Family and marital support have been shown to be associated with better treatment adherence, illness adaptation, and blood sugar control in studies of individuals with diabetes. However, the behaviors and attitudes that describe appropriate support have not been defined. This is a qualitative study which asked couples who live with diabetes to define support. Seventy-four individuals (patients and spouses) participated in semi-structured interviews. Transcripts of these interviews were rigorously coded and analyzed by a team of researchers. A sampling of quotes is provided. Helpful behavior was particularly evident in the areas of dietary control and regimen specific support, general relational support, and reminders.
OBJECTIVETo compare glycemic control and secondary outcomes of a 4-month telephonic couples behavioral intervention to individual intervention, and to education, for adults with type 2 diabetes.RESEARCH DESIGN AND METHODSA randomized trial with the following three arms: couples calls (CC) (n = 104); individual calls (IC) (n = 94); and diabetes education (DE) (n = 82). All arms had self-management education (two calls). CC and IC had 10 additional behavior change calls. CC addressed collaboration and relationships/communication. Participants consisted of 280 couples, among whom one partner had type 2 diabetes and an A1C level ≥7.5%. Blinded assessments occurred at 4, 8, and 12 months. The primary outcome was change in A1C; and secondary outcomes were BMI, waist circumference, blood pressure, depressive symptoms, diabetes self-efficacy, and diabetes distress.RESULTSPatients had a mean age of 56.8 years; 61.6% were male, and 30.4% were minorities. The baseline mean A1C level was 9.1%. Intention-to-treat analyses found significant A1C reductions for all (12 months: CC −0.47%, IC −0.52%, DE −0.57%), with no differences between arms. Preplanned within-arm analyses were stratified by baseline A1C tertiles: lowest tertile (7.5–8.2%), no change from baseline; middle tertile (8.3–9.2%), only CC led to significantly lower A1C level; and highest tertile (≥9.3%), significant improvement for all interventions. For BMI, CC showed significant improvement, and CC and DE led to decreased waist circumference. The IC group showed greater blood pressure improvement. Results for secondary psychosocial outcomes favored the CC group.CONCLUSIONSIn adults with poorly controlled type 2 diabetes, a collaborative couples intervention resulted in significant, lasting improvement in A1C levels, obesity measures, and some psychosocial outcomes. For those with exceedingly high A1C levels, education alone was beneficial, but additional intervention is needed to achieve glycemic targets.
This article describes the purpose, reliability, validity, and potential clinical applications of the brief accessibility, responsiveness, and engagement (BARE) scale. In addition to focusing on the central attachment behaviors of accessibility and responsiveness, this instrument highlights the key role of engagement in couple bonding. The BARE is a short, systemic, self-report measure of attachment behaviors in couple relationships. Both classical testing theory and item response theory were used to test the psychometric properties of the instrument. The BARE demonstrated appropriate reliability and validity while maintaining its brevity and potential usefulness for clinicians and researchers. The BARE also accurately predicted the key relationship outcomes of stability and satisfaction. The data for this study were collected from the RELATE assessment (see www.relate-institute.org).
OBJECTIVELittle is known about the psychosocial challenges of adults living with type 1 diabetes or its impact on partner relationships. This qualitative study was undertaken to gain better understanding of these issues.RESEARCH DESIGN AND METHODSFour focus groups were held, two with adult type 1 diabetic patients (n = 16) and two with partners (n = 14). Two broad questions were posed: “What are the emotional and interpersonal challenges you have experienced because you have (your partner has) type 1 diabetes?” and “How does the fact that you have (your partner has) type 1 diabetes affect your relationship with your partner, positively and/or negatively?” Sessions were recorded and transcribed, and analyzed by a team of four researchers, using constant comparative methods to identify core domains and concepts.RESULTSFour main domains were identified: 1) impact of diabetes on the relationship, including level of partner involvement, emotional impact of diabetes on the relationship, and concerns about child-rearing; 2) understanding the impact of hypoglycemia; 3) stress of potential complications; and 4) benefits of technology. Themes suggest that, although partner involvement varies (very little to significant), there exists significant anxiety about hypoglycemia and future complications and sources of conflict that may increase relationship stress. Partner support is highly valued, and technology has a positive influence.CONCLUSIONSAdults with type 1 diabetes face unique emotional and interpersonal challenges. Future research should focus on gaining a better understanding of how they cope and the effect of psychosocial stressors and coping on adherence, quality of life, and glycemic control.
A pilot study was conducted to assess the feasibility and potential efficacy of a couples focused diabetes intervention in which a collaborative problem-solving approach to diabetes self-care was promoted. Couples (N = 44), in which one partner had Type 2 diabetes and was in poor blood glucose control were randomly assigned to one of three groups: a couples intervention, an individual intervention, or individual diabetes education. The intervention included goal-setting, dietary behavior change, and a focus on emotions. For those in the couples arm, this was done within the framework of promoting collaborative communication between the partners. All intervention contacts were over the telephone to increase reach. Results showed that both the individual and couples interventions yielded meaningful clinical improvements in medical outcomes. Diabetes education also resulted in improved blood glucose control. Despite the small number, mixed-model regression analyses found statistically significant treatment effects for total cholesterol. This pilot demonstrates the feasibility and potential efficacy of a telephone intervention for Type 2 diabetes patients and their partners. Information from implementing this pilot led to refinement and further development of the intervention, which is being assessed in a larger, more comprehensive trial.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.