Spouses use of social control to improve diabetic patients' dietary adherence.

Abstract

We investigated two types of negative and positive social control strategies, warning and encouragement, used by spouses to urge patients with type II diabetes to improve adherence to the diabetic diet. Warning refers to things a spouse may say or do to caution the patient about the consequences of eating a poor diet, and encouragement refers to things a spouse may say or do to promote healthier food choices by the patient. Our dyadic design (n=109 couples) assessed spouses' use of warning and encouragement (reported by spouses and by patients), as well as patients' reports of dietary adherence. Spouses being actively involved in patients' dietary choices was the largest category of open-ended descriptors of both warning and encouragement. Both spousal warning and encouragement were associated with patients' adherence to the recommended diabetic diet, with warning associated with poorer adherence and encouragement associated with better adherence. Moreover, it was the spouses' perceptions of their own influence attempts, and not patients' reports, that were consequential for patients' adherence. Patients' dietary behavior, and ultimately disease management, appears to be best served when the spouse uses more positively toned and less coercive influence attempts.

Self-management as a mediator of the relationship between social support and health outcomes of African American adults with type 2 diabetes.

“…These findings are similar to the findings of other studies in which race/ethnicity (Bohanny et al, 2013;Stephens, Rook, Franks, Khan, &Iida, 2010;Trinacty et al, 2007) and marital status (Wong, Gucciardi, Li & Grace, 2005) were among the sociodemographic characteristics that influenced T2D self-management and dietary adherence. This study was unique in that many self-report indicators were used to measure adherence with ADA dietary guidelines, specifically losing weight, reducing intake of fats and carbohydrates, and increasing intake of fruits and vegetables.…”

“…Health promoting behaviors of spouses were positively related to better dietary adherence; for example, spouses encouraged selecting healthier foods. On the other hand, spousal behaviors that were negative, such as warning of adverse consequences of non-healthy food choices, were associated with poor dietary adherence (Stephens et al, 2010).…”

“…In addition, women were negatively influenced by their husbands; women expressed that their husbands exhibited more control and hostile behaviors in relation to their diet adherence (Wong et al, 2005). On the other hand, men were positively supported by their wives; this support is usually described as instrumental support (e.g., with food preparation) (Wong et al, 2005) Spouses attempt to regulate health behaviors of their partners who are diagnosed with T2D; this regulation was conceptualized as spousal support that occurs within the context of social control and social influence of spouses upon each other (Stephens, Rook, Franks, Khan, &Iida, 2010). Health promoting behaviors of spouses were positively related to better dietary adherence; for example, spouses encouraged selecting healthier foods.…”

N-of-1 study of weight loss maintenance assessing predictors of physical activity, adherence to weight loss plan and weight change

“…As demonstrated in other studies, there are various ways in which others can support a person's WLM, some of which may be more effective than others (e.g. encouragement compared to personally giving health warnings (Stephens, Rook, Franks, Khan, & Iida, 2010)). Social support could be further investigated as a within-person factor in terms of need for social support and amount of support received.…”

Impact of Obstructive Sleep Apnea and Its Treatments on Partners: A Literature Review

“…[55][56][57][58][59][60][61][62] Partners can positively and negatively affect all phases of CPAP therapy, from purchase to initiation and early and later use. Patients are frequently prompted by their partners to seek treatment in the first place, which can have potentially adverse consequences for CPAP adherence over time, 63 particularly if participation is viewed by the patient as coercive.…”