{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T20:21:47Z","timestamp":1773001307775,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":49,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72264037"],"award-info":[{"award-number":["72264037"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Diabetes"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetes distress is prevalent among youth with type 1 diabetes mellitus (T1DM) and can negatively impact their quality of life and metabolic control. Identifying modifiable factors to reduce this distress is crucial. This study investigates the interplay between diabetes distress, self\u2010management, and quality of life in school\u2010aged children with T1DM amidst the COVID\u201019 pandemic. Its primary objective is to identify modifiable factors that can assist these children as they navigate the challenges associated with transitioning into adolescence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional study with data from 341 Chinese school\u2010age children aged 8\u201312 was conducted. Data were collected through an online self\u2010report survey during the COVID\u201019 pandemic (June\u2013December 2022). The data included sociodemographic and clinical characteristics, diabetes distress, diabetes care activities and diabetes problem solving of diabetes self\u2010management and quality of life. Structural equation modeling assessed relationships and mediation effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All four domains of diabetes distress exhibited negative associations with quality of life (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.74 to \u22120.77,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.01). Care activities and problem\u2010solving related to diabetes self\u2010management mediated the associations of emotional burden and regimen\u2010related distress with quality of life (both\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Conversely, neither diabetes care activities nor diabetes problem\u2010solving mediated the relationship between physician\u2010related distress and quality of life.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings indicate that problem\u2010solving techniques related to diabetes self\u2010management might be more effective at alleviating various aspects of diabetes distress\u2014such as emotional burden, regimen\u2010related distress, and interpersonal distress\u2014compared to diabetes care activities. Interventions that teach structured problem\u2010solving strategies could be beneficial. Given the ongoing pandemic, these findings could also serve as useful guidance for developing support strategies for school\u2010age children with chronic conditions during future public health emergencies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/pedi\/2022750","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T06:30:38Z","timestamp":1771569038000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Mediating Effects of Diabetes Self\u2010Management on the Relationship Between Diabetes Distress and Quality of Life Among School\u2010Age Children With Type 1 Diabetes Mellitus During the COVID\u201019 Pandemic"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9579-7477","authenticated-orcid":false,"given":"Jiaxin","family":"Luo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4493-4633","authenticated-orcid":false,"given":"Qingting","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2058-3441","authenticated-orcid":false,"given":"Yuwen","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1419-2803","authenticated-orcid":false,"given":"Fang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1025-7785","authenticated-orcid":false,"given":"Jie","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3953-9065","authenticated-orcid":false,"given":"Ka Yan","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9434-0230","authenticated-orcid":false,"given":"Robin","family":"Whittemore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8304-9947","authenticated-orcid":false,"given":"Jia","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-S013"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2019.107842"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30024-2"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2010.05.001"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1555938"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.11852\/zgetbjzz2017-25-05-08"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1590\/1518-8345.2961.3210"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-015-0081-9"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.02.050"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2012.04299.x"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14565"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2015.11.001"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-85729-751-8_2"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.3.626"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15159"},{"key":"e_1_2_12_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.12641"},{"key":"e_1_2_12_17_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2002.02061.x"},{"key":"e_1_2_12_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13760"},{"key":"e_1_2_12_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/0193945913516546"},{"key":"e_1_2_12_20_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_2_12_21_2","doi-asserted-by":"publisher","DOI":"10.20982\/tqmp.03.2.p043"},{"key":"e_1_2_12_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-012-0339-8"},{"key":"e_1_2_12_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2017.09.017"},{"key":"e_1_2_12_24_2","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1008-9969.2010.17.003"},{"key":"e_1_2_12_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2012.06129.x"},{"key":"e_1_2_12_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/NNR.0b013e3181ac142a"},{"key":"e_1_2_12_27_2","unstructured":"XuY. The Relationships Among Family Resilience Self-Management and Quality of Life in Children and Adolescents With Diabetes Mellitus 2020 Qingdao University Master\u2019s Thesis Accessed December 16 2020. China Doctoral\/Master\u2019s Theses Full-text Database (CNKI)https:\/\/kns.cnki.net\/kcms2\/article\/abstract?v=YQFK0XGjx40hgE1yYu4GbHjEv-75qVOoYb4mT6W9MubEi_Udijz9890AdIpsZ6JquSSTUyE-NJ98AcTSqsIWoaefgcxcWk_oN9cU47esq6fKZzSK1YLo-EFR2wluXU_g31elTzeeIIo6XZw3zsRuuESbL-OgTAzoHfwtiRfVmb2In_lV2d935T_WUBjXrrYG&uniplatform=NZKPT&language=CHS."},{"key":"e_1_2_12_28_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-2707"},{"key":"e_1_2_12_29_2","doi-asserted-by":"publisher","DOI":"10.1080\/10705519909540118"},{"key":"e_1_2_12_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15742"},{"key":"e_1_2_12_31_2","doi-asserted-by":"publisher","DOI":"10.33588\/rn.7108.2020381"},{"key":"e_1_2_12_32_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1056967"},{"key":"e_1_2_12_33_2","doi-asserted-by":"publisher","DOI":"10.1177\/1074840720971584"},{"key":"e_1_2_12_34_2","doi-asserted-by":"publisher","DOI":"10.2217\/dmt.11.61"},{"key":"e_1_2_12_35_2","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2023-0282"},{"key":"e_1_2_12_36_2","doi-asserted-by":"publisher","DOI":"10.1177\/1742395311403636"},{"key":"e_1_2_12_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2021.104000"}],"container-title":["Pediatric Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/pedi\/2022750","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/pedi\/2022750","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/pedi\/2022750","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:57:38Z","timestamp":1772992658000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/pedi\/2022750"}},"subtitle":[],"editor":[{"given":"Kalyani","family":"Sen","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/pedi\/2022750"],"URL":"https:\/\/doi.org\/10.1155\/pedi\/2022750","archive":["Portico"],"relation":{},"ISSN":["1399-543X","1399-5448"],"issn-type":[{"value":"1399-543X","type":"print"},{"value":"1399-5448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2024-10-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"2022750"}}