Attributions of Teacher Reactions to Diabetes Self-care Behaviors

Objective This study had two objectives: examine relationships among negative attributions of teacher reactions, anticipated adherence difficulties, teacher support, diabetes stress, and metabolic control; and develop questionnaires to test these relationships. Methods One hundred and two youths with type 1 insulin-dependent diabetes completed instruments measuring attribution of teacher reactions, anticipated adherence, teacher support, and diabetes stress. Metabolic control was measured by percentage of hemoglobin A1c. Results Structural equation modeling demonstrated that negative attributions had direct effects on anticipated adherence difficulties and diabetes stress. Diabetes stress had a direct effect on metabolic control. Negative attributions had a significant indirect effect on metabolic control through associations with diabetes stress. Teacher support moderated the path between negative attributions and anticipated adherence difficulties. Conclusions Youths making negative attributions about teacher’s reactions are likely to find adherence difficult in school situations and have increased stress. Results are discussed in terms of a social information processing model of adjustment and practical applications. Key words adherence; adolescents; attributions; diabetes; teachers. Management of type 1 insulin-dependent diabetes (T1D) involves adherence to a series of complex daily behaviors such as monitoring blood glucose levels, injecting insulin, carefully maintaining diet plans, and exercising. Adolescents have more problems with adherence than younger children, despite having greater diabetes knowl