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Supportive family members improved self-care in adults with type 2 diabetes
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Patients with type 2 diabetes who have supportive family members have a better chance of achieving glycemic control vs. those whose family members exhibit nonsupportive behavior.
“Our findings suggest a new direction for future work to develop effective family-based interventions for adults with diabetes,” the researchers wrote.
Lindsay S. Mayberry, MS, and Chandra Y. Osborn, PhD, MPH, both from Vanderbilt University, used a mixed-methods approach to examine the role of family support as it relates to self-care behavior of family members with diabetes.
For 6 months, the researchers recruited English-speaking adults diagnosed with type 2 diabetes who were taking glucose-lowering diabetes medication. Of 75 participants, 45 (61%) attended a focus group session, and the remainder was given the opportunity to answer a survey. Sixteen additional patients completed the survey.
The researchers conducted 11 focus groups with two to six patients, including a 60-minute discussion and a 20- to 30-minute survey. Patients were asked about their medication adherence, experience and attitudes toward health information to manage their condition, as well as ideas for improving self-care.
Results revealed that 34% of the sample had uncontrolled glycemia, and 45 focus group patients described their family members as “somewhat informed about diabetes,” the researchers wrote.
According to the data, advancing age was related to nonsupportive family behavior (P<.05), and patients with higher incomes were more likely to have supportive family members (P<.05). Education, marriage and race were also associated with variables of interest.
The researchers concluded that many patients said they felt sabotaged by uninformed family members, thus creating conflict and interfering with self-care behavior.
Future qualitative research should be developed to determine relevant nonsupportive family behaviors, the researchers said.
Reference:
- Mayberry LS. Diabetes Care. 2012;doi:10.2337/dc11-2103.
Disclosures:
- The researchers report no relevant financial disclosures.
Perspective
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Donna Rice, MBA, RN, CDE
Today, the management and care of chronic illness is still in its infancy. Diabetes is still being treated in acute care settings with very little connection to the ongoing support that individuals need to self-manage their disease. An individual usually sees their provider maybe three to four times per year, for about 10 minutes. The remaining time is spent self-managing, and the family support and the “community” play an integral role both in the management and in the outcomes of this disease.
Often times there is a disconnect between the person with diabetes and their family; miscommunications and misconceptions can occur. Families that are most helpful are sometimes viewed by the individual with diabetes as the diabetes police, while other families whose members don’t recognize and articulate self-management practices may be viewed as saboteurs or that they just don’t care or understand.
Unfortunately, in today’s health care arena, the emphasis is not on holistic care. As diabetes clinicians, we have to bring the family into the loop. Education and support are extremely important for family members to better understand the disease and develop the skills to help co-manage the disease. Individuals with diabetes must surround themselves with the necessary support to manage this chronic condition. The greater the support system, the more likely self-care behaviors are developed and enforced.
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