Which Dimensions of Family Support Matter for Diabetes Self-Care? Evidence from Adults with Type 2 Diabetes in Primary Care
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Abstract
Family support is an important social resource for diabetes self-management, yet different forms of support may not contribute equally to specific self-care behaviors. This study examined the associations between emotional, instrumental, informational, and appraisal support and diabetes self-care among adults with type 2 diabetes receiving primary care. An analytical cross-sectional study was conducted among 99 adults with type 2 diabetes recruited using consecutive sampling. Family support was assessed using the Family Support Questionnaire, while diabetes self-care behaviors were measured using the Summary of Diabetes Self-Care Activities. Associations were examined using correlation analyses and multivariable linear regression adjusted for age, sex, educational attainment, duration of diabetes, and frequency of healthcare follow-up. Perceived family support was generally high across all dimensions. Medication adherence was the most frequently performed self-care behavior (5.24 ± 2.08 days/week), whereas blood glucose monitoring was the least frequent (2.40 ± 1.93 days/week). Although several family-support dimensions were positively correlated with physical activity, medication adherence, and foot care in bivariate analyses, most associations were attenuated after multivariable adjustment. Informational support showed the clearest independent associations, with higher informational support associated with more frequent blood glucose monitoring (β = 0.31, 95% CI [0.02, 0.60], p = .036) and foot care (β = 0.42, 95% CI [0.07, 0.76], p = .018). No consistent independent associations were observed for emotional, instrumental, or appraisal support across the self-care domains. These findings suggest that the contribution of family support to diabetes self-management may depend on the type of support provided. Family-oriented diabetes care in primary care may benefit from emphasizing specific informational support that helps patients perform practical and preventive self-care behaviors.
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References
I. Almomani, M. H., & AL-Tawalbeh, S. (2022). Glycemic control and its relationship with diabetes self-care behaviors among patients with type 2 diabetes in Northern Jordan: A cross-sectional study. Patient Preference and Adherence, 16, 449–465. https://doi.org/10.2147/PPA.S343214
II. Alrasasimah, W. A., & Alsabaani, A. (2024). Predictors of diabetes self-management behaviour among type 2 diabetics in Saudi Arabia: A cross-sectional study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 17, 2371–2384. https://doi.org/10.2147/DMSO.S455193
III. Alrasheeday, A. M., Alshammari, H. S., Alshammari, B., Alkubati, S. A., Llego, J. H., Alshammari, A. D., Alshammari, M. H., Almohammed, R. A., Alsheeb, S. M. S., & Alshammari, F. (2024). Perceived barriers to healthy lifestyle adherence and associated factors among patients with type 2 diabetes mellitus: Implications for improved self-care. Patient Preference and Adherence, 18, 2425–2439.
https://doi.org/10.2147/PPA.S432806
IV. Busebaia, T. J. A., Thompson, J., Fairbrother, H., & Ali, P. (2023). The role of family in supporting adherence to diabetes self-care management practices: An umbrella review. Journal of Advanced Nursing, 79, 3652–3677.
https://doi.org/10.1111/jan.15689
V. El-Radad, H. M., Sayed Ahmed, H. A., & Eldahshan, N. A. (2023). The relationship between self-care activities, social support, and glycemic control in primary healthcare patients with type 2 diabetes. Diabetology International, 14, 65–75.
https://doi.org/10.1007/s13340-022-00598-7
VI. Ernawati, Yuwono, P., & Sari, D. T. (2023). Sikap dan motivasi keluarga dalam perawatan penderita diabetes melitus di wilayah kerja Puskesmas Adimulyo: Family attitudes and motivation in caring for diabetes mellitus patients in the Adimulyo Community Health Center working area. Journal of Holistic Health Science, 5, 349–356. https://doi.org/10.35473/jhhs.v5i2.356
VII. Khairnar, R., Kamal, K. M., Giannetti, V., Dwibedi, N., & McConaha, J. (2019). Barriers and facilitators to diabetes self-management in a primary care setting—Patient perspectives. Research in Social and Administrative Pharmacy, 15, 279–286. https://doi.org/10.1016/j.sapharm.2018.05.003
VIII. Masupe, T., Onagbiye, S., Puoane, T., Pilvikki, A., Alvesson, H. M., & Delobelle, P. (2022). Diabetes self-management: A qualitative study on challenges and solutions from the perspective of South African patients and health care providers. Global Health Action, 15, 2090098.
https://doi.org/10.1080/16549716.2022.2090098
IX. Oktavia, S. (2022). Hubungan dukungan keluarga dengan kepatuhan diet terhadap kualitas hidup pasien diabetes melitus di Puskesmas Cikalong Kulon tahun 2021: Relationship between family support and diet compliance with quality of life for diabetes mellitus patients at Cikalong Kulon Health Center in 2021. Indonesian Scholar Journal of Nursing and Midwifery Science, 2, 503–512.
https://doi.org/10.54402/isjnms.v2i01.223
X. Shrivastava, S. R., Shrivastava, P. S., & Ramasamy, J. (2013). Role of self-care in management of diabetes mellitus. Journal of Diabetes & Metabolic Disorders, 12, Article 14.
https://doi.org/10.1186/2251-6581-12-14
XI. Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000). The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care, 23(7), 943–950.
https://doi.org/10.2337/diacare.23.7.943
XII. von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. The Lancet, 370(9596), 1453–1457.
https://doi.org/10.1016/S0140-6736(07)61602-X
XIII. Yuwono, P., Ernawati, E., Marsito, M., & Wardani, N. R. (2023). Dukungan emosional dalam perawatan diabetes mellitus di Puskesmas Karangsambung. Jurnal Manajemen Asuhan Keperawatan, 7, 17–21.
https://doi.org/10.33655/mak.v7i1.155
XIV. Zeren, F. G., & Canbolat, O. (2023). The relationship between family support and the level of self care in type 2 diabetes patients. Primary Care Diabetes, 17, 341–347.