Adherence in Diabetes: Can We Define It and Can We Measure It?

McNabb, Wylie L.

doi:10.2337/diacare.20.2.215

Cited by 148 publications

(112 citation statements)

References 25 publications

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“…Because no universally accepted regimens incorporating all of these domains exist for the treatment of diabetes, assessment of selfcare behaviors is extremely challenging (3,4) and remains a critical problem for clinical care and research. Although clinicians and researchers require a simple, practical method of assessing self-care behaviors, there are few easy-to-use instruments with established psychometric properties (3). Most methods to assess self-care behaviors rely on patient memory, using time-intensive interviews of behavior recall over a specific time period, typically 24 h (5) or 1 week (6), or using surveys covering the previous week (7).…”

mentioning

confidence: 99%

Measuring Diabetes Self-Care

et al. 2005

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OBJECTIVE -To examine psychometric properties of the Self-Care Inventory-revised (SCI-R), a self-report measure of perceived adherence to diabetes self-care recommendations, among adults with diabetes.RESEARCH DESIGN AND METHODS -We used three data sets of adult type 1 and type 2 diabetic patients to examine psychometric properties of the SCI-R. Principal component and factor analyses examined whether a general factor or common factors were present. Associations with measures of theoretically related concepts were examined to assess SCI-R concurrent and convergent validity. Internal reliability coefficients were calculated. Responsiveness was assessed using paired t tests, effect size, and Guyatt's statistic for type 1 patients who completed psychoeducation.RESULTS -Principal component and factor analyses identified a general factor but no consistent common factors. Internal consistency of the SCI-R was ␣ ϭ 0.87. Correlation with a measure of frequency of diabetes self-care behaviors was r ϭ 0.63, providing evidence for SCI-R concurrent validity. The SCI-R correlated with diabetes-related distress (r ϭ Ϫ0.36), self-esteem (r ϭ 0.25), self-efficacy (r ϭ 0.47), depression (r ϭ Ϫ0.22), anxiety (r ϭ Ϫ0.24), and HbA 1c (r ϭ Ϫ0.37), supporting construct validity. Responsiveness analyses showed SCI-R scores improved with diabetes psychoeducation with a medium effect size of 0.62 and a Guyatt's statistic of 0.85.CONCLUSIONS -The SCI-R is a brief, psychometrically sound measure of perceptions of adherence to recommended diabetes self-care behaviors of adults with type 1 or type 2 diabetes. Diabetes Care 28:1346 -1352, 2005T o prevent serious morbidity and mortality, diabetes treatment requires dedication to demanding self-care behaviors in multiple domains, including food choices, physical activity, medications, glucose monitoring, and symptom management (1,2). Because no universally accepted regimens incorporating all of these domains exist for the treatment of diabetes, assessment of selfcare behaviors is extremely challenging (3,4) and remains a critical problem for clinical care and research. Although clinicians and researchers require a simple, practical method of assessing self-care behaviors, there are few easy-to-use instruments with established psychometric properties (3). Most methods to assess self-care behaviors rely on patient memory, using time-intensive interviews of behavior recall over a specific time period, typically 24 h (5) or 1 week (6), or using surveys covering the previous week (7). Another approach uses patients' reports of frequency of specific self-care behaviors (7), but such measures may not take into account differences in patients' prescriptions for diabetes care. The Self-Care Inventory (SCI) developed by La Greca and colleagues (8,9) is a self-report questionnaire assessing patients' perceptions of self-care behaviors. Self-care is defined as the daily regimen tasks that the individual performs to manage diabetes. The SCI, unlike measures that assess the frequency of self-care behaviors,...

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confidence: 99%

Measuring Diabetes Self-Care

et al. 2005

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“…Likewise, the level of self-care change between different situations and people may give different impressions about good selfcare. On the whole, adherence to self-care is considered quite a difficult variable to analyse, because there is no commonly accepted way to measure it (Kyngäs 1995, Furlong 1996, McNabb 1997. It is useful to explore adherence to diabetes self-care regimens simultaneously with metabolic control levels (Haynes et al 1998), because they are complementary.…”

Section: Self-reporting and Clinical Examinationsmentioning

confidence: 99%

“…The terms´compliance´and adherence´should be distinguished, because compliance means only strict observance of instructions, while adherence refers to more flexible self-care and control of situations. Adherence is a more suitable term than compliance to describe diabetes care (McNabb 1997), and it is therefore used in this study.…”

Section: Diabetes Self-carementioning

confidence: 99%

Communication and Community

Shepherd¹,

Rothenbuhler²

2000

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Associations have been found between diabetes status and periodontal diseases and dental caries. In addition to biological explanations, psychological features can be proposed to affect the relations between oral health and IDDM (=insulin-dependent diabetes mellitus). The aim of this study was to evaluate the psychological features characterizing oral hygiene practices, dental visiting and diabetes self-care. The research population consisted of 149 IDDM patients, and cross-sectional data were collected by a quantitative questionnaire, in clinical examinations and from patient records.There was a positive correlation between the sum scores for dental self-efficacy and diabetes self-efficacy and, correspondingly, between the dental and diabetes locus of control beliefs. High self-esteem was found to associate with good adherence to some specific health behaviors, such as tooth brushing, exercising and insulin adjustment. When Weiner´s attribution theory was used, there were similarities in the causal thinking in oral and diabetes view. All in all, especially the perception of self-efficacy was found to be a powerful feature characterizing health behavior. There were overlapping relations showing an association of high dental self-efficacy with good diabetes adherence, of high diabetes self-efficacy with frequent dental visiting, and of good metabolic control with high tooth brushing self-efficacy, frequent tooth brushing and low plaque level. On the basis of these results, enhancement of self-efficacy appears important.These results suggest that there might, indeed, be some common psychological features for both oral health behavior and diabetes self-care. These could partly explain the relations between diabetes status and periodontal diseases and dental caries. The results can be utilized in patientcentered health education by identifying and enhancing the psychological features that characterize health behavior and health status. The results emphasize the need for co-operation between dental and diabetes health care professionals in their daily practice.

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“…[1][2][3][4] However, only 25% of patients adhere to recommendations related to medicine, diet and exercise. 5 Accordingly the recommended approach to support patients to diabetes self-management has recently changed from a compliance-expecting approach in favour of an individualized, patient-centred approach. 6 Studies indicate that changes in usual patient-provider collaboration influence patients' ability to selfmanage, e.g., when health care professionals (HCP) use dialogue tools and go through communication skills training.…”

Section: Introductionmentioning

confidence: 99%

The effect of using interactive communication tools in adults with type-2 diabetes

et al. 2017

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The purpose of this study was to investigate whether glycaemic control and diabetes self-management could be improved in patients with type-2 diabetes following education using the EMMA dialogue tools facilitated by a health care professional. Glycosylated haemoglobin (HbA1c) and Summary of Diabetes Self Care Activities (SDSCA) scores were collected at baseline and three months after the intervention from 22 participating patients. Participants significantly improved self-reported foot care (P<0.001) and exercise (P<0.001) whereas no significant changes were found in HbA1c (P=0.606) blood sugar measurements (P=0.213), and diet (P=0.061). In conclusion, the dialogue tools had a positive effect by improving diabetes self-management regarding foot care and exercise. The purpose of this study was to investigate whether glycaemic control and diabetes self-management could be improved in patients with type-2 diabetes following education using the EMMA dialogue tools facilitated by a health care professional. Glycosylated haemoglobin (HbA1c) and Summary of Diabetes Self Care Activities (SDSCA) scores were collected at baseline and three months after the intervention from 22 participating patients. Participants significantly improved self-reported foot care (P<0.001) and exercise (P<0.001) whereas no significant changes were found in HbA1c (P=0.606) blood sugar measurements (P=0.213), and diet (P=0.061). In conclusion, the dialogue tools had a positive effect by improving diabetes self-management regarding foot care and exercise.

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Adherence in Diabetes: Can We Define It and Can We Measure It?

Cited by 148 publications

References 25 publications

Measuring Diabetes Self-Care

Measuring Diabetes Self-Care

Communication and Community

The effect of using interactive communication tools in adults with type-2 diabetes

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