Psychosocial factors and diabetes treatment adherence in children

Abstract

Diabetes-specific psychosocial and environmental variables were examined in relation to self-report adherence to diabetes treatment in a sample of 51 children and adolescents, ages 10-16, attending a diabetes summer camp. The following scales were administered in interview format: a self-report measure of adherence, The Self-efficacy for Diabetes Scale, The Barriers to Adherence Scale, and The Diabetes Family Behavior Checklist. The variables measured were related to adherence both individually and interactively. Specifically, the number of barriers and family nonsupport were negatively associated with adherence (p =.02, and p =.02), respectively, while family support was positively associated with adherence (p =.002). Significant interactions were found between family nonsupport and barriers (p =.02), family nonsupport and self-efficacy (p =.02), family support and self-efficacy (p =.01), family nonsupport and age (p =.002), and barriers and age (p =.003). The results indicate that adherence to diabetes treatment recommendations is complicated, with subjects reporting better adherence to insulin therapy and blood glucose monitoring than with either dietary or exercise recommendations. The findings also indicate that diabetes-specific psychosocial/environmental variables and age appear to be related to adherence and that multivariate analyses appear to be appropriate methods by which to delineate the complex interactions between these diabetes-specific variables themselves and with age in relation to adherence to diabetes treatment recommendations.