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Published on: March 23, 2018
Illness representations predict adherence in adolescents and young adults with type 1 diabetes
Meghan E McGrady1, James L Peugh, Korey K Hood
1a Division of Behavioral Medicine and Clinical Psychology, Center for Adherence and Self-Management, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.
Objective:
Most adolescents and young adults (AYAs) with type 1 diabetes struggle with diabetes self-management and exhibit suboptimal glycemic control. This study examined two models of association between illness representations, a modifiable predictor of suboptimal outcomes, and adherence and glycemic control in AYAs with type 1 diabetes.
Design And Main Outcome Measures:
Ninety-nine AYAs (ages 15-20 years) completed measures of illness representations and adherence at two visits. Blood glucose monitoring frequency and haemoglobin A1c were obtained via chart review. Relationships were examined using structural equation modelling.
Results:
Illness representations accounted for a significant proportion of the variance in blood glucose monitoring frequency (ΔR2 = .23, p < .01) and adherence to emergency precautions at Time 1 (ΔR2 = .07, p = .03). Illness representations also accounted for significant variance in blood glucose monitoring frequency (ΔR2 = .08, p = .01), adherence to recommendations for insulin and food (ΔR2 = .08, p = .02) and exercise (ΔR2 = .10, p < .01), and adherence to emergency precautions (ΔR2)= .16, p < .01) at Time 2.
Conclusion:
Illness representations are salient predictors of adherence in this population. Interventions targeting adherence promotion and glycemic control in AYAs with type 1 diabetes may be enhanced by efforts to modify illness representations.
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