Assessing daily management in childhood diabetes

One hundred sixty-eight patients with childhood diabetes (6 to 19 years of age) and their parents participated in 24-hr recall interviews concerning daily diabetes management behavior. Each patient and parent was interviewed independently on three separate occasions. The information obtained was used to construct measures of 13 different adherence behaviors. Parent-patient agreement was good to excellent for most of the 13 behaviors. Agreement was influenced by the patient's age, with the most consistently high parent-child agreement found in the 10- to 15-year-old age group. Factor analysis of the 13 adherence behaviors resulted in a five-factor solution accounting for 70.6% of the variance. Adherence in childhood diabetes appears to be a complex construct, consisting of at least five different components unrelated to each other. Teenagers in this sample were less adherent than their younger counterparts on most of the adherence measures studied.