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Adherence decision making in the everyday lives of emerging adults with type 1 diabetes

Authors Pyatak EA, Florindez D, Weigensberg MJ

Received 3 May 2013

Accepted for publication 18 June 2013

Published 29 July 2013 Volume 2013:7 Pages 709—718


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Elizabeth A Pyatak,1 Daniella Florindez,1 Marc J Weigensberg2

1Division of Occupational Science and Occupational Therapy, University of Southern California, 2Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA

Purpose: 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.
Conclusion: 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.

Keywords: compliance, health behavior, nonadherence, motivations

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