Türkan Akyol Güner
Self-efficacy emerged as the strongest independent predictor of quality of life, surpassing demographic, clinical, and technology-related variables. Advanced diabetes technology use was consistently associated with more favorable psychosocial outcomes.
PURPOSE: This study aimed to examine the associations among diabetes technology satisfaction, self-efficacy, and quality of life in adolescents with Type 1 Diabetes (T1D).
DESIGN AND METHODS: This descriptive, cross-sectional study included 235 adolescents with T1D registered at Family Health Centers in a provincial center in Turkey's Western Black Sea Region. Data were collected using the Diabetes Technology Questionnaire (DTQ), the Diabetes Management Self-Efficacy Scale, and the Kiddo-KINDL Quality of Life Scale.
RESULTS: The mean HbA1c was 9.05 ± 1.38%. Insulin pump (±CGM) users demonstrated significantly higher technology satisfaction (118.9 vs. 90.3; F = 47.23, p < .01), better self-efficacy (58.3 vs. 76.4; F = 18.42, p < .01; lower scores indicate higher self-efficacy), and higher quality of life (112.3 vs. 92.5; F = 21.87, p < .01) compared to the MDI + SMBG group. Hierarchical regression identified self-efficacy as the strongest predictor of quality of life (β = -0.39, p < .001), followed by DTQ score (β = 0.30, p < .001). The model explained 37.2% of total variance, with modifiable psychosocial factors contributing 28.0%. Female adolescents showed lower self-efficacy and quality of life than males (p < .01).
CONCLUSION: Self-efficacy emerged as the strongest independent predictor of quality of life, surpassing demographic, clinical, and technology-related variables. Advanced diabetes technology use was consistently associated with more favorable psychosocial outcomes.
APPLICATION TO PRACTICE: Pediatric nurses should integrate self-efficacy-enhancing strategies and gender-sensitive psychosocial support into diabetes education, while advocating for equitable access to advanced technologies.