Illness Acceptance and Medication Adherence in Patients with Diabetes in Poland: A Cross-Sectional Study

Agnieszka Pluta^1*Alicja Marzec¹Marzena Humańska¹Edyta Kobus¹Mariola Głowacka²

• ¹Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
• ²Akademia Mazowiecka w Plocku, Plock, Poland

Background: Diabetes management strongly depends on patient adherence to treatment, which is influenced by psychological factors such as illness acceptance. Objective: This study aimed to assess the levels of illness acceptance and medication adherence among patients with diabetes and to examine the relationship between these factors. Methods: A cross-sectional study was conducted among 190 adult patients with type 1 or type 2 diabetes attending outpatient clinics in Poland. Patients were approached and invited to participate in the study when they attended their scheduled outpatient clinic appointments. A total of 256 patients were invited, of whom 36 declined. Out of the 220 questionnaires returned, 190 were fully completed and included in the final statistical analysis. The study was conducted between May 16, 2017, and the end of 2017. Illness acceptance was measured using the Acceptance of Illness Scale (AIS), and adherence was assessed with the Morisky Medication Adherence Scale (MMAS-8). Sociodemographic and clinical data were also collected. Results: The mean illness acceptance score was 29.16 ± 6.53, with 53.2% of participants demonstrating a high level of acceptance. Medication adherence was moderate according to the MMAS-8 classification (6.49 ± 1.5 points). Illness acceptance was positively correlated with adherence (R = 0.29, p < 0.001). Patients who reported a preference for structured education and psychological support showed higher adherence scores, emphasizing the importance of patient-centered interventions. Conclusion: The findings indicate that higher illness acceptance is associated with better adherence in patients with diabetes. Enhancing illness acceptance through tailored education, psychological counseling, and shared decision-making may improve adherence and contribute to better disease outcomes. Structured and individualized interventions should be incorporated into diabetes care to address patient concerns, strengthen psychological adaptation, and support long-term self-management. In our sample, preferences for structured diabetes education and psychological support were linked with higher adherence scores, suggesting these patient-centred components may be particularly effective. Tailored education, brief psychological counselling, and shared decision-making should be incorporated into diabetes care to strengthen acceptance and support long-term self-management. Further studies are recommended to examine the effectiveness of acceptance-based interventions and to confirm these findings in larger and more diverse samples.