Association Between Intolerance of Uncertainty and Treatment Adherence in Patients With Diabetes; [ارتباط عدم تحمل بلاتكليفي با تبعيت از درمان در بيماران مبتلا به ديابت]



Karimi R ; Rooddehghan Z ; Khajezadeh A ; Sardarpour N ; Abbaszadeh M ; Zeidi M J A
Source: HAYAT Published:2026

Abstract

Background & Aim: Intolerance of uncertainty is an emerging psychological construct that may influence health-related behaviors, particularly treatment adherence. The present study aimed to determine the association between intolerance of uncertainty and treatment adherence in patients with diabetes. Methods & Materials: This cross-sectional descriptive-correlational study was conducted in 2024 on 103 patients with diabetes referred to Imam Khomeini Hospital in Tehran. Samples were selected using a convenience sampling method. Data were collected using a demographic and clinical characteristics form, the Morisky Medication Adherence Scale, and the Intolerance of Uncertainty Scale developed by Freeston et al. Data were analyzed using descriptive (mean, standard deviation, and frequency) and inferential statistics (independent t-test, Pearson correlation coefficient, and one-way ANOVA) in SPSS version 16. Results: Intolerance of uncertainty showed a significant positive correlation with age (r=0.27, P=0.006) and a significant negative correlation with diabetes duration (r=-0.27, P=0.006). Single participants had significantly higher levels of intolerance of uncertainty compared to married participants (P=0.005). Furthermore, treatment adherence demonstrated a significant positive relationship with age (r=0.34, P<0.001) and was higher among women (P=0.021) and single individuals (P=0.032). Among the participants, 50 individuals (48.5%) had high intolerance of uncertainty, and 44 individuals (42.7%) had low treatment adherence. A significant positive correlation was observed between intolerance of uncertainty and treatment adherence (r=0.65, P<0.001). Conclusion: The findings of the present study indicate that diabetic patients who experience higher levels of intolerance of uncertainty are more likely to adopt treatment adherence as a coping strategy when faced with uncertain circumstances and unpredictable outcomes of their disease. This behavior serves as a means to reduce psychological distress and regain a sense of control. These findings underscore the importance of addressing psychological dimensions, particularly intolerance of uncertainty, by nurses and other healthcare team members. However, due to the cross-sectional nature of this study and other limitations, the interpretation of the results should be approached with caution. Copyright © 2026 The Authors.