Self-efficacy as a mediator variable for adolescents' adherence to treatment for insulin-dependent diabetes mellitus

Bandura's (1982) self-efficacy theory was applied to explain the process by which self-efficacy for managing pediatric diseases can be enhanced. Adolescents (N = 143) diagnosed with insulin-dependent diabetes mellitus (IDDM) completed measures of adherence to IDDM treatment, self-efficacy for diabetes care, personal responsibility for diabetes care, and a measure of supportive and nonsupportive diabetes-specific behaviors exhibited by their parents. Self-efficacy was tested as a mediator variable for hypothesized relations between adherence to treatment and 2 methods proposed to enhance self-efficacy, including mastery experience (i.e., responsibility for treatment) and social persuasion (i.e., supportive and nonsupportive parental behaviors). Regression analyses revealed support for self-efficacy as a mediator variable for the relation between mastery experience and adherence to treatment. Self-efficacy was also a mediator variable for the relation between nonsupportive parental behaviors and adolescents' nonadherence to blood glucose monitoring but not for nonadherence to other components of treatment or for overall adherence. Self-efficacy, however, was not a significant mediator for the relation between supportive parental behaviors and adherence.