{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T22:15:05Z","timestamp":1771884905396,"version":"3.50.1"},"reference-count":34,"publisher":"Baishideng Publishing Group Inc.","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Diabetes"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n                  <jats:p>Diabetic ketoacidosis (DKA) remains a serious and potentially preventable complication among children with type 1 diabetes mellitus (T1DM), particularly in Saudi Arabia. Psychological constructs such as perceived severity and susceptibility influence health behaviour, yet their role in pediatric diabetes management remains underexplored.<\/jats:p>\n                  <jats:p>AIM<\/jats:p>\n                  <jats:p>To examine psychological predictors of DKA in children with T1DM using the health belief model, and to assess the role of caregiver-perceived understanding in influencing adherence and DKA occurrence.<\/jats:p>\n                  <jats:p>METHODS<\/jats:p>\n                  <jats:p>A case-control study was conducted at Prince Sultan Military Medical City in Riyadh, Saudi Arabia, involving 191 caregivers of children with T1DM (96 cases with a history of DKA and 95 controls without). Validated questionnaires measured perceived severity, susceptibility, understanding, and adherence. Statistical analyses included independent t -tests, Pearson and Spearman correlations, and multiple regression.<\/jats:p>\n                  <jats:p>RESULTS<\/jats:p>\n                  <jats:p>Perceived understanding was the strongest predictor of adherence (\u03b2 = 1.03, P  &lt; 0.001) and was inversely associated with DKA occurrence (P  &lt; 0.001). Children without a DKA history had significantly higher levels of perceived understanding and adherence. Perceived severity had a moderate positive association with adherence, while perceived susceptibility showed a weak negative correlation.<\/jats:p>\n                  <jats:p>CONCLUSION<\/jats:p>\n                  <jats:p>Caregiver-perceived understanding plays a critical role in adherence and DKA prevention. These findings support expanding the health belief model to include perceived understanding as a distinct construct and highlight the importance of integrating comprehension-focused strategies into pediatric diabetes education.<\/jats:p>","DOI":"10.4239\/wjd.v16.i8.110088","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T02:00:57Z","timestamp":1755136857000},"source":"Crossref","is-referenced-by-count":1,"title":["Psychological predictors of diabetic ketoacidosis in children: Health belief model-based case-control study"],"prefix":"10.4239","volume":"16","author":[{"given":"Nawal","family":"Alissa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Al Zahrani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2060","published-online":{"date-parts":[[2025,8,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-9032"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(20)30042-5"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.53350\/pjmhs2023171749"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2015.04.002"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16282"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5448.2010.00689.x"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.24456"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2024.45.12.20240734"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.5144\/0256-4947.2018.399"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3390\/children12010110"},{"key":"B11","unstructured":"Lucier J, Mathias PM.   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