Predictors of treatment adherence in young children with type 1 diabetes

Abstract

Nurses can facilitate treatment adherence through provision of educational, practical and socio-emotional support. Nursing interventions should target blood glucose monitoring and dietary regimens in particular, and nurses should be sensitive to the various caretaking challenges presented to parents by different components of the diabetes regimen.

Type I Diabetes in Children and Adolescents

“…Moreover, the phase of the child's life and phase in the family's own life-cycle impacts disease management and glycemic control (Chisholm et al, 2007;Rolland, 1987). We recommend that health and mental health professionals provide support as needed to children and parents, providing education based on child and parent needs.…”

“…For example, Hema et al (2009) discovered that children and adolescents with diabetes reported daily stressors similar to youth without chronic illnesses; interestingly, they did not report significant diabetes-related stressors as being hassles. Consequently, health care professionals need to consider the social and emotional needs of children with diabetes to determine whether recommendations for stress management or referral for counseling is appropriate (Chisholm et al, 2007). Children with diabetes also can experience stress related to negative school experiences.…”

“…Type I diabetes affects approximately 1 in every 400 to 600 children (Centers for Disease Control and Prevention, 2003). Rates of Type I diabetes are increasing (Chisholm et al, 2007). This is concerning as this disease has long-term health care consequences including problems with circulation, vision, and cardiovascular issues (Frey et al, 2006).…”

“…Monitoring blood glucose levels has become an increasingly important self-management task for children who have diabetes (Bui et al, 2005). Psychosocial factors, such as attitudes about one's diabetes, support from others, and stress, have been related to HbA1c levels or other factors serving as proxy variables for diabetes management (Chisholm et al, 2007;Nabors et al, 2010). This chapter reviews the relationship between psychosocial factors, chiefly children's attitudes, support from others, stress, and diabetes management.…”

Adherence to Insulin Treatment in Children With Type I Diabetes Mellitus at a Hospital in Malaysia

“…Chang et al studied non-adherence behavior (mean of A1c=10.26%) but not the factors influencing adherence in Taiwanese children and adolescents with T1DM [5]. Young children with T1DM adhered better to insulin treatment with better maternal diabetes knowledge, shorter duration of disease, and younger age [6]. A review by Schwartz et al revealed that adolescents with T1DM between the age of 13 and 15 years, females with depression and eating disorders, and males with behavior and learning problems were at risk for non-adherence among pediatric patients with T1DM [4].…”