Adherence Behaviors and Health Status in Childhood Diabetes
Defining adherence to the diabetes regimen is difficult for several reasons. First, there is the vast array of regimen behaviors required. Insulin injections must be given at regular times and appropriately timed in relationship to meals. Dietary proscriptions are numerous; small meals must be taken frequently and certain types of foods, those high in concentrated sweets and fats, are to be minimized. Regular exercise is considered beneficial as it improves insulin utilization and lowers blood glucose, but it must be carefully coordinated with food intake so as to avoid hypoglycemia. Since current treatment methods only approximate normal pancreatic function, wide swings in blood glucose can and do occur. For this reason, patients are encouraged to test their blood glucose two or more times a day. These data are then utilized by the physician and/or patient to make insulin dose, dietary, or other changes to the patient’ s daily regimen. Consequently, defining adherence in childhood diabetes means defining numerous regimen behaviors.
KeywordsBlood Glucose Insulin Dose Dietary Behavior Childhood Diabetes Adherence Measure
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- Barrett-Connor, E., & Orchard, T. (1985). Diabetes and heart disease. In National Diabetes Data Group (Eds.). Diabetes in America(pp. XVI: 1–41) (NIH Publication No. 85 –1468 ). Washington, D.C.: U.S. Department of Health and Human Services/Public Health Service.Google Scholar
- Brownlee-Duffeck, M. Peterson, L., Simonds, J.F., Goldstein, D., Kilo, C., & Hoette, S. (1987). The role of health beliefs in the regimen adherence and metabolic control of adolescents and adults with diabetes mellitus. Journal of Consulting and Clinical Psychology, 55, 139–144.PubMedCrossRefGoogle Scholar
- Freund, A., Johnson, S.B., Silverstein, J., & Thomas, J. (1989). Assessing daily management of childhood diabetes using 24-hr. recall interviews: Reliability and stability. Unpublished manuscript, University of Florida.Google Scholar
- Johnson, S.B., Freund, A., Silverstein, J., Hansen, C., & Malone, J., (1989). Adherence/health status relationships in childhood diabetes. Unpublished manuscript, University of Florida.Google Scholar
- Marquis, K.H., Ware, J.E., Jr., & Relies, D.A. (1979). Measures of diabetic patient knowledge, attitudes and behavior regarding self-care: Summary Report Atlanta, GA: Center for Disease Control (NTIS No. PB83-134528).Google Scholar
- Reynolds, L., Johnson, S.B., and Silverstein, J. (in press). Assessing daily diabetes management by 24-hr. recall interview: The validity of children’ s reports. Journal of Pediatric Psychology.Google Scholar
- Schade, D.S., Santiago, J.V., Skyler, J.S., & Rizza, R.A. (1983). Intensive insulin therapy. Amsterdam: Excerpta Medica.Google Scholar
- Spevack, M. Johnson, S.B., & Riley, W. (1988). The effect of diabetes summer camp on adherence behaviors and glycemic control. Presented at the Florida Conference on Child Health Psychiology, Gainesville, Florida.Google Scholar
- Travis, L.B., Brouhard, B.H., & Schreiner, B. (1987). Diabetes mellitus in children and adolescents. Philadelphia: W.B. Saunders Co.Google Scholar