title: Family function, stress, and locus of control. Relationships to glycemia in adults with diabetes mellitus.
abstract: OBJECTIVE
  To determine whether glycemic control in adults with either insulin-dependent diabetes mellitus (IDDM) or non-insulin-dependent diabetes mellitus (NIDDM) is related to perceived family function, stress/coping, affect, and locus of control.
  
  
  METHODS
  Cross-sectional, observational study.
  
  
  METHODS
  Four hundred seven subjects from a family medicine ambulatory care unit, a tertiary pediatric diabetic unit, or a public-funded community health center, all located in Winston-Salem, NC, completed a series of psychometric instruments that included the Family APGAR (Adaptation, Partnership, Growth, Affection, and Resolve), FACES III (Family Adaptability and Cohesion Evaluation Scales) Cohesion subscale, Affect Balance Scale, Multidimensional Health Locus of Control Scales, and the Brief Encounter Psychosocial Instrument.
  
  
  METHODS
  Glycemic control was measured by fasting blood glucose levels and glycosylated hemoglobin A1C levels as well as by patients' perception of their control.
  
  
  RESULTS
  Those with NIDDM had scores indicative of more external sources of control than those with IDDM. A greater proportion of adults with both subtypes of diabetes perceived their families to be disengaged than subjects from families without diabetes. In a bivariate analysis, family dysfunction correlated with lack of perceived glycemic control, while perceived stress and negative affect correlated with fasting glucose levels in those with NIDDM but not those with IDDM. Using multivariate discriminant analysis, adults with NIDDM in good glycemic control as measured by glycosylated hemoglobin levels had lower family cohesion and negative affect than those in poor control. Conversely, those with IDDM with acceptable glycosylated hemoglobin levels had higher family cohesion, less negative affect, fewer chance loci of control, but higher perception of inadequate coping than those in poor control.
  
  
  CONCLUSIONS
  Knowledge of the family function, affect, locus of control, perceived stress, and coping may be useful to the family physician in the care of adults with diabetes mellitus, since these psychosocial parameters are associated with objective and perceived glycemic control.
authors.affiliation: Department of Family and Community Medicine, Bowman Gray School of Medicine, Winston-Salem, NC.
authors.forename: J C
authors.initials: JC
authors.lastname: Konen
authors.forename: J H
authors.initials: JH
authors.lastname: Summerson
authors.forename: M B
authors.initials: MB
authors.lastname: Dignan
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001786:Blood Glucose; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D005190:Family; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007389:Internal-External Control; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013315:Stress, Psychological
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin