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

Abstract

OBJECTIVE: We assessed the relationships between supportive and obstructive family behaviors and patients' diabetes self-care activities and HbA1C, 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 (HbA1C) 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 HbA1C (β=0.18, p<0.05). Supportive behaviors protected against the detrimental effect of obstructive behaviors on HbA1C (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 HbA1C. 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.