• Ancuta Elena PADURARU “Alexandru Ioan Cuza” University Iasi, Romania
  • Doina AZOICAI “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Camelia SOPONARU “Alexandru Ioan Cuza” University Iasi, Romania


The identification of the connections between illness representation, the quality of life, and treatment adherence, among the children diagnosed with diverse chronic diseases. Furthermore, we wished to see whether there were differences by gender at the level of the three variables. Material and methods: 94 children - 52 boys and 42 girls - with a mean age M = 13.63 ± 2.68, filled out the Perceptions Questionnaire-Revised, the Self-Regulation of Medication Adherence Battery, and the Pediatric Quality of Life Inventory™ Version 4.0.  Results: Preponderantly, the correlations identified between the three variables are negative. We have not identified any significant differences by gender, in what concerns illness representations. However, girls have higher control over treatment adherence (M girls = 3.30, M boys = 3.49, p = 0.035) and lower emotional functioning compared to boys (M girls = 62.14, M boys = 73.40, p = 0.016). Conclusions: The higher level of illness identity, illness coherence, and personal control among children, the more likely for them to adhere to treatment. Furthermore, the higher control over the treatment, the greater motivation of children to adhere to treatment. Consequently, practical interventions should focus on instilling the children’s perceived control over their treatment.

Author Biographies

Ancuta Elena PADURARU, “Alexandru Ioan Cuza” University Iasi, Romania

Faculty of Psychology and Education Science
Service for Students, Career Guidance, Professional Insertion and Alumni

Doina AZOICAI, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Preventive Medicine and Interdisciplinarity

Camelia SOPONARU, “Alexandru Ioan Cuza” University Iasi, Romania

Faculty of Psychology and Education Science
Department of Psychology


1. ***Raportul Național de Sănătate a Copiilor și Tinerilor din România 2018
2. Wijlaars LP, Gilbert R, Hardelid P. Chronic conditions in children and young people: learning from administrative data. Archives of disease in childhood 2016; 101(10): 881-885.
3. Van Cleave J, Gortmaker SL, Perrin, JM. Dynamics of obesity and chronic health conditions among children and youth. JAMA 2010; 303(7): 623-630.
4. Bucks RS, Hawkins K, Skinner TC, Horn S, Seddon P, Horne R. Adherence to Treatment in Adoles-cents with Cystic Fibrosis: The Role of Illness Perceptions and Treatment Beliefs. Journal of Pediatric Psychology 2009; 34(8): 893-902.
5. Quittner AL, Zhang J, Marynchenko M, et al. Pulmonary medication adherence and health-care use in cystic fibrosis. Chest 2014; 146: 142-151.
6. Kosse RC, Koster ES, Kaptein AdA, de Vries TW, Bouvy ML. Asthma control and quality of life in adolescents: The role of illness perceptions, medication beliefs, and adherence. Journal of Asthma, 2020; 57(10): 1145-1154.
7. Kim Y, Evangelista LS. Relationship between illness perceptions, treatment adherence, and clinical outcomes in patients on maintenance hemodialysis. Nephrol Nurs J 2010; 37(3): 271-281.
8. Leventhal H, Philips LA, Burns E. The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management. J Behav Med 2016; 39: 935-946.
9. Diefenbach MA, Leventhal H. The Common-Sense Model of Illnes Representation: Theoretical and Practical Considerations, Journal of Social Distress and the Homeless 1996; 5(1): 11-38.
10. Gur M, Raz-Yaniv L, Teleshov A, BarYoseph R, Hakim F, Bentur L. Cultural differences in illness perception and adherence to treatment of cystic fibrosis patients. Pulm Res Respir Med Open J 2015; 2(3): 114-119.
11. Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med 1993; 118: 622-628.
12. Atwa, ZTH, Wahed, WYA. The impact of illness perception and socio-clinico-demographic factors on perceived quality of life in children and adolescents with thalassemia intermedia. Pediatr Blood Cancer 2019; 66(7):e27735.
13. Thomson P, Rushworth GF, Andreis F, et al. Longitudinal study of the relationship between patients’ medication adherence and quality of life outcomes and illness perceptions and beliefs about cardiac rehabilitation. BMC Cardiovasc Disord 2020; 20(1): 71.
14. Tiemensma J, Gaab E, Voorhaar M, Asijee G, Kaptein AA. Illness perceptions and coping determine quality of life in COPD patients. Int J Chron Obstruct Pulmon Dis 2016; 11: 2001-2007.
15. van der Have M, Minderhoud IM, Kaptein AA, et al.Substantial impact of illness perceptions on quality of life in patients with Crohn's disease. J Crohns Colitis 2013; 7(8): e292-301.
16. Goodfellow NA, Hawwa AF, Reid A.JM, Horne R, Shields MD, McElnay JC. Adherence to treat-ment in children and adolescents with cystic fibrosis: a cross-sectional, multi-method study investigating the influence of beliefs about treatment and parental depressive symptoms. BMC Pulmonary Medicine 2015; 15: 43.
17. Lahai M, Jame PB, Wannang NN, et al. A cross-sectional study on caregivers’ perspective of the quality of life and adherence of pediatric HIV patients to highly active antiretroviral therapy. BMC Pediatr 2020; 20: 286.
18. Reid AM, Balkhi AM, St. Amant J, McNamara JPH, Silverstein JH, Navia L, Geffken G. Relations Between Quality of Life, Family Factors, Adherence, and Glycemic Control in Pediatric Patients With Type 1 Diabetes Mellitus. Children’s Health Care 2013; 42(4): 295-310.
19. Hommel KA, Davis CM, Baldassano RN. Medication adherence and quality of life in pediatric in-flammatory bowel disease. J Pediatr Psychol 2008; 33(8): 867-874.
20. Al Jaouni SK, Al Muhayawi MS, Halawa TF. Treatment adherence and quality of life outcomes in patients with sickle cell disease. Saudi Med J 2013; 34(3): 261-265.
21. Varni JW, Jacobs JR, Seid M. Treatment adherence as predictor of health-related quality of life. D Drotar (Eds) Promoting Adherence to Medical Treatment in Chronic Childhood Illness: Concepts, methods, and interventions. Lawrence Erlbaum Mahwah, NJ 287-305.
22. Varni JW, Delamater AM, Hood KK, et al. Diabetes management mediating effects between diabetes symptoms and health-related quality of life in adolescents and young adults with type 1 diabe-tes. Pediatr Diabetes 2018; 19(7): 1322-1330.
23. Asnani MR, Barton-Gooden A, Grindley M, Knight-Madden J. Disease Knowledge, Illness Percep-tions, and Quality of Life in Adolescents With Sickle Cell Disease: Is There a Link ? Glob Pediatr Health. 2017; 4: 2333794X17739194.
24. Moss-Morris R, Weinman J, Petrie K, Horne R, Cameron L, Buick D. The Revised Illness Perception Questionnaire (IPQ-R). Psychology & Health 2002; 17(1): 1-16.
25. Tucker CM. Self-Regulation Predictors of Medication Adherence Among Ethnically Different Pediatric Patients With Renal Transplants. Journal of Pediatric Psychology 2001; 26(8): 455-464.
26. Varni JW, Katz ER, Seid M, et al.The Pediatric Cancer Quality of Life Inventory (PCQL). I. Instrument Development, Descriptive Statistics, and Cross-Informant Variance. J Behav Med 1998; 21: 179-204.
27. Barakat LP, Lutz M, Smith-Whitley K, et al. Is treatment adherence associated with better quality of life in children with sickle cell disease ? Qual Life Res 2005; 14: 407-414.
28. Samardzic M, Tahirovic H, Popovic N, Popovic-Samardzic M. Health-related quality of life in children and adolescents with type 1 diabetes mellitus from Montenegro: relationship to metabolic control. Journal of Pediatric Endocrinology and Metabolism, 2016; 29(6): 663-668.