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Modification and testing of the chronic disease compliance instrument to measure treatment compliance in adolescents with diabetes

Authors

  • Ralston Fernandes,

    1. Authors:Ralston Fernandes, BSc, PhD, Research Officer, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital; Sandra Wales, RN, Clinical Nurse Consultant, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital; Jackie Crisp, PhD, RN, Professor of Child & Adolescent Nursing, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital, Randwick, NSW, Australia; Helvi Kyngas, PhD, RN, Professor of Nursing, Department of Nursing and Health Administration, University Hospital, University of Oulu, Oulu, Finland
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  • Sandra Wales,

    1. Authors:Ralston Fernandes, BSc, PhD, Research Officer, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital; Sandra Wales, RN, Clinical Nurse Consultant, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital; Jackie Crisp, PhD, RN, Professor of Child & Adolescent Nursing, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital, Randwick, NSW, Australia; Helvi Kyngas, PhD, RN, Professor of Nursing, Department of Nursing and Health Administration, University Hospital, University of Oulu, Oulu, Finland
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  • Jackie Crisp,

    1. Authors:Ralston Fernandes, BSc, PhD, Research Officer, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital; Sandra Wales, RN, Clinical Nurse Consultant, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital; Jackie Crisp, PhD, RN, Professor of Child & Adolescent Nursing, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital, Randwick, NSW, Australia; Helvi Kyngas, PhD, RN, Professor of Nursing, Department of Nursing and Health Administration, University Hospital, University of Oulu, Oulu, Finland
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  • Helvi Kyngas

    1. Authors:Ralston Fernandes, BSc, PhD, Research Officer, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital; Sandra Wales, RN, Clinical Nurse Consultant, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital; Jackie Crisp, PhD, RN, Professor of Child & Adolescent Nursing, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital, Randwick, NSW, Australia; Helvi Kyngas, PhD, RN, Professor of Nursing, Department of Nursing and Health Administration, University Hospital, University of Oulu, Oulu, Finland
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Ralston Fernandes, Research Officer, Practice Development Unit, Level 2 (South), Sydney Children’s Hospital, High Street, Randwick, NSW 2031, Australia. Telephone: +61 2 9382 1887.
E-mail:ralston.fernandes@sesiahs.health.nsw.gov.au

Abstract

Aims and objectives.  To examine the factor structure and internal consistency of the Chronic Disease Compliance Instrument–Diabetes in an Australian sample of adolescents with diabetes, to modify the instrument and re-examine factor structure and internal consistency of subsequent scales and to examine the relationship between compliance behaviour and theoretically relevant explanatory factors.

Background.  Compliance is a key challenge for adolescents with a chronic disease; however, valid and reliable self-report measures of compliance behaviour and explanatory factors for diabetes remain elusive, particularly applied in an Australian setting.

Design.  Correlational design.

Methods.  Participants were 133 adolescents (12–17 years) diagnosed with diabetes and receiving treatment at several health care settings in New South Wales. Participants voluntarily completed the self-report instrument while waiting to see their Physician/Clinical Nurse Consultant/Diabetes Educator.

Results.  On logical modification of the instrument based on exploratory factor analysis and thorough review of item content, the instrument was shown to have sufficient factor structure and internal consistency. Further, eight of the 11 explanatory factor scales were significantly related to compliance behaviour (accounting for 31% of variance).

Conclusions.  The present study represents the first application of an established instrument to measure compliance to diabetes treatment among adolescents in an Australian sample and demonstrates that the instrument has sufficient factor structure and internal consistency in this setting. Findings provide a list of relevant factors for explaining compliance, which may be employed to guide the development of initiatives to increase the level of compliance to treatment among Australian adolescents with diabetes.

Relevance to clinical practice.  The Chronic Disease Compliance Instrument–Diabetes is a tool that can help nurses with their clinical practice by allowing for more efficient identification of adolescent compliance to diabetes treatment, which may be used in conjunction with HbA1c values already employed.

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