A motivational approach to psychological predictors of adherence behaviors in adolescents with diabetes mellitus
Description
This study explored the correlates of adherence behaviors and metabolic control in groups of adolescents of different ethnic backgrounds with diabetes mellitus. The study used the motivational variables of attribution, self-efficacy, and value along with other predictors (including race, age, gender, socioeconomic status, number of adults involved in diabetic care, family structure, family disagreement about diabetic responsibilities, disease duration, number of hospitalizations, and parent and child knowledge of diabetes) and a multidimensional measurement of adherence. The minority group (N = 25) and the Caucasian group (N = 20) did not differ significantly in age, gender, or socioeconomic status. The minority group had a shorter disease duration and tended to have experienced more hospitalizations since diagnosis than the Caucasian group. The minority group consumed more fat and carbohydrates than the Caucasian group, less concentrated sweets than the Caucasian group, and tended to eat less often than the Caucasian group. Better metabolic control was best predicted by being a member of the Caucasian group and having a shorter disease duration (R$\sp2$ =.31). The minority group also a lower level of parental knowledge of diabetes and tended to have lower levels of child knowledge about diabetes, lower levels of self-efficacy for diabetes management, and used more effort attributions to explain successful outcomes. The use of effort attributions was associated with worse adherence to diet Implications for clinical practice are discussed, including cultural sensitivity training for medical staff and the development of educational programs that can accommodate various family structures. Future researchers need to replicate these findings with a larger sample size that can detect more subtle racial differences