Adherence to Treatment in Youths with Insulin-Dependent Diabetes Mellitus

Thursday, 10 July 2008: 1:15 PM
Aida Cruz Mendes, PhD, RN , Health Sciences Research Unit: Nursing Domain, Coimbra Nursing School, Coimbra, Portugal
Cristiana Vazo, RN , Well being, health and illness, Health Sciences Research Unit: Nursing Domain, Coimbra, Portugal
Dora Pereira, RN , Well being, health and Illness, Health Sciences Research Unit: Nursing Domain, Coimbra, Portugal
Ins Santos, RN , Well being, health and Illness, Health Sciences Research Unit: Nursing Domain, Coimbra, Portugal

Learning Objective 1: acknowledge the importance of adherence to treatment;

Learning Objective 2: identify variables that influence adherence;

Poor adherence to therapeutic regimen is a prevalent problem of patients with chronic disorders and has a substantial impact on costs in the health care arena, on clinical outcomes, and on quality of life. Given the magnitude of the problem of poor adherence and the significance of its impact, there is considerable interest in identifying factors that can promote adherence. This study aims to analyze the influence of belonging to an association of youth diabetics, the knowledge and self-efficacy to the treatment adherence.

Method: Correlational descriptive study. An accidental, convenience sample was selected, constituted by 40 youths under treatment to diabetic illness. Adherence was assessed by EAT (Almeida e Matos, 2000), self-efficacy by EAED (Grossman et al, 1987) and knowledge by a questionnaire designed by the authors.

Results: Mean age was 14,68 years, 57,5% boys and 42,5% girls, 45% belong to the association of youth diabetics and 55% don't. No differences were found between groups in adherence and knowledge, but the youths that belong to the association have higher feelings of self-efficacy (p=0,004). Positive correlations, statistically very significant, were found between adherence and self-efficacy (r = 0,347; p = 0,028) and between adherence and knowledge (r = 0,510; p = 0,001).

Conclusion: Effective diabetes management requires adherence to a complex regimen to maintain quality of life and prevent complications. The relationship between adherence and psychosocial factors is complex. Social support, such as belonging to an association of youth diabetics did not mean better adherence, despite those youths have higher feelings of self-efficacy and the positive correlation found between these two variables. Our findings suggest that knowledge and self-efficacy are related to higher rates of adherence.

The limited investigations of predictors of adherence from a development perspective in paediatrics suggest the need for further study.