedness, psychosocial competencies, resilience and recognition for positive behavior [J]. Journal of alternative medicine research, 2013, 5(1): 3.

[248] Hains AA, Berlin KS, Hobart Davies W, et al. Attributions of Adolescents with Type 1 Diabetes Related to Performing Diabetes Care around Friends and Peers: The Moderating Role of Friend Support [J]. Journal of pediatric psychology, 2007, 32(5): 561-570.

[249] Lan X, Wang W. Direct and interactive effects of peer support and resilience on psychosocial adjustment in emerging adults with early left-behind experiences [J]. Psychology research and behavior management, 2019, 12: 277-288.

[250] Agarwal B, Brooks SK, Greenberg N. The Role of Peer Support in Managing Occupational Stress: A Qualitative Study of the Sustaining Resilience at Work Intervention [J]. Workplace health & safety, 2020, 68(2): 57-64.

[251] Palladino DK, Helgeson VS. Friends or Foes? A Review of Peer Influence on Self-Care and Glycemic Control in Adolescents With Type 1 Diabetes [J]. Journal of pediatric psychology, 2012, 37(5): 591-603.

[252] Lehmkuhl HD, Merlo LJ, Devine K, et al. Perceptions of type 1 diabetes among affected youth and their peers [J]. Journal of clinical psychology in medical settings, 2009, 16(3): 209-215.

[253] Williams LB, Laffel LMB, Hood KK. Diabetes‐specific family conflict and psychological distress in paediatric Type 1 diabetes [J]. Diabetic medicine, 2009, 26(9): 908-914.

[254] Dempster KW, Liu A, Nansel TR. Depression and parenting in youth with type 1 diabetes: Are general and diabetes-specific parenting behaviors associated with depressive symptoms over a 2-year period? [J]. Journal of behavioral medicine, 2019, 42(5): 842-850.

[255] Rohan JM, Huang B, Pendley JS, et al. Predicting Health Resilience in Pediatric Type 1 Diabetes: A Test of the Resilience Model Framework [J]. J Pediatr Psychol, 2015, 40(9): 956-967.

[256] Faulkner MS, Chang LI. Family influence on self-care, quality of life, and metabolic control in school-age children and adolescents with type 1 diabetes [J]. J Pediatr Nurs, 2007, 22(1): 59-68.

[257] Walsh F. Family resilience: a framework for clinical practice [J]. Fam Process, 2003, 42(1): 1-18.

[258] Leipold B, Greve W. Resilience: A Conceptual Bridge Between Coping and Development [J]. European psychologist, 2009, 14(1): 40-50.

[259] Bowlby J. The making and breaking of affectional bonds. II. Some principles of psychotherapy. The fiftieth Maudsley Lecture [J]. British journal of psychiatry, 1977, 130(5): 421-431.

[260] Brenning K, Brenning K, Soenens B, et al. The Role of Parenting and Mother-Adolescent Attachment in the Intergenerational Similarity of Internalizing Symptoms [J]. Journal of youth and adolescence, 2012, 41(6): 802-816.

[261] Vaid E, Lansing AH, Stanger C. Problems With Self-Regulation, Family Conflict, and Glycemic Control in Adolescents Experiencing Challenges With Managing Type 1 Diabetes [J]. Journal of pediatric psychology, 2018, 43(5): 525-533.

[262] Maliszewski G, Patton SR, Midyett LK, et al. The Interactive Effect of Diabetes Family Conflict and Depression on Insulin Bolusing Behaviors for Youth [J]. Journal of diabetes science and technology, 2017, 11(3): 493-498.

[263] Benner P. Quality of life: a phenomenological perspective on explanation, prediction, and understanding in nursing science [J]. Advances in nursing science, 1985, 8(1): 1-14.

[264] 葛均波, 徐永健, 王辰. 内科学 [M]. 第9版. 北京: 人民卫生出版社, 2018.

[265] Smith FJ, Taylor KMG, Newbould J, et al. Medicines for chronic illness at school: experiences and concerns of young people and their parents [J]. Journal of clinical pharmacy and therapeutics, 2008, 33(5): 537-544.

[266] Werner EE. Risk, resilience, and recovery: Perspectives from the Kauai Longitudinal Study [J]. Development and psychopathology, 1993, 5(4): 503-515.

[267] Rutter M. Resilience in the face of adversity. Protective factors and resistance to psychiatric disorder [J]. The British journal of psychiatry : the journal of mental science, 1985, 147: 598-611.

[268] Resilience for Today: Gaining Strength from Adversity [M]. Portland: Ringgold, 2004.

[269] Lockwood P, Shaughnessy SC, Fortune JL, et al. Social Comparisons in Novel Situations: Finding Inspiration During Life Transitions [J]. Personality & social psychology bulletin, 2012, 38(8): 985-996.

[270] 吴子敬. 乳腺癌患者心理韧性模型构建的研究 [D]. 中国医科大学, 2017.

[271] Ellis SE, Speroff T, Dittus RS, et al. Diabetes patient education: a meta-analysis and meta-regression [J]. Patient education and counseling, 2004, 52(1): 97-105.

[272] Joormann J, Stanton CH. Examining emotion regulation in depression: A review and future directions [J]. Behaviour research and therapy, 2016, 86: 35-49.

[273] Fisher L, Hessler D, Polonsky W, et al. Toward effective interventions to reduce diabetes distress among adults with type 1 diabetes: Enhancing?Emotion regulation and cognitive skills [J]. Patient education and counseling, 2019, 102(8): 1499-1505.

[274] Dagan E, Dubovi I, Levy M, et al. Adherence to diabetes care: Knowledge of biochemical processes has a high impact on glycaemic control among adolescents with type 1 diabetes [J]. Journal of advanced nursing, 2019, 75(11): 2701-2709.

[275] Sanders T, Elliott J, Norman P, et al. Disruptive illness contexts and liminality in the accounts of young people with type 1 diabetes [J]. Sociology of health & illness, 2019, 41(7): 1289-1304.

[276] Browne JL, Ventura AD, Mosely K, et al. Measuring Type 1 diabetes stigma: development and validation of the Type 1 Diabetes Stigma Assessment Scale (DSAS‐1) [J]. Diabetic medicine, 2017, 34(12): 1773-1782.

[277] Lam PK, Naar-King S, Wright K. Social support and disclosure as predictors of mental health in HIV-positive youth [J]. AIDS patient care and STDs, 2007, 21(1): 20-29.

[278] Charmaz K. Stories and Silences: Disclosures and Self in Chronic Illness [J]. Qualitative inquiry, 2002, 8(3): 302-328.

[279] Kalichman SC, Dimarco M, Austin J, et al. Stress, Social Support, and HIV-Status Disclosure to Family and Friends Among HIV-Positive Men and Women [J]. Journal of behavioral medicine, 2003, 26(4): 315-332.

[280] Werner CM, Altman I, Brown BB. A Transactional Approach to Interpersonal Relations: Physical Environment, Social Context and Temporal Qualities [J]. Journal of social and personal relationships, 1992, 9(2): 297-323.

[281] Pihlaskari AK, Anderson BJ, Eshtehardi SS, et al. Diabetes disclosure strategies in adolescents and young adult with type 1 diabetes [J]. Patient education and counseling, 2020, 103(1): 208-213.

[282] Dugan AB. Interpersonal Aspects of Nursing [J]. The Journal of nursing administration, 1973, 3(1): 14-15.

[283] Affleck G, Tennen H. Construing benefits from adversity: adaptational significance and dispositional underpinnings [J]. Journal of personality, 1996, 64(4): 899-922.

[284] Fergus S, Zimmerman MA. Adolescent resilience: a framework for understanding healthy development in the face of risk [J]. Annual review of public health, 2005, 26: 399-419.

[285] Buckingham A, Richardson EJ. The Relationship Between Psychological Resilience and Pain Threshold and Tolerance: Optimism and Grit as Moderators [J]. 2020, online ahead of print.

[286] 江笑笑, 李惠萍, 张婷等. 掌控感和自我效能感在乳腺癌患者乐观与心理韧性间的链式中介作用 [J]. 中华行为医学与脑科学杂志, 2018, 27(3): 256-260.

[287] Türk-Kurt?a T, Kocatürk M. The Role of Childhood Traumas, Emotional Self-Efficacy and Internal-External Locus of Control in Predicting Psychological Resilience [J]. International journal of education and literacy studies, 2020, 8(3): 105-115.

[288] Rajan AM, Srikrishna G, Romate J. Resilience and Locus of Control of Parents Having a Child with Intellectual Disability [J]. Journal of developmental and physical disabilities, 2018, 30(3): 297-306.

[289] Kong LN, Hu P, Yang L, et al. The effectiveness of peer support on self‐efficacy and quality of life in adults with type 2 diabetes: A systematic review and meta‐analysis [J]. Journal of advanced nursing, 2019, 75(4): 711-722.

[290] Acevedo‐Ibarra JN, Juárez‐García DM, Espinoza‐Velazco A, et al. Cognitive Behavioral Stress Management intervention in Mexican colorectal cancer patients: Pilot study [J]. Psycho-oncology (Chichester, England), 2019, 28(7): 1445-1452.

[291] Zimmermann FF, Burrell B, Jordan J. Patients' experiences of a mindfulness intervention for adults with advanced cancer: a qualitative analysis [J]. Supportive care in cancer, 2020, 28(10): 4911-4921.

[292] Ungar M, Theron L. Resilience and mental health: how multisystemic processes contribute to positive outcomes [J]. The Lancet Psychiatry, 2020, 7(5): 441-448.

[293] Rothbaum F, Rosen K, Ujiie T, et al. Family systems theory, attachment theory, and culture [J]. Fam Process, 2002, 41(3): 328-350.

[294] Missotten LC, Missotten LC, Luyckx K, et al. Family Climate of Adolescents with and Without Type 1 Diabetes: Longitudinal Associations with Psychosocial Adaptation [J]. Journal of child and family studies, 2013, 22(3): 344-354.

[295] Anderson B, Ho J, Brackett J, et al. Parental involvement in diabetes management tasks: Relationships to blood glucose monitoring adherence and metabolic control in young adolescents with insulin-dependent diabetes mellitus [J]. The Journal of pediatrics, 1997, 130(2): 257-265.

[296] Pelicand J, Charlier D, Maes M, et al. Metabolic control in adolescents with type 1 diabetes: Looking at the role of perceived consistent parenting support of self-care [J]. Therapeutic patient education, 2018, 10(1): 10204.

[297] Reddy M, Rilstone S, Cooper P, et al. Type 1 diabetes in adults: supporting self management [J]. BMJ, 2016, 352: i998.

[298] Svedbo EM, Leksell J, Johansson U,?et al. What is important for you? A qualitative interview study of living with diabetes and experiences of diabetes care to establish a basis for a tailored Patient-Reported Outcome Measure for the Swedish National Diabetes Register [J]. 2016, 6(3): e010249.

[299] Phillips SP, Reipas K, Zelek B. Stresses, Strengths and Resilience in Adolescents: A Qualitative Study [J]. The Journal of primary prevention, 2019, 40(6): 631-642.

[300] Goffman E. Stigma: notes on the management of spoiled identity [M]. Englewood Cliffs: Prentice-Hall, 1963.

[301] Haas L, Maryniuk M, Beck J, et al. National Standards for Diabetes Self-Management Education and Support [J]. Diabetes care, 2013, 36(Suppl 1): S100-S108.

[302] Phelan H, Lange K, Cengiz E, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes education in children and adolescents [J]. Pediatric diabetes, 2018, 19: 75-83.

[303] Ungar M. Resilience, Trauma, Context, and Culture [M]. Los Angeles: SAGE Publications, 2013: 255-266.

[304] Beck J, Greenwood DA, Blanton L, et al. 2017 National Standards for Diabetes Self-Management Education and Support [J]. The Diabetes educator, 2017, 43(5): 449-464.

[305] Department of Health. National Service Framework for Diabetes Standards. London: Department of Health, 2001.

[306] Price KJ, Knowles JA, Fox M, et al. Effectiveness of the Kids in Control of Food (KICk–OFF) structured education course for 11–16?year olds with Type?1 diabetes [J]. Diabetic medicine, 2016, 33(2): 192-203.

[307] Coates V, Chaney D, Bunting B, et al. Evaluation of the Effectiveness of a Structured Diabetes Education Programme (CHOICE) on Clinical Outcomes for Adolescents with Type 1 Diabetes: A Randomised Controlled Trial[J]. Journal of diabetes & metabolism, 2013, 4(6): 1000280.

[308] Christie D, Thompson R, Sawtell M, et al. Structured, intensive education maximising engagement, motivation and long-term change for children and young people with diabetes: a cluster randomised controlled trial with integral process and economic evaluation - the CASCADE study [J]. Health technology assessment, 2014, 18(20): 1-202.

[309] Thabane L, Ma J, Chu R, et al. A tutorial on pilot studies: The what, why and how [J]. BMC medical research methodology, 2010, 10(1): 1.

[310] Kovacs AH, Bandyopadhyay M, Grace SL, et al. Adult Congenital Heart Disease-Coping And REsilience (ACHD-CARE): Rationale and methodology of a pilot randomized controlled trial [J]. Contemporary clinical trials, 2015, 45(Pt B): 385-393.

[311] Hsieh H-F, Shannon SE. Three Approaches to Qualitative Content Analysis [J]. Qualitative health research, 2005, 15(9): 1277-1288.

[312] Henríquez-Tejo R, Cartes-Velásquez R. Psychosocial impact of type 1 diabetes mellitus in children, adolescents and their families. Literature review [J]. Revista Chilena de pediatría, 2018, 89(3): 391-398.

[313] Kongkaew C, Kongkaew C, Jampachaisri K, et al. Depression and adherence to treatment in diabetic children and adolescents: a systematic review and meta-analysis of observational studies [J]. European journal of pediatrics, 2014, 173(2): 203-212.

[314] Schmitt A, Reimer A, Kulzer B, et al. How to assess diabetes distress: comparison of the Problem Areas in Diabetes Scale (PAID) and the Diabetes Distress Scale (DDS) [J]. Diabetic medicine, 2016, 33(6): 835-843.

[315] Nguyen LA, Pouwer F, Winterdijk P, et al. Prevalence and course of mood and anxiety disorders, and correlates of symptom severity in adolescents with type 1 diabetes: Results from Diabetes LEAP [J]. Pediatric diabetes, 2020,online ahead of print.

[316] Far?i? N, Bara? I, Plu?ari? J, et al. Personality traits of core self-evaluation as predictors on clinical decision-making in nursing profession [J]. PloS one, 2020, 15(5): e0233435.

[317] Orchard F, Reynolds S. The combined influence of cognitions in adolescent depression: Biases of interpretation, self‐evaluation, and memory [J]. British journal of clinical psychology, 2018, 57(4): 420-435.

[318] Williams J, Stickley T. Empathy and nurse education [J]. Nurse education today, 2010, 30(8): 752-755.

[319] Lu Y, Pyatak EA, Peters AL, et al. Patient Perspectives on Peer Mentoring: Type 1 Diabetes Management in Adolescents and Young Adults [J]. The Diabetes educator, 2015, 41(1): 59-68.

[320] 李炳全. 中国传统文化中的逆境观探析 [J]. 阴山学刊（社会科学版）, 2014, 27(6): 12-17.

[321] Farmer RF, Chapman AL, American Psychological A. Behavioral interventions in cognitive behavior therapy: practical guidance for putting theory into action [M]. Second ed. Washington, DC: American Psychological Association, 2016.

[322] Charalampopoulos D, Hesketh KR, Amin R, et al. Psycho-educational interventions for children and young people with Type 1 Diabetes in the UK: How effective are they? A systematic review and meta-analysis [J]. PloS one, 2017, 12(6): e0179685.

[323] 刘叶灵, 李明子, 江华,等. 非胰岛素治疗2型糖尿病患者结构化治疗与教育课程开发的初步实践 [J]. 2016, 24(7): 638-644.

[324] Xie Y, Liu F, Huang F, et al. Establishment of a type 1 diabetes structured education programme suitable for Chinese patients: Type 1 diabetes education in lifestyle and self adjustment (TELSA) [J]. BMC endocrine disorders, 2020, 20(1): 37.

[325] Taggart L, Truesdale M, Carey ME, et al. Pilot feasibility study examining a structured self‐management diabetes education programme, DESMOND‐ID, targeting HbA1c in adults with intellectual disabilities [J]. Diabetic medicine, 2018, 35(1): 137-146.

[326] Nijhof SL, Vinkers CH, Van Geelen SM, et al. Healthy play, better coping: The importance of play for the development of children in health and disease [J]. Neuroscience and biobehavioral reviews, 2018, 95: 421-429.

[327] Schache KR, Hofman PL, Serlachius AS. A pilot randomized controlled trial of a gratitude intervention for adolescents with Type 1 diabetes [J]. 2020, 37(8): 1352-1356.

[328] Sawtell M, Jamieson L, Wiggins M, et al. Implementing a structured education program for children with diabetes: lessons learnt from an integrated process evaluation [J]. BMJ open diabetes research & care, 2015, 3(1): e000065.

[329] Silverman AH, Hains AA, Davies WH, et al. A Cognitive Behavioral Adherence Intervention for Adolescents with Type 1 Diabetes [J]. Journal of clinical psychology in medical settings, 2003, 10(2): 119-127.

[330] Paul LL. "Can-Do-Tude": An Online Intervention Using Principles of Motivational Interviewing and Tailored Diabetes Self-Management Education for Adolescents with Type 1 Diabetes [D]. ProQuest LLC, 2017.

[331] Gu Y, Gu Y, Hsu H-T, et al. A systematic survey on the diagnosis strategy and patient management of type 1 diabetes by Chinese physicians [J]. Science China Life Sciences, 2018, 61(3): 318-327.

[332] Holmes CS, Chen R, Mackey E, et al. Randomized clinical trial of clinic-integrated, low-intensity treatment to prevent deterioration of disease care in adolescents with type 1 diabetes [J]. Diabetes care, 2014, 37(6): 1535-1543.

[333] 唐云燕. 饮食指导卡片用于妊娠期糖尿病患者的效果观察 [J]. 中国卫生健康, 2012, 22(5): 1042-1043.

[334] Harris S, Miller A, Amiel S, et al. Characterization of Adults With Type 1 Diabetes Not Attending Self-Management Education Courses: The Barriers to Uptake of Type 1 Diabetes Education (BUD1E) Study [J]. Qualitative health research, 2019, 29(8): 1174-1185.

[335] Hadjiconstantinou M, Byrne J, Bodicoat DH, et al. Do Web-based interventions improve well-being in type 2 diabetes? A systematic review and meta-analysis [J]. Journal of medical Internet research, 2016, 18(10): e270.

[336] 黄小燕, 肖智智, 闵庆艳. 视频示范宣教在妇科恶性肿瘤患者双下肢主动锻炼中的应用 [J]. 护理实践与研究, 2020, 17(10): 88-89.

[337] 刘汉梅. 直肠癌保肛术后患者肠道症状自我管理影响因素及对策 [D]. 遵义医学院, 2018.

[338] Basarir H, Pollard D, Brennan A, et al. The Potential Value of Ongoing Support In Type-1 Diabetes Mellitus With Dafneplus: Exploratory Pre-Trial Cost-Effectiveness Analysis On Proposed Trial End-Point Target For 12-Month Hba1c Improvement [J]. Value in health, 2014, 17(7): A350.