The Relationship Between Health Beliefs,Adherence,and Metabolic Control of Diabetes

Abstract

There is evidence that an individual's health beliefs influence performance of health behaviors. The purpose of this study was to determine whether health beliefs in persons with diabetes could be modified during a clinical education program and whether the health beliefs were related to adherence to self-care instructions and metabolic control of diabetes.

Health beliefs and HbA_lc were measured at baseline in 189 adult outpatients with diabetes. Diabetes educators then attempted to modify health beliefs that were not conducive to positive health behaviors. Following education, some health beliefs were modified in a positive direction. Modest, but statistically significant increases in perceived severity of diabetes, perceived ability to carry out recommended behaviors, and perceived benefits of treatment were observed. Although HbA_lc improved significantly in a subgroup of patients, this improvement could not be directly associated with any health belief or with self-reported adherence by the iizeasitres used in this study.

Get full access to this article

View all access options for this article.

References

Becker M. , Janz N. The health belief model applied to understanding diabetes regimen compliance . Diabetes Educ 1985;11:41-47.

Janz N. , Becker M. The health belief model: a decade later. Health Educ Q. 1984;11:1-47.

Harris R. , Linn M. Health beliefs, compliance and control of diabetes mellitus. South Med J 1985;78:162-66.

Kirscht JP Research related to the modification of health beliefs. In: Becker MH , ed. The health belief model and personal health behavior. New Jersey: Charles B. Slack Co, 1976.

Kirsch JP The health belief model and illness behavior. Health Educ Monographs 1974;2:387-408.

Maiman L. , Becker M. Scales for measuring health belief model dimensions: a test of predictive value, internal consistency, and relationships among beliefs. Health Educ Monographs 1977;5:215-31.

Cerkoney Kab , Hart LK The relationship between the health belief model and compliance of persons with diabetes mellitus. Diabetes Care 1980;3:594-98.

Alogna M. Perception of severity of diabetes and health locus of control in compliant and noncompliant diabetic patients. Diabetes Care 1980 ;3:533-44.

Kurtz MS Adherence to diabetes regimens: empirical status and clinical applications . Diabetes Educ 1990;16:50-55.

10.

McCusker J. , Morrow J. The relationship of health locus of control to preventive health behaviors and health beliefs. Patient Couns Health Educ 1979;1:146-50.

11.

American Diabetes Association. The physicians guide to type II diabetes: diagnoses and treatment . Alexandria, Va: The American Diabetes Association, 1985.

12.

American Diabetes Association. The physicians guide to insulin-dependent diabetes: diagnosis and treatment . Alexandria, Va: The American Diabetes Association, 1988.

13.

Lockington TJ , Meadows KA , Wise PH Compliant behavior: relationship to attitudes and control in diabetic patients. Diabetic Med 1987;4:56-61.

14.

Fishbein HA Precipitants of hospitalization in insulin-dependent diabetes mellitus (IDDM): a statewide perspective. Diabetes Care 1985;8: 61-64.

15.

ADA Committee on Professional Practice Standards of Medical Care for Patients with Diabetes Mellitus. Diabetes Care 1989;12:365-68.

16.

Klein R. , Klein Bek , Moss SE , Davis MD , DeMets DL Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. JAMA 1988;2864-71.

17.

Hernandez CG The pathophysiology of diabetes mellitus: an update. Diabetes Educ 1989;15:162-69.

18.

Givens CW , Givens BA , Gallin RS , Condon J. Development of a scale to measure beliefs of diabetic patients. Res Nurs Health 1983;6: 127-41.

19.

Wallston KA Assessment of control in health care settings . In: Step-toe A , Appels A , eds. Stress, personal control and health. Chichester, England: Wiley, 1989.

20.

Harris R. , Linn M. , Skyler J. , Sandifer R. Development of the diabetes health belief scale. Diabetes Educ 1987;13:292-97.