Dissertations & Theses (Open Access)

Date of Award

Spring 5-2018

Degree Name

Doctor of Philosophy in Nursing (PhD)


Geri Wood, PhD - Chair

Second Advisor

Diane W. Wardell, PhD

Third Advisor

Muhammad D. Al-Jarrah, PhD


Background: Adolescents with Type 1 Diabetes (T1D) display a greater than two-fold higher risk of developing microvascular and macrovascular complications compared with the non-diabetic population and the risk increases markedly as glycated hemoglobin (HbA1c) increases. The majority of the findings on the associated factors with improved glycemic control are geared toward Western population with a clear lack of studies on Middle Eastern populations.

Purpose: This study aimed to examine the effect of Physical Activity (PA), Health-Related Quality of Life (HRQoL), and regimen adherence on glycemic control in Jordanian adolescents with T1D.

Methods: The study utilized a cross-sectional design. Jordanian adolescents (aged 12-18) with T1D (n=74) were recruited. Self-reported measures were used including the Pediatric Quality of Life-Diabetes Module, the International Physical Activity Questionnaire, and the Summary of Diabetes Self-Care Activities. HbA1c values were obtained from the medical records. Correlation analyses were conducted using Pearson’s and Spearman’s correlation tests. Multiple regression analyses were conducted to determine if HRQoL, PA, and regimen adherence predict glycemic control.

Results: Only 14.8% of the participants demonstrated good glycemic control (HbA1c ≤7.5%). Participants with poor control had a statistically significant lower mean PA of MET-minutes/week (3531.9 ± 1356.75 vs. 1619.81 ± 1481.95, p < .001) compared to those with good control. The total sample was found to demonstrate low HRQoL (47.70 ± 10.32). Participants were within the acceptable range of PA (1885.38 ±1601.13) MET-minutes/week. HbA1c significantly inversely correlated with PA (r = -.328, p= .010) and regimen adherence (r= -.299, p= .018). Regimen adherence and PA significantly predicted HbA1c in the unadjusted regression model (β= -.367, p< .01; β= -.409, p< .01) and after adjustment for age and disease duration (β = -.360, p< .01; β= -.475, p< .01). In the interaction model, the interaction between PA and regimen adherence was statistically significant (β= -.304, p< .05).

Conclusion: Better glycemic control was significantly predicted by higher PA and regimen adherence levels. There was no significant association between glycemic control and HRQoL. Further research is needed to provide more information on psychosocial and cultural factors that impact glycemic control and quality of life in this population.


Adolescents, Glycemic Control, Physical Activity, Quality of Life, Regimen Adherence, Type 1 Diabetes

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Nursing Commons



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