اثربخشي درمان روان شناختي چند جنبه اي بر بهبود پايبندي به درمان پزشكي در نوجوانان مبتلا به ديابت نوع يك

The Effectiveness of Multidimentional Psychological Treatment in Enhancing the Adherence to Medical Treatment in Adolescents with Type 1 Diabetes

Introduction: A chronic illness, such as diabetes mellitus, creates changes in the life style and requires constant adjustment. The onset of a chronic illness can be a stressful event in any life stage including adolescence.. The interaction between the illness related problems and the psychosocial changes associated with normal adolescence makes it difficult for the patient to cope with the chronic illness in a constructive way.. Poor adherence to medical treatment and poor drug compliance are common concerns of the families and physicians dealing with diabetic adolescents. It is of an urgent importance to study effective, culturally appropriated interventions which focus on the high-risk diabetic adolescents with severe adherence difficulties and/or chronically poor metabolic control.Methods: This was a randomized controlled trial (Experimental design). The sample consisted of sixty randomly selected male and female diabetic adolescents living in Esfahan, with an age range between 12 to 18 years old. They were randomly assigned to four groups with different subjects of training including: personal self-efficacy, communication skills, both subjects and no training (control group). The scale of self- efficacy in diabetes and Family Assessment Device (FAD) were then administered to all participants. Treatment adherene was also evaluated using laboratory tests for Hemoglobin A1C (HbAlc) index. Data were analysed using the one-way Analysis of the Variance (one-way ANOVA).Findings: Significant difference was found between the groups regardind the scores of self-efficacy (F=3.725, P=0.017), FAD (F=4.151, P=0.01) and communication (F=8.302, P=0.000), as well as HbAlc results (F=3.088, P=0.035).Discussion: For preventing the short and the long term side effects of the diabetes mellitus, patientsʹ treatment adherence should be improved. Psychological interventions for enhancing self-efficacy and improving communication skills can be effective in this respect.