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Journal of Pediatric Psychology Advance Access published online on April 29, 2008
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsn041
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Attributions of Teacher Reactions to Diabetes Self-care Behaviors

Anthony A. Hains, PhD1, Kristoffer S. Berlin, PhD2, W. Hobart Davies, PhD1,3, Amy F. Sato, MS1, Melissa K. Smothers, MS1, Lisa C. Clifford, MS1 and Ramin Alemzadeh, MD3

1University of Wisconsin-Milwaukee, 2Brown Medical School and Rhode Island Hospital, and 3Medical College of Wisconsin

All correspondence concerning this article should be addressed to Anthony Hains, Department of Educational Psychology, PO Box 413, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA. E-mail: aahains{at}uwm.edu


  Abstract

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.

Received October 22, 2007; revision received March 31, 2008; accepted April 4, 2008


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