SITUATIONAL OBSTACLES TO DIETARY ADHERENCE FOR ADULTS WITH DIABETES

Objective To develop a taxonomy of everyday situations that create obs tacles for adherence to dietary management in patients with diabetes. Subjects Twenty-six adults with diabetes (12 with insulin-dependent di abetes mellitus and 14 with non-insulin-dependent diabetes mellitus) w ere recruited from an outpatient diabetes clinic. Main outcome measure s Subjects were interviewed to identify problem situations that create obstacles for dietary adherence. The resulting 69 situations were jud ged for the presence or absence of 32 environmental features using a r eliable coding system. Statistical analysis A hierarchical cluster ana lysis was used to identify homogeneous groups of dietary adherence obs tacles. Results Twelve types of problem situations were identified: ne gative emotions, resisting temptation, eating out, feeling deprived, t ime pressure, tempted to relapse, planning, competing priorities, soci al events, family support, food refusal, and friends' support. Conclus ions The resulting taxonomy provides an outline for the detailed asses sment of obstacles to dietary adherence. An individual's ability to co pe with this array of obstacles to dietary adherence should be assesse d so treatment can be individualized.