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Family support in facilitating adherence to Diabetes self-care and metabolic control
 
Family support in facilitating adherence to Diabetes self-care and metabolic control
 

Tali Cinamon, Maccabi Health Services

 

Abstract 

Aims

To examine the unique contribution of family structure and family support  (beyond the contribution of patient’s characteristics), to adherence to diabetes self-care and to glycemic control.

 

Working hypothesis

Adherence to self-care will be higher among diabetes patients living with a family member, and among those with higher family support in self-care. These associations will be maintained when the patient’s personal characteristics and medical history are examined. We expect that the associations of family structure and support with glycemic control will be weaker than those with adherence.

 

Methodology

: The study population will include 429 adult (30-50 years old) non-insulin dependent type 2 diabetes patients, registered in Maccabi Diabetes Register for at least two years. A two-stage sampling procedure will be conducted. Using criteria available in the Register, patients will be first stratified to three groups 1) Those that have not  undergone HBA1c testing in the previous year 2) Well controlled HbA1c <7 3) Poorly controlled HbA1c >8.5. Random samples from all three groups will be  taken from all  the Maccabi regions. Then telephone interviews will be undertaken in Hebrew. The variables include: a) Family characteristics – family structure, patient’s willingness to involve the family in self-care behaviors, and a scale of family support in diabetes self-care behaviors (diet, physical activity, smoking, foot care, taking medications, and measuring blood glucose). b) Patient’s characteristics – cognitive (beliefs about diabetes, self-efficacy), psychological (stress, depression) and satisfaction with the treating physician. c) Adherence to self-care (the weekly number of performing each self-care behaviors). Glycemic control will be assessed from the Diabetes Register by the HbA1c values of the last laboratory test.

 

Significance

The study will provide more detailed data in Israel on the role of family support and family characteristics in adherence to self-care and metabolic control.   The findings will have practical implications for the design of psychosocial and family interventions by Maccabi social work services, as part of multi-disciplinary interventions to empower patients for self-care and for promoting their health.

 

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