Date of Award


Degree Name

Doctor of Philosophy




The success of medical interventions for patients with diseases that require consistent adherence to a medical regimen is largely contingent upon the patient’s ability to consistently follow medical recommendations. Medical regimen adherence significantly influences the patient’s health and impacts the health care providers’ ability to treat any disease or medical problem. Adherence levels are particularly low in the pediatric population among young patients with diabetes and cystic fibrosis. Researchers and clinicians hypothesize that levels of adherence are particularly low during adolescence (ages 11-15) because this may be the period in which primary responsibility for daily adherence is transferred from the parent to the child patient (Miller & Drotar, 2003).

The current investigation is designed to provide a systematic analysis of how age, perceived responsibility for treatment procedures, levels of parental involvement in treatment procedures, and conflict are related to treatment adherence in diabetic and cystic fibrosis populations. Data were collected from 64 diabetic parent-child dyads, and 27 cystic fibrosis parent-child dyads (children ages 7-18). Several significant results are reported from the current data set. First, internal consistency and test-retest psychometric data are provided for previously established adherence assessment instruments including the Cystic Fibrosis Family Responsibility Questionnaire (CFFRQ), the Diabetes Family Responsibility Questionnaire (DFRQ), the Conflict Subscale of the Diabetes Responsibility and Conflict Scale (Conflict Subscale-DRCS) and the Self-Care Inventory (SCI). In addition, the internal consistency and test-retests reliability results are reported for the newly developed versions of the Modified Conflict Subscale for the Cystic Fibrosis Responsibility and Conflict Scale (Conflict Subscale-CFRCS) and the Modified Self-Care Inventory- Cystic Fibrosis (SCI-CF).

Results of this investigation suggest that agreement between parents and their children regarding who is primarily responsible for completing treatment tasks on a daily basis may be the most significant predictor of adherence levels within both the diabetic and cystic fibrosis populations. These findings are discussed in relation to the impact they may have on providing medical recommendations for similar patients in the medical setting, and how these results compare to the findings in similar studies that have been conducted in the area of pediatric medical regimen treatment adherence.

Access Setting

Dissertation-Open Access