Social support, automatic thought processes and coping style as predictors of compliance with treatment among adult diabetes patients in Northland : a dissertation presented to the School of Psychology in partial fulfilment of the requirements for the Masters Degree of Psychology

Abstract

Little research has examined the relationship of automatic negative thought patterns, coping styles and depression to compliance with treatment for diabetes. A questionnaire consisting of demographic questions, the Ways of Coping Checklist, the Automatic Thoughts Questionnaire, a depression inventory and a compliance rating scale was completed by 114 adult diabetes patients attending the Northland Health retinopathy clinic. There were equal numbers of men and women, whose median age was 59 years (M = 59.2, SD = 14.9). Clinicians who were responsible for one or more of the patients independently completed a separate compliance rating scale for their respective patient(s). Multivariate analysis of variance revealed that there were no significant overall difference for gender and ethnic identity on any of the variables. Automatic negative thoughts, avoidance and blaming coping styles were positively related to depression, and negatively related to patients' ratings of compliance. A problem focus coping style correlated positively with patients' ratings of compliance. Patients tended to rate their own compliance as better than the staff ratings. According to staff ratings, Maori patients who identified less strongly with their culture, were also less likely to comply with treatment than the other ethnic groups. Staff and patients seemed to differ on what 'compliance' meant. Staff appeared to see compliance as how well the patients followed the treatment instructions. Patients were concerned about their thought content (i.e. positive or negative thinking) and their ability to act or decide for themselves. Hierarchical regression analysis showed that negative thought patterns and problem focused coping were significant predictors of patients' compliance ratings, while negative thought patterns and depression were significant predictors of staff's compliance ratings. The findings were discussed in terms of risk factors for lack of compliance and psychosocial treatment options for diabetes patients.