Psychological predictors of diabetic ketoacidosis in children: Health belief model-based case-control study

Table 1 Reliability of measurement scales

Scale	Cronbach’s alpha
Perceived severity	0.78
Perceived susceptibility	0.68
Perceived understanding	0.94
Behavioral adherence practices	-
Dietary adherence	0.94
Glucose testing adherence	0.91
Treatment adherence	0.93

Table 2 Demographic and clinical characteristics of pediatric patients with type 1 diabetes mellitus

Variable	Cases (n = 96)	Controls (n = 95)	P value
Age (years), mean ± SD	9.74 ± 2.21	9.90 ± 2.40	0.626
Sex - male	41.8%	57.0%	-
Sex - female	58.2%	43.0%	-
HbA1c (%), mean ± SD	9.82 ± 1.80	8.80 ± 1.59	< 0.001
HbA1c category - good control (< 7.5%)	9.9%	20.2%	-
HbA1c category - moderate (7.5%-9.9%)	29.7%	48.9%	-
HbA1c category - poor (≥ 10%)	60.4%	30.9%	0.004
pH, mean ± SD	7.21 ± 0.17	7.42 ± 0.08	< 0.001
Ketonuria	100%	0%	< 0.001
PICU admission	73.2%	0%	< 0.001
GI symptoms	59.8%	9.6%	< 0.001

HbA1c: Hemoglobin A1c; PICU: Pediatric intensive care unit; GI: Gastrointestinal.

Table 3 Differences in psychological factors and adherence behaviors between groups, mean ± SD

Variable	Case group	Control group	P value
Perceived severity	3.65 ± 0.82	4.27 ± 0.74	< 0.001
Perceived susceptibility	4.42 ± 0.55	3.02 ± 0.94	< 0.001
Perceived understanding	2.46 ± 0.99	4.47 ± 0.55	< 0.001
Dietary adherence	2.34 ± 0.94	4.44 ± 0.54	< 0.001
Glucose testing adherence	2.32 ± 0.96	4.45 ± 0.56	< 0.001
Treatment adherence	2.35 ± 0.95	4.42 ± 0.54	< 0.001

Table 4 Correlations between psychological factors and adherence behaviors

Variable	Dietary adherence (r)	Glucose testing adherence (r)	Treatment adherence (r)
Perceived severity	0.38	0.36	0.37
Perceived susceptibility	-0.24	-0.23	-0.23
Perceived understanding	0.95	0.93	0.94

Table 5 Regression analysis predicting adherence behaviors

Predictor	Adherence behavior	β	95%CI
Understanding	Overall adherence	1.03b	0.97-1.09
Understanding	Glucose testing adherence	0.91b	0.85-0.97
Understanding	Treatment adherence	1.14b	1.06-1.22
Gender	Overall adherence	0.15a	0.05-0.25
Gender	Glucose testing adherence	0.09	-0.01-0.19
Gender	Treatment adherence	0.20a	0.06-0.34
Perceived severity	All	Not significant	CI includes 0
Perceived susceptibility	All	Not significant	CI includes 0

^aP < 0.05.

^bP < 0.01.

CI: Confidence interval.