Vol. 36 (2026): Volumen 36
Artículos de Investigación

Marital subsystem and psychosocial factors in therapeutic adherence in patients with diabetes of the Veracruz Naval Specialty Hospital

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  • Darío Martínez-Pascual,
  • Gaudencia S Flores-Sánchez,
  • Julia Isabel Diaz Lendeche,
  • Bianca Susana Romero-Martinez,
  • Edgar Flores Soto
Darío Martínez-Pascual
Escuela de Posgrado en Sanidad Naval, Universidad Naval, Secretaría de Marina de México, 04800 Veracruz, México.
Gaudencia S Flores-Sánchez
Hospital Naval de Especialidades de Veracruz, Especialista en Nefrología, 91700 Veracruz, México.
Julia Isabel Diaz Lendeche
Hospital Naval de Especialidades de Veracruz, Especialista en Nefrología, 91700 Veracruz, México
Edgar Flores Soto
Departamento de Farmacología, UNAM
DOI: https://doi.org/10.15174/au.2026.4410

Published 2026-02-18

How to Cite

Martínez-Pascual, D., Flores-Sánchez, G. S., Diaz Lendeche, J. I., Romero-Martinez, B. S., & Flores Soto, E. (2026). Marital subsystem and psychosocial factors in therapeutic adherence in patients with diabetes of the Veracruz Naval Specialty Hospital. Acta Universitaria, 36, 1–12. https://doi.org/10.15174/au.2026.4410

Copyright (c) 2026 Darío Martínez-Pascual, Gaudencia S Flores-Sánchez, Julia Isabel Diaz Lendeche, Bianca Susana Romero-Martinez, Edgar Flores Soto

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Abstract

The aim is to associate marital dysfunction and treatment adherence in patients with type 2 diabetes mellitus (DM2). The study was developed with adults of both sexes, people over 18 years old, who attended the service of the Naval Specialty Hospital in Veracruz. Four instruments were used: the Chávez Aguilar marital subsystem functionality scale, the family APGAR, the Morisky-Green test, and the AMAI 2022 questionnaire. A total of 186 patients were evaluated, predominantly women (60.2%), aged 51 to 60 (60.8%). Most participants were relatives of military personnel (82.2%), and 50% of the total population were obese. Only 18.8% were adherent to treatment, with a higher proportion of men than women (65.7% and 34.3%). Marital dysfunction was associated with non-adherence to treatment in patients with DM2 (OR = 25.27, p < 0.001). Smoking and marital dysfunction showed a positive association with adherence (p < 0.001).

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References

  1. Amezcua-Macías, A., Rodríguez-Weber, F. L., & Díaz-Greene, J. (2015). Apego al tratamiento y control de los pacientes diabéticos en la comunidad. Medicina Interna de Mexico, 31(3), 274-280. https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=58590
  2. Biessels, G. J., & Despa, F. (2018). Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implications. Nature Reviews Endocrinology, 14, 591-604. https://doi.org/10.1038/s41574-018-0048-7
  3. Bonikowska, I., Szwamel, K., & Uchmanowicz, I. (2021). Analysis of the impact of disease acceptance, demographic, and clinical variables on adherence to treatment recommendations in elderly type 2 diabetes mellitus patients. International Journal of Environmental Research and Public Health, 18(16), 8658. https://doi.org/10.3390/ijerph18168658
  4. Chaves, N. M., Echeverri, J. E., Ballesteros, D. A., Quijano, J., & Camacho, D. (2016). Validación de la escala de morisky de 8 ítems en pacientes con enfermedad renal crónica. Revista Med, 24(2), 23-32. https://doi.org/10.18359/rmed.2627
  5. Delamater, A. M. (2023). Forty years of behavioral diabetes research: a personal journey. Diabetes Spectrum, 36(1), 88-96. https://doi.org/10.2337/ds22-0086
  6. Elsayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Cusi, K., Das, S. R., Gibbons, C. H., Giurini, J. M., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Kosiborod, M., Leon, J., Lyons, S. K.,… & Gabbay, R. A. (2023). Introduction and methodology: standards of care in diabetes—2023. Diabetes Care, 46(1), 1-4. https://doi.org/10.2337/dc23-sint
  7. Gálvez, H. J., & Camarillo, V. M. (2022). Evidencia de validez del instrumento: evaluación del subsistema conyugal de Chávez-Velazco. Revista de Extensión Científica de Salud UPAEP, (5), 1-3. https://recsu.upaep.mx/index.php/recsu/article/view/27
  8. Gonzalez, J. S., Tanenbaum, M. L., & Commissariat, P. V. (2016). Psychosocial factors in medication adherence and diabetes self-management: implications for research and practice. The American psychologist, 71(7), 539–551. https://doi.org/https://doi.org/10.1037/a0040388
  9. Guthrie, R. A., & Guthrie, D. W. (2004). Pathophysiology of diabetes mellitus. Critical Care Nursing Quarterly, 27(2), 113–125. https://doi.org/https://doi.org/10.1097/00002727-200404000-00003
  10. Huang, J., Ding, S., Xiong, S., & Liu, Z. (2021). Medication adherence and associated factors in patients with type 2 diabetes: a structural equation model. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.730845
  11. Jaam, M., Awaisu, A., Ibrahim, M. I. M., & Kheir, N. (2017). A holistic conceptual framework model to describe medication adherence in and guide interventions in diabetes mellitus. Research in Social and Administrative Pharmacy, 14(4), 391-397. https://doi.org/10.1016/j.sapharm.2017.05.003.
  12. Juvinyà-Canal, D., Bertran-Noguer, C., & Suñer-Soler, R. (2018). Alfabetización para la salud, más que información. Gaceta Sanitaria, 32(1), 8-10. https://doi.org/10.1016/j.gaceta.2017.07.005
  13. Kirkman, M. S., Rowan-Martin, M. T., Levin, R., Fonseca, V. A., Schmittdiel, J. A., Herman, W. H., & Aubert, R. E. (2015). Determinants of adherence to diabetes medications: findings from a large pharmacy claims database. Diabetes Care, 38(4), 604-609. https://doi.org/10.2337/dc14-2098
  14. Lara-Morales, A., Gandarillas-Grande, A., Díaz-Holgado, A., & Serrano-Gallardo, P. (2022). Psychosocial factors in adherence to pharmacological treatment and diabetes mellitus control in patients over 65. Atencion Primaria, 54(5), 102302. https://doi.org/https://doi.org/10.1016/j.aprim.2022.102302
  15. Martire, L. M., Hemphill, R. C., Zhaoyang, R., Stephens, M. A. P., Franks, M. M., & Stanford, A. M. (2018). Daily marital tension and symptom severity in older adults with diabetes or osteoarthritis. Annals of Behavioral Medicine, 52(10), 842–853. https://doi.org/https://doi.org/10.1093/abm/kax062
  16. Mora, J. F. (2022). Adherencia al tratamiento en personas con diabetes mellitus tipo 2 en México: estudio de metaanálisis. Psicumex, 12(1), 1-20. https://doi.org/10.36793/psicumex.v12i1.493
  17. Mutyambizi, C., Pavlova, M., Hongoro, C., & Groot, W. (2020). Inequalities and factors associated with adherence to diabetes self-care practices amongst patients at two public hospitals in Gauteng, South Africa. BMC Endocrine Disorders, 20, 15. https://doi.org/10.1186/s12902-020-0492-y
  18. Northouse, L. L., & Northouse, P. G. (1998). Health communication: strategies for health professionals (3a ed.). Pearson Education.
  19. Özkaptan, B. B., Kapucu, S., & Demi̇rci̇, İ. (2019). Relationship between adherence to treatment and acceptance of illness in patients with type 2 diabetes. Cukurova Medical Journal, 44(1), 447–454. https://doi.org/doi:10.17826/cumj.554402
  20. Parra, D. I., Romero, S. L., & Rojas, L. Z. (2019). Influential factors in adherence to the therapeutic regime in hypertension and diabetes. Investigación y Educación en Enfermería, 37(3), e02. http://www.scielo.org.co/scielo.php?pid=S0120-53072019000300002&script=sci_arttext
  21. Price, C., Bush, K., & Price, S. (2016). Families & change: coping with stressful events and transitions (5a ed.). Sage.
  22. Rastkar, M., & Jalalifar, E. (2023). The association between marital quality and diabetes mellitus: a systematic review. Health Science Reports, 6(2), e1106. https://doi.org/10.1002/hsr2.1106
  23. Rolnick, S. J., Pawloski, P. A., Hedblom, B. D., Asche, S. E., & Bruzek, R. J. (2013). Patient characteristics associated with medication adherence. Clinical Medicine & Research, 11(2), 54-65. https://doi.org/10.3121/cmr.2013.1113
  24. Shahabi, N., Fakhri, Y., Aghamolaei, T., Hosseini, Z., & Homayuni, A. (2023). Socio-personal factors affecting adherence to treatment in patients with type 2 diabetes: a systematic review and meta-analysis. Primary Care Diabetes, 17(3), 205–220. https://doi.org/https://doi.org/10.1016/j.pcd.2023.03.005
  25. Tiv, M., Viel, J. F., Mauny, F., Eschwège, E., Weill, A., Fournier, C., Fagot-Campagna, A., & Penfornis, A. (2012). Medication adherence in type 2 diabetes: the ENTRED study 2007, a French population-based study. PLoS ONE, 7(3), e32412. https://doi.org/10.1371/journal.pone.0032412
  26. Xie, Z., Liu, K., Or, C., Chen, J., Yan, M., & Wang, H. (2020). An examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension. BMC Public Health, 20, 1227. https://doi.org/10.1186/s12889-020-09274-4
  27. Świątoniowska-Lonc, N., Tański, W., Polański, J., Jankowska-Polańska, B., & Mazur, G. (2021). Psychosocial determinants of treatment adherence in patients with type 2 diabetes – a review. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, (14), 2701-2715. https://doi.org/10.2147/dmso.s308322