The Relationship Between Compliance and Quality of Life among Adolescents with Diabetes Mellitus Type 1: Exploring the Impact of an Information-Giving Intervention

Objectives: This study investigated the relationship between compliance and quality of life among adolescents with diabetes mellitus type 1 (DMT1), and specifically examined the impact of an information-giving intervention on compliance and quality of life, together with the factors related to compliance and its effect on quality of life.
Methodology: A controlled trial with an intervention group and a wait-list control group was used; participants were allocated to groups using a systematic, non-random procedure based on alphabetical list position rather than true randomisation (see Methods). Data were collected from 40 adolescents aged 16 to 19 years attending the Diabetes Association of Zambia (DAZ) Centre at the University Teaching Hospital (UTH), Lusaka.
Measures: A social-demographic questionnaire, the Rating Scale for Compliance (RSC) and the Diabetes Quality of Life Scale modified for youths (DQOL) were administered at baseline and at eight-week follow-up.
Main outcomes: Compliance to treatment, impact of diabetes and worries about diabetes were significantly better in the intervention group at follow-up, and compliance and quality of life were positively correlated. Because groups were not randomly allocated and differed significantly on compliance at baseline, these findings are consistent with, but cannot on their own establish, a positive effect of the information-giving intervention on adolescents' behaviour toward their prescribed treatment regimen.
Conclusion: Participation in the information-giving intervention was associated with improvements in compliance and most dimensions of quality of life among adolescents with DMT1. Given the non-random allocation, baseline imbalance in compliance, and small single-site sample, these findings should be treated as preliminary evidence for, rather than confirmation of, the value of structured psychoeducational interventions in diabetes care.

Adolescents, diabetes, compliance, quality of life, information-giving intervention

1. Baren, D., Yudkin, J.S., & Courten, M. (2005). Access to care for patients with insulin-requiring diabetes in developing countries: case studies of Mozambique and Zambia. Diabetes Care, 28(9), 2136–2140. [Google Scholar] [Crossref]

2. Battista, A., Hart, T.A., & Greco, L. (2009). Type 1 diabetes among adolescents. Sage Journals, 35(3), 465–471. [Google Scholar] [Crossref]

3. Cadena, C. (2007). Medication compliance important to diabetes. Retrieved from voices.yahoo.com. [Google Scholar] [Crossref]

4. Clarke, D., & Goosen, T. (2005). Depression and compliance with treatment in a sample of Northland diabetes patients. New Zealand Medical Journal, 118(1222). [Google Scholar] [Crossref]

5. Court, J.M., Cameron, F.J., Berg-Kelly, K., & Swift, G.F.P. (2009). Diabetes in adolescence. Pediatric Diabetes, 10(12), 185–194. [Google Scholar] [Crossref]

6. Daneman, D. (2006). Type 1 diabetes. Lancet, 367, 847–858. [Google Scholar] [Crossref]

7. De Jong, R., & Bennink, C. (2006). You, Me and Diabetes: Kids and Care. Johannesburg, South Africa. [Google Scholar] [Crossref]

8. Delamater, A.M. (2006). Improving patient adherence. Clinical Diabetes, 24(2), 71–77. [Google Scholar] [Crossref]

9. Frank, M.R. (2005). Psychological issues in the care of children and adolescents with type 1 diabetes. Paediatric Child Health, 10(1), 18–20. [Google Scholar] [Crossref]

10. Grayson, N.H. (2002). A developmental perspective on adolescent health and illness. Journal of Pediatric Psychology, 27(5), 409–416. [Google Scholar] [Crossref]

11. Guthrie, W.D., Bartsocas, C., Chabot, J.P., & Konstantinova, M. (2003). Psychosocial issues for children and adolescents with diabetes: overview and recommendations. Diabetes Spectrum, 16, 7–12. [Google Scholar] [Crossref]

12. Health Information (2012). Type 1 diabetes in children. Foundation for Medical Education and Research. [Google Scholar] [Crossref]

13. International Diabetes Federation (2009). Diabetes Atlas, Fourth Edition. [Google Scholar] [Crossref]

14. Jacobson, A.M., Barofsky, I., Cleary, P., & Rand, L. (1988). Diabetes Quality of Life Measure for youths. [Google Scholar] [Crossref]

15. Kaseba, C. (2012). Diabetic eye care programme launched in Kitwe. Extreme Zambia. [Google Scholar] [Crossref]

16. Kent, D., Haas, L., Randall, D., Lin, E., et al. (2010). Healthy coping: issues and implications in diabetes education and care. [Google Scholar] [Crossref]

17. Kyngäs, H.A. (2000). Predictors of good adherence of adolescents with diabetes (insulin-dependent diabetes mellitus). Sage Journals, 3(1), 20. [Google Scholar] [Crossref]

18. Novato, T., & Gross, S.A.A. (2009). Factors associated with the quality of life of adolescents with type 1 diabetes mellitus. Rev Esc Enferm USP, 45(3), 766–772. [Google Scholar] [Crossref]

19. Patton, S. (2006). Adherence to treatment in children and adolescents with type 1 diabetes mellitus. US Paediatric Review. [Google Scholar] [Crossref]

20. Taddeo, D., Egedy, M., & Frappier, J. (2008). Adherence to treatment in adolescents. Paediatric Child Health, 13(1), 19–24. [Google Scholar] [Crossref]