Objectives:
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.
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.
Methods:
The study population will include 425 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 adherent (performing HbA1c test at least three times/year and LDL at least twice/year) or non-adherent (performing these tests once a year or more seldom) to medical guidelines.
Second, telephone interviews will include:
1) 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).
2) Patient’s characteristics – cognitive (beliefs about diabetes, self-efficacy), psychological (stress, depression) and satisfaction with the treating physician.
3) 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. |