title: Modification and testing of the chronic disease compliance instrument to measure treatment compliance in adolescents with diabetes.
abstract: OBJECTIVE
  To examine the factor structure and internal consistency of the Chronic Disease Compliance Instrument-Diabetes in an Australian sample of adolescents with diabetes, to modify the instrument and re-examine factor structure and internal consistency of subsequent scales and to examine the relationship between compliance behaviour and theoretically relevant explanatory factors.
  
  
  BACKGROUND
  Compliance is a key challenge for adolescents with a chronic disease; however, valid and reliable self-report measures of compliance behaviour and explanatory factors for diabetes remain elusive, particularly applied in an Australian setting.
  
  
  METHODS
  Correlational design.
  
  
  METHODS
  Participants were 133 adolescents (12-17 years) diagnosed with diabetes and receiving treatment at several health care settings in New South Wales. Participants voluntarily completed the self-report instrument while waiting to see their Physician/Clinical Nurse Consultant/Diabetes Educator.
  
  
  RESULTS
  On logical modification of the instrument based on exploratory factor analysis and thorough review of item content, the instrument was shown to have sufficient factor structure and internal consistency. Further, eight of the 11 explanatory factor scales were significantly related to compliance behaviour (accounting for 31% of variance).
  
  
  CONCLUSIONS
  The present study represents the first application of an established instrument to measure compliance to diabetes treatment among adolescents in an Australian sample and demonstrates that the instrument has sufficient factor structure and internal consistency in this setting. Findings provide a list of relevant factors for explaining compliance, which may be employed to guide the development of initiatives to increase the level of compliance to treatment among Australian adolescents with diabetes.
  
  
  CONCLUSIONS
  The Chronic Disease Compliance Instrument-Diabetes is a tool that can help nurses with their clinical practice by allowing for more efficient identification of adolescent compliance to diabetes treatment, which may be used in conjunction with HbA1c values already employed.
authors.affiliation: Practice Development Unit, Level 2 South, Sydney Children's Hospital, Randwick, NSW, Australia. ralston.fernandes@sesiahs.health.nsw.gov.au
authors.forename: Ralston
authors.initials: R
authors.lastname: Fernandes
authors.forename: Sandra
authors.initials: S
authors.lastname: Wales
authors.forename: Jackie
authors.initials: J
authors.lastname: Crisp
authors.forename: Helvi
authors.initials: H
authors.lastname: Kyngas
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D006801:Humans; D009517:New South Wales; D010349:Patient Compliance; D015203:Reproducibility of Results