Family involvement is helpful and harmful to patients’ self-care and glycemic control

Objective

We assessed the relationships between supportive and obstructive family behaviors and patients’ diabetes self-care activities and HbA_1C, and potential interaction effects and differences by demographic characteristics.

Methods

In a cross-sectional study, 192 adults with type 2 diabetes completed the Diabetes Family Behavior Checklist-II, the Summary of Diabetes Self-Care Activities, and a glycemic control (HbA_1C) test.

Results

Participants reported similar rates of supportive and obstructive behaviors that were positively correlated (rho = 0.61, p < 0.001). In adjusted analyses, supportive family behaviors were associated with adherence to different self-care behaviors (β = 0.20 to 0.50, p < 0.05), whereas obstructive family behaviors were associated with less adherence to self-care behaviors (β = −0.28 to −0.39, p < 0.01) and worse HbA_1C (β = 0.18, p < 0.05). Supportive behaviors protected against the detrimental effect of obstructive behaviors on HbA_1C (interaction β = −0.22, p < 0.001). Non-Whites reported more supportive and obstructive behaviors than Whites, but race did not affect the relationships between family behaviors and self-care or HbA_1C.

Conclusion

Involving family members in patients’ diabetes management may impede patients’ self-care and compromise their glycemic control unless family members are taught to avoid obstructive behaviors.

Practice implications

Our findings endorse interventions that help family members develop actionable plans to support patients’ self-care and train them to communicate productively about diabetes management.