Family and disease management in African-American patients with type 2 diabetes

OBJECTIVE: The aim of this project is to specify features of family life that are associated with disease management in African Americans with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 159 African-American patients with type 2 diabetes were assessed on three domains of family life (structure/organization, world view, and emotion management) and three key dimensions of disease management (morale, management behaviors, and glucose regulation). Analyses assessed the associations of family factors with disease management. RESULTS: Multivariate tests for the main effects of three family variables were significantly related to the block of disease management variables for morale (F=3.82; df=12,363; P <0.0001) and behavior (2.12; 9,329; P <0.03). Structural togetherness in families was positively related to diabetes quality of life (DQOL)-Satisfaction (P <0.01). High family coherence, a world view that life is meaningful and manageable, was positively associated with general health (P <0.05) and DQOL-Impact (P <0.05) and negatively associated with depressive symptoms (P <0.001). Emotion management, marked by unresolved family conflict about diabetes, was related to more depressive symptoms (P <0.001), lower DQOL-Satisfaction (P <0.01), and lower DQOL-Impact (P <0.001). No family measures were related to HbA1c levels. CONCLUSIONS: The family domain of emotion management demonstrates the strongest associations with diabetes management in African-American patients, followed by family beliefs. Patient morale is the aspect of disease management that seems most related to family context.