title: How are adherent people more likely to think? A meta-analysis of health beliefs and diabetes self-care.
abstract: Diabetes is increasingly prevalent, and nonadherence with diabetes treatment regimens is associated with physical and social costs. Psychological predictors of adherence have been investigated in the literature, including cognitive factors. The present meta-analysis was conducted to investigate the association between beliefs related to diabetes and adherence to diabetes regimens.
  
  
  
  Studies that measured both (a) beliefs, perceptions, or cognitions about diabetes and (b) the relationship between such cognitive factors and blood glucose levels or other adherence behaviors were included. This research focused on adults with any type of diabetes, reaching a final sample of 48 studies. The effect size r was calculated for all types of beliefs and outcomes.
  
  
  
  The types of beliefs most strongly associated with adherence were self-efficacy, perceiving a positive relationship with physician, and beliefs about the personal consequences of adherence. A few limitations of this meta-analysis are that studies were only retrieved through databases and other sources were not searched, only articles in English were included, and only adult participants were included.
  
  
  
  People who are more adherent have a higher level of confidence in their ability to follow medical recommendations, expect more meaningful positive consequences for adherence, and perceive a more positive relationship with their health care provider. Educators and clinicians could use cognitive restructuring techniques to facilitate these types of beliefs and perceptions in people with diabetes.
authors.affiliation: Babes-Bolyai University, Department of Clinical Psychology and Psychotherapy, Cluj-Napoca, Romania; Clinic of Diabetes, Nutrition and Metabolic Disorders, Cluj-Napoca, Romania (Gherman)
authors.forename: Amfiana
authors.initials: A
authors.lastname: Gherman
authors.affiliation: Mount Sinai School of Medicine, Department of Cancer Prevention and Control, New York, USA (Schnur, Montgomery)
authors.forename: Julie
authors.initials: J
authors.lastname: Schnur
authors.affiliation: Mount Sinai School of Medicine, Department of Cancer Prevention and Control, New York, USA (Schnur, Montgomery)
authors.forename: Guy
authors.initials: G
authors.lastname: Montgomery
authors.affiliation: Lucian Blaga University, Department of Psychology, Sibiu, Romania (Sassu)
authors.forename: Raluca
authors.initials: R
authors.lastname: Sassu
authors.affiliation: Iuliu Hatieganu School of Medicine and Pharmacy, Cluj-Napoca, Romania; Clinic of Diabetes, Nutrition and Metabolic Disorders, Cluj-Napoca, Romania (Veresiu)
authors.forename: Ioan
authors.initials: I
authors.lastname: Veresiu
authors.affiliation: Babes-Bolyai University, Department of Clinical Psychology and Psychotherapy, Cluj-Napoca, Romania; Mount Sinai School of Medicine, Department of Cancer Prevention and Control, New York, USA (David)
authors.forename: Daniel
authors.initials: D
authors.lastname: David
mesh_terms: D000328:Adult; D015190:Blood Glucose Self-Monitoring / Q000523:psychology; D003071:Cognition; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy