Abstract
ABSTRACTThis is the first study to investigate the associations of self-care, illness perceptions and psychological distress with metabolic control in Singaporean adolescents with Type 1 Diabetes Mellitus (T1DM). A cross-sectional sample of 41 adolescents (aged 14–20) completed measures of self-care, illness perceptions and psychological distress. Demographic and medical information were also obtained. Glycated haemoglobin (HbA1c) levels were analysed both as continuous variable to explore dose–effect relationships and as a categorical variable to classify poor versus good metabolic control. A total of 65.9% (n = 27) of the adolescents had poor metabolic control (HbA1c <7.5%). Logistic regression modelling showed that poor metabolic control was associated with lower beliefs in treatment control (OR = 5.51), lower levels of foot care (OR = 3.81) and general diet (OR = 2.44) (total Nagelkerke R square = 78.6%). Similar associations for treatment control beliefs and diet have been noted when modelling HbA1c as a continuous variable. The results highlight the importance of the perceptions of treatment control and dietary self-care in diabetes outcomes for adolescents with T1DM. Future studies are warranted to replicate findings in larger samples and explore longitudinal associations.
Highlights
Type 1 Diabetes Mellitus (T1DM) is one of the most common childhood chronic illnesses
The present study aimed to explore the relationship between self-care, illness perceptions and psychological distress with metabolic control in Singaporean adolescents with T1DM
The multivariate logistic regression model to predict poor vs. good metabolic control included treatment control, general diet and foot care as independent variables
Summary
Type 1 Diabetes Mellitus (T1DM) is one of the most common childhood chronic illnesses. According to the SRM, people develop implicit beliefs and emotions about their illness, which span across dimensions: (i) identity: beliefs about the nature of illness and its symptoms, (ii) timeline: duration of the illness, (iii) consequence: beliefs about the impact of illness on the individual’s life, (iv) cause: perceptions of the cause of the illness and (v) cure/control: beliefs about how available treatments and individual’s behaviour can influence the course of the illness These beliefs help to guide the management of health threat and how people cope with symptoms and the diagnosis/condition and any associated treatments. Guided by the SRM and previous research in other settings, it is hypothesised that poorer metabolic control will be associated with lower adherence/self-care behaviours, more negative illness perceptions (i.e. lower perceptions of control; more perceived consequences and symptoms, stronger identity) and higher distress
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