emotional health

Barriers to adherence

•  Many obstacles interfere with adherence to the diabetes regimen. A limited support system may hinder adherence to the diabetes regimen.

A person living alone or separated from loved ones may lack the support and encouragement often necessary to follow the regimen.

A poor self-image and a sense of powerlessness can be devastating to adherence behaviors. Subconscious thoughts such as "I´m not worth the effort" or "What´s the use? Can sabotage the regimen.

Other stressors in a person´s life may push the diabetes regimen lower on the list of priorities. These other stressors may consume so much time and energy that the patient has very little of either to direct toward personal health care.

Insufficient financial resources often interfere with adherence. The treatment of diabetes is expensive, and many patients do not have insurance or qualify for assistance programs.

A lack of diabetes education can be a barrier to adherence. For example, if the patient and family do not receive an explanation as to why a particular regimen is important, the motivation for adherence may disappear over time.

Multicultural issues:

•  Because some cultural practices may create barriers to adherence, the diabetes educator should determine how customs, traditions, values, and ethnic foods may present obstacles to a traditional diabetes regimen.

Some European cultures and American Indians consider it impolite to refuse food that is offered when visiting another person´s home. The gifts that are exchanged often are sweet foods. Holidays are celebrated with special foods that are high in calories and simple sugars.

Fasting may be a cultural or religious practice, and must be done very carefully with supervision and adequate understanding of the impact on the person with diabetes.

Other cultural factors may relate to acceptance.. A parent or spouse may feel that the person with the diagnosis of diabetes now is contaminated, or imperfect.

If diabetes interferes with one´s lifestyle, the associated frustration may greatly diminish adherence.
Educational Treatment Unit
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