Autonomy-Supportive Healthcare, Medication Adherence, and Life Satisfaction in Adolescents with Epilepsy: A Cross-Sectional Association

Adolescence is a critical developmental period in which epilepsy can affect both health behaviors and psychological well-being. However, clinical indicators alone do not fully capture adolescents’ lived experience. Grounded in Self-Determination Theory, this study examined the cross-sectional associations among autonomy-supportive healthcare (ASH) environments, medication adherence, and life satisfaction in adolescents with epilepsy. A cross-sectional design was used with 1219 Italian adolescents with epilepsy (M age = 15.58, SD = 1.72), recruited through pediatric neurology clinics and national patient support organizations. Participants completed validated self-report measures: the Health Care Climate Questionnaire (HCCQ) for ASH, the Medication Adherence Report Scale (MARS) for medication adherence, and the Satisfaction With Life Scale (SWLS) for life satisfaction. A mediation model was tested to evaluate the indirectly associated paths among the variables. The mediation model showed a good fit to the data (χ2/df = 2.45, CFI = 0.994, RMSEA = 0.034, SRMR = 0.029). ASH was positively associated with both medication adherence (β = 0.40, p < 0.001) and life satisfaction (β = 0.23, p < 0.001), while medication adherence was positively associated with life satisfaction (β = 0.35, p < 0.001). The indirect statistical path from ASH to life satisfaction through medication adherence was also significant (β = 0.08, p < 0.001), indicating partial mediation. Overall, these findings highlight positive cross-sectional links between ASH environments, medication adherence, and psychological well-being in adolescents with epilepsy, underscoring the potential relevance of relational aspects of care in chronic disease management.