World journal of diabetes · 2025
Psychological predictors of diabetic ketoacidosis in children: Health belief model-based case-control study.
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Alissa Nawal, Al Zahrani Sara
Аннотация
BACKGROUND: Diabetic ketoacidosis (DKA) remains a serious and potentially preventable complication among children with type 1 diabetes mellitus (T1DM), particularly in Saudi Arabia. Psychological constructs such as perceived severity and susceptibility influence health behaviour, yet their role in pediatric diabetes management remains underexplored.
AIM: To examine psychological predictors of DKA in children with T1DM using the health belief model, and to assess the role of caregiver-perceived understanding in influencing adherence and DKA occurrence.
METHODS: A case-control study was conducted at Prince Sultan Military Medical City in Riyadh, Saudi Arabia, involving 191 caregivers of children with T1DM (96 cases with a history of DKA and 95 controls without). Validated questionnaires measured perceived severity, susceptibility, understanding, and adherence. Statistical analyses included independent t-tests, Pearson and Spearman correlations, and multiple regression.
RESULTS: Perceived understanding was the strongest predictor of adherence (β = 1.03, P < 0.001) and was inversely associated with DKA occurrence (P < 0.001). Children without a DKA history had significantly higher levels of perceived understanding and adherence. Perceived severity had a moderate positive association with adherence, while perceived susceptibility showed a weak negative correlation.
CONCLUSION: Caregiver-perceived understanding plays a critical role in adherence and DKA prevention. These findings support expanding the health belief model to include perceived understanding as a distinct construct and highlight the importance of integrating comprehension-focused strategies into pediatric diabetes education.
AIM: To examine psychological predictors of DKA in children with T1DM using the health belief model, and to assess the role of caregiver-perceived understanding in influencing adherence and DKA occurrence.
METHODS: A case-control study was conducted at Prince Sultan Military Medical City in Riyadh, Saudi Arabia, involving 191 caregivers of children with T1DM (96 cases with a history of DKA and 95 controls without). Validated questionnaires measured perceived severity, susceptibility, understanding, and adherence. Statistical analyses included independent t-tests, Pearson and Spearman correlations, and multiple regression.
RESULTS: Perceived understanding was the strongest predictor of adherence (β = 1.03, P < 0.001) and was inversely associated with DKA occurrence (P < 0.001). Children without a DKA history had significantly higher levels of perceived understanding and adherence. Perceived severity had a moderate positive association with adherence, while perceived susceptibility showed a weak negative correlation.
CONCLUSION: Caregiver-perceived understanding plays a critical role in adherence and DKA prevention. These findings support expanding the health belief model to include perceived understanding as a distinct construct and highlight the importance of integrating comprehension-focused strategies into pediatric diabetes education.