Adherence decision making in the everyday lives of emerging adults with type 1 diabetes.
OBJECTIVE
The purpose of this study was to explore motivations underlying nonadherent treatment decisions made by young adults with type 1 diabetes.


METHODS
Eight emerging adults each completed a series of semi-structured interviews concerning their approaches to diabetes care, relationships with clinicians, and everyday activities and routines. A narrative thematic analysis was used to develop initial themes and refine them through continued data collection and review of the research literature.


RESULTS
FIVE THEMES WERE IDENTIFIED AS MOTIVATING NONADHERENCE: (1) efforts to mislead health care providers, (2) adherence to alternative standards, (3) treatment fatigue and burnout, (4) social support problems, and (5) emotional and self-efficacy problems.


CONCLUSIONS
Instances of nonadherence generally involved a combination of the five identified themes. Participants reporting nonadherence also described difficulties communicating with care providers regarding their treatment. Nonjudgmental communication between providers and emerging adults may be particularly important in promoting positive health outcomes in this population.
Division of Occupational Science and Occupational Therapy, University of Southern California, USA.
Elizabeth A
EA
Pyatak
Daniella
D
Florindez
Marc J
MJ
Weigensberg
compliance; health behavior; motivations; nonadherence