Adherence to Diabetic Self-Care Activities in Adolescent and Factors Contributing to Their Management within Sakaka City in Saudi Arabia
Many evidence suggest that adherence to diabetes self-care regimens during adolescence is particularly poor. The Pressures and changes of normal adolescent development can conflict with the self- awareness, restraint and orderliness needed to manage living with a chronic disease. The aim of the study was to identify the level of the adherence to diabetic self-care activities in adolescent and factors contributing to their management within Sakaka City in Saudi Arabia. Descriptive cross sectional research design used in this study. The participants selected using purposeful convenient sampling from the outpatients at two regional hospitals at Sakaka City. The data collected using two questionnaires (1) a researcher-made questionnaire designed to collect participants' demographic data, clinical data and their level of knowledge. (2) Diabetes Self-Management Questionnaire used to evaluate the adherence of diabetic adolescent to the prescribed management regimen. Results of this study showed that 63.3% of participants were female with mean age 12.6 ± 4.86 years and most of them (94.4%) had previous diabetic family history. Also, the results showed that, participants' scored suboptimal mean in all domains regarding diabetic self-care control especially diet control and physical activity (6.5±1.1, 6.1±.74) respectively. In addition the findings illustrated that the most contributing factors which were significantly correlated with diabetes self-management scores were gender, duration of illness, mothers' level of knowledge, peers' support where p <0.05. Also, the frequency of hypo/ hyperglycemic has highly significant correlations with diabetes self-management mean scores where p < 0.01. This study concluded that the diabetes self-care management among studied adolescents were suboptimal level as reported by the participants and according to the scoring style of Diabetes Self-Management Questionnaire. as well as, this study suggested that educational it is necessary to provide diabetic adolescents with knowledge and information in all aspects of diabetes control especially dietary and physical activity control. Continuous evaluation of self-care management activities among adolescents using valid measures recommended.
Adherence, Adolescent, Type 1 Diabetes, Self-care, Management
[1]
Australian Institute of Health and Welfare: Diabetes Series 15: Prevalence of Type 1 diabetes in Australian children in 2008. Canberra: Australian Institute of Health and Welfare; (2011), http://www.aihw.gov.au/publication-detail/?id=10737419239.
[2]
Deshpande A, Harris-Hayes M, Schootman M: Epidemiology of diabetes and diabetes-related complications. Phys Ther 2008, 88:1254–1264.
[3]
International Diabetes Federation (2013), International Diabetes Federation 6th ed. Brussels (Belgium): IDF Diabetes Atlas. Available from: http://www.idf.org/diabetesatlas.
[4]
Al-Herbish, A. S, El-Mouzan, MI, Al-Salloum AA, Al-Qurachi MM, Al-Omar AA. Prevalence of type 1 diabetes mellitus in Saudi Arabian children and adolescents. Saudi Med J. 2008;29:1285–1288.
[5]
Valentine U. O, Paul D. I & Aihanuwa E,(2011), Patients’ Knowledge of Diabetes Mellitus in a Nigerian City, Trop J Pharm Res, October10(5): 637.
[6]
Mohamed A. Abdullah. (2005) Epidemiology of type 1diabetes Mellitus among Arab children Saudi Med J 2005; Vol. 26 (6): 911-917.
[7]
Northam E, Lin A, Finch S, Werther G, Cameron F: Psychosocial well-being and functional outcomes in youth with type 1 diabetes 12 years after disease onset. Diabetes Care 2010, 33:1430–1437.
[8]
Scaramuzza A, De Palma A, Mameli C, Spiri D, Santoro L, Zuccotti G: Adolescents with type 1 diabetes and risky behaviour. Acta Paediatr 2010, 99:1237–1241.
[9]
Hackworth NJ, Hamilton VE, Moore SM, Northam EA, Bucalo Z, Cameron FJ: Predictors of diabetes self-care, metabolic control, and mental health in youth with type 1 diabetes. Aust Psychol. 2013;48(5):360-368. Pediatr Diabetes.
[10]
World Health Organization (2016), WHO statistics about diabetes eastern mediterranean: WHO eastern mediterranean region. World Health Day, campaign Plan of action for the prevention and control of noncommunicable diseases in the Eastern Mediterranean Region.
[11]
Didarloo A, Shojaeizadeh D, Eftekhareardebili H, Niknami SH, Hajizadeh A, Alizadeh M., Factors affecting self-care behaviors in women with diabetes referred to the diabetic clinic, Khoy developed based on the theory of rational action. J Pub Health School Pub Health Res Inst. 2011;2(9):79-92.
[12]
Shrivastava. S., Shrivastava, P, & Ramasamy, J, Role of self-care in management of diabetes mellitus, Journal of Diabetes & Metabolic Disorders 2013, http://www.jdmdonline.com/content/12/1/14.
[13]
Paterson B, Thorne S: Developmental evolution of expertise in diabetes self-management. Clin Nurs Res 2000, 9(4):402–419.
[14]
Cooper H, Booth K, Gill G: Patients’ perspectives on diabetes health care education. Health Educ Res 2003, 18(2):191–206.
[15]
Schmitt A, Reimer A, Hermanns N, Huber J, Ehrmann D, Schall S, et al. (2016) Assessing Diabetes Self-Management with the Diabetes Self- Management Questionnaire (DSMQ) Can Help Analyse Behavioural Problems Related to Reduced Glycaemic Control. PLoS ONE 11(3): e0150774. doi:10.1371/ journal.pone.0150774
[16]
Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A: Improving chronic illness care: translating evidence into action. Health Aff (Millwood) 2001, 20(6):64–78.
[17]
Salehi S., Shafiei, S, Ami. P, & Abdeyazdan G, (2014) Self-Care Performance in Children and Adolescents With Type 1 Diabetes Mellitus Jundishapur Journal of Chronic Disease Care. 2014 August; 3(3): e21706, DOI: 10.17795/jjcdc-21706
[18]
Wysocki T, Harris MA, Wilkinson K, Sadler M, Mauras N, White NH. Self-management competence as a predictor of outcomes of intensive therapy or usual care in youth with type 1 diabetes. Diabetes Care. 2003;26(7):2043–7.
[19]
Peters A, Laffel L, American Diabetes Association Transitions Working G. Diabetes care for emerging adults: recommendations for transition from pediatric to adult diabetes care Diabetes Care. 2011 Nov;34(11):2477-85. doi: 10.2337/dc11-1723.
[20]
Zinn, Kelly K., An Exploration of Diabetes Self-Care Among Older Adolescents with Type 1 Diabetes: A Focus Group Study" (2012). Dissertations (6 month embargo). Paper 10. http://ecommons.luc.edu/luc_diss_6mos/10.
[21]
Morovati SHarifabad MH, RohaniTonkaboni N. [Effects of perceived benefits and barriers to self-care behaviors on performance patients with diabetes]. J Nurs Midwifery Birjand. 2007;1(13):17-27.
[22]
Jaser SS, Faulkner MS, Whittemore R, et al. Coping, self-management, and adaptation in adolescents with type 1 diabetes. Ann Behav Med 2012; 43: 311–319.
[23]
Funnell MM, Brown TL, Childs BP, et al. National standards for diabetes self-management education. Diabetes Care 2012; 35(Suppl 1): S101–S108.
[24]
Heidari G, Moslemi S, Montazerifar F, Heidari M. [Efficacy of education on knowledge, attitude & practice of type II diabetic patients in relation to correct nutrition]. J Tabib Shargh. 2002; 4(4):207–13.
[25]
Salam MA, Siddiqui AF. Socio-demographic Determinants of Compliance among Type 2 Diabetic Patients in Abha, Saudi Arabia. J Clin Diagn Res. 2013; 7(12): 2810 – 2813.
[26]
Diabetes Atlas Committee. Diabetic Atlas, 2nd edition. Belgium: International Diabetic Federation. 2003; 123-240.
[27]
Yousr M. Home blood glucose monitoring. Fifth Pan Arab Congress on Endocrinology and Diabetes in Riyadh. 2004; p. 67.
[28]
American Diabetes Association: Standards of medical care in diabetes, (2011). Diabetes Care 2011, 34(Suppl 1):S11–S61.
[29]
Gusso S. Diabetes Care. (2012), Type 1 diabetes associated with reduced exercise capacity, altered cardiac function among adolescents Endocrine Today, August 2012, doi: 10.2337/dc11-2331.
[30]
Pathiranage, D., Mori, Y., & de Silva., K, ( 2016), Self-care behavior among adolescents with Type1 Diabetes Mellitus within the Sri Lankan context, Conference Paper • August 2016.
[31]
Joshua S. B. & Lori, L .(2010), Adherence challenges in the management of type 1 diabetes in adolescents: prevention and intervention, Published in final edited form as: Curr Opin Pediatr. 2010 August; 22(4): 405–411. doi:10.1097/MOP.0b013e32833a46a7.
[32]
Hood KK, Peterson CM, Rohan JM, Drotar D. Association between adherence and glycemic control in pediatric type 1 diabetes: a meta-analysis. Pediatrics. 2009; 124:e1171–e1179.
[33]
Stewart S, Emslie G, Klein D, Haus S, White P: Self-care and glycemic control in adolescents with Type 1 diabetes. Child Health Care 2005, 34:239–244.
[34]
Polonsky W. Emotional and quality-of-life aspects of diabetes management. Curr Diab Rep. 2002; 2:153–159.
[35]
Jacquez Farrah, Stou Stacey, Alvarez-Salvat Rose., Fernandez Michelle, Villa M, Sanchez. J, Eidson, M, Nemery, R, Delamater A. Parent Perspectives of Diabetes Management in Schools diabetes Educ. Author manuscript; available in PMC 2010 Aug 30. Published in final edited form as: Diabetes Educ. 2008 Nov–Dec; 34(6): 996–1003. doi: 10.1177/0145721708325155.
[36]
Sabri, S. Shukry A., (2005), assessment of self – care practices among diabetic children in jeddah city a thesis submitted in partial fulfillment of the requirement for the master’s degree in pediatric nursing maternal and child health nursing department college of nursing king saudi university, 2005.
[37]
Kelishadi R, Hashemiweak M, Ansari R, Roohafza HR, Sarrafzadegan N, Bashardoost N., Comparison quantity of exercise in Isfahan, s adolescents between 1373 and 1380. J Res Med Sci. 2002; 7(2):112–7.
[38]
Khan AR, Lateef ZN, Khamseen MA, Al- Aithan MA, Khan SA, Ibrahim IAl. Knowledge, attitude and practice of ministry of health primary health care physicians in the management of type 2 diabetes mellitus: A cross-sectional study in the Al Hasa District of Saudi Arabia, 2010. Niger J Clin Pract 2011;14:52-9.
[39]
Keough L1, Sullivan-Bolyai S, Crawford S, Schilling L, Dixon JSelf-management of Type 1 Diabetes Across Adolescence. Diabetes Educ. 2011 Jul-Aug; 37(4):486-500. doi: 10.1177/0145721711406140. Epub 2011 May 20.
[40]
Peel E, Douglas M, Lawton J: Self monitoring of blood glucose in type-2 diabetes: longitudinal qualitative study of patients’ perspectives. BMJ 2007, 335(7618):493.
[41]
Helgeson VS, Reynolds KA, Escobar O, et al. The role of friendship in the lives of male and female adolescents: does diabetes make a difference? J Adolesc Health. 2007; 40:36–43. [PubMed:17185204].
[42]
Bearman KJ, La Greca AM. Assessing friend support of adolescents' diabetes care: the diabetes social support questionnaire-friends version. J Pediatr Psychol. 2002; 27:417–428. [PubMed:12058006]
[43]
Skinner TC, John M, Hampson SE. Social support and personal models of diabetes as predictors of self-care and well being: a longitudinal study of adolescents with diabetes. J Pediatr Psychol.2000; 25:257–267. [PubMed: 10814692]
[44]
Wysocki T, Ianotti R, Weissberg-Benchell J, et al. Diabetes problem solving by youths with type 1diabetes and their caregivers: measurement, validation, and longitudinal associations with glycemic control. J Pediatr Psychol. 2008; 33:875–884. [PubMed: 18346973]
[45]
Moore S, Naomi J, Hackworth N, Cameron J, et al. Health and Quality of Life Outcomes 2013, 11:50 http://www.hqlo.com/content/ 11/1/50, Adolescents with Type 1 Diabetes: parental perceptions of child health and family functioning and their relationship to adolescent metabolic control.
