Adolescents, parents and physicians: a comparison of perspectives on type 1 diabetes self-care.
OBJECTIVE
No research to date has compared the beliefs of adolescents, parents and physicians with respect to type 1 diabetes mellitus self-care perceptions and barriers. This study examined how adolescents with type 1 diabetes, their parents and physicians perceive 4 key diabetes self-care behaviours (testing blood glucose, taking insulin, exercise and diet) and what influences those behaviours.


METHODS
Forty-eight adolescent/parent dyads and 21 pediatric endocrinologists rated importance, difficulty and proficiency for 4 self-care behaviours, and provided up to 5 perceived influences on these behaviours. We compared adolescents to parents and families to physicians.


RESULTS
Groups rated all self-care behaviours as important, with taking insulin as most important. Families rated behaviours as relatively easy compared to physicians. All groups agreed that diet was both the most difficult self-care behaviour and the behaviour at which adolescents were least proficient. Although families rated teens as proficient overall, physicians disagreed. Adolescent and parent perception of diet difficulty was related to poorer glycemic control, and blood glucose testing and insulin administration proficiency were linked to better glycemic control. Compared to other groups, teens were especially likely to mention internal and hindering influences, and more likely to mention other people as negative influences.


CONCLUSIONS
Although all groups agreed that all self-care behaviours are important, there are key areas of discrepancy in perceptions, particularly between families and physicians. Further research should connect the beliefs examined in this study to actual self-care behaviours.
Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA. Electronic address: dkpalladino@cmu.edu.
Dianne K
DK
Palladino
Vicki S
VS
Helgeson
D000293:Adolescent; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology* / Q000628:therapy*; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D000297:Psychology, Adolescent; D012648:Self Care
adhésion des patients; adolescent; facteurs psychosociaux; patient adherence; psychosocial factors