AlBurno Hanan, Francine Schneider, de Vries Hein, Mohanadi Dabia Al, Jongen Stefan, Mercken Liesbeth
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands.
Department of Endocrinology and Diabetes, Hamad General Hospital, Doha, Qatar.
Health Psychol Rep. 2025 Jan 31;13(1):1-26. doi: 10.5114/hpr/194439. eCollection 2025.
Non-adherence to insulin treatment is common in adolescents and young adults (AYAs) with type 1 diabetes (T1D) and is associated with increased morbidity and mortality. However, the socio-cognitive determinants (SCDs) of adherence in AYAs with T1D are less frequently represented in systematic reviews. This systematic review aimed to investigate the key SCDs associated with adherence/non-adherence to insulin treatment in AYAs in the age range of 17-24 years with T1D. A systematic review in PubMed, Embase, Web of Science, and PsycINFO was conducted. The search took place from 2021, to January 1st, 2022, and was repeated on June 5-7, 2022 and from July 18 to July 24, 2023. The methodological quality of studies was assessed by the National Heart, Lung, and Blood Institute quality assessment tool for observational cohort and cross-sectional studies. Six articles representing 973 AYAs with T1D were included for data extraction. The identified SCDs included risk perceptions, attitude, family and friends' social support, self-efficacy, and information factors. However, there was inconsistency in correlational findings among studies. The identified SCDs influencing insulin adherence in AYAs with T1D could serve as targets for patients' consultations and tailored interventions to improve adherence and overall health outcomes, as well as for policymakers to integrate these interventions into diabetes care planning. However, further research in the area of factors affecting insulin adherence in quality-designed studies that use detailed and comprehensive measures for assessing adherence is needed.
在1型糖尿病（T1D）青少年及青年（AYAs）中，不坚持胰岛素治疗的情况很常见，且与发病率和死亡率增加相关。然而，系统评价中较少提及T1D青少年坚持治疗的社会认知决定因素（SCDs）。本系统评价旨在调查17至24岁患有T1D的AYAs中，与坚持/不坚持胰岛素治疗相关的关键SCDs。我们在PubMed、Embase、科学网和PsycINFO上进行了系统评价。检索时间从2021年至2022年1月1日，并于2022年6月5日至7日以及2023年7月18日至7月24日重复进行。研究的方法学质量通过美国国立心肺血液研究所观察性队列研究和横断面研究质量评估工具进行评估。纳入了6篇代表973名患有T1D的AYAs的文章进行数据提取。确定的SCDs包括风险认知、态度、家人和朋友的社会支持、自我效能感和信息因素。然而，各研究的相关结果存在不一致性。确定的影响T1D青少年胰岛素治疗依从性的SCDs可作为患者咨询和量身定制干预措施的目标，以提高依从性和整体健康结果，也可供政策制定者将这些干预措施纳入糖尿病护理计划。然而，需要在设计质量高的研究中，对影响胰岛素治疗依从性的因素进行进一步研究，这些研究应使用详细且全面的措施来评估依从性。
