The family and disease management in Hispanic and European-American patients with type 2 diabetes.
OBJECTIVE
To determine the relationship between the characteristics of families involved in disease management and the self-care practices of Hispanic and European-American (EA) patients with type 2 diabetes.


METHODS
A total of 74 Hispanic patients and 113 EA patients with type 2 diabetes recruited from managed care settings were assessed on three domains of family life (family structure/organization, family world view, and family emotion management [four scales]) and five areas of disease management (biological, general health and function status, emotional tone, quality of life, and behavioral [seven scales]). Analyses assessed the independent associations of patient sex, family, and sex by family interactions with disease management.


RESULTS
Both sex and the three domains of family life were related to disease management, but the results varied by ethnic group. For EA patients, sex, family world view, and family emotion management were related to disease management (scores for Family Coherence were negatively associated with HbA1c level and depression, and poor scores for Conflict Resolution were linked with high depression); for Hispanic patients, sex and family structure/organization were related to disease management (high scores for Organized Cohesiveness were associated with good diet and exercise, and high scores for Family Sex-Role Traditionalism were related to high quality of life). No significant interactions with sex occurred.


CONCLUSIONS
Characteristics of the family setting in which disease management takes place are significantly linked to patient self-care behavior, and these linkages vary by patient ethnicity. A family's multiple independent dimensions provide multiple targets for intervention, and differences in family norms, structures, and emotion management should be considered to ensure that interventions are compatible with the setting of disease management.
Fisher
L
L
Department of Family and Community Medicine, University of California-San Francisco, 94143, USA. fisher@itsa.ucsf.edu
Chesla
C A
CA
Skaff
M M
MM
Gilliss
C
C
Mullan
J T
JT
Bartz
R J
RJ
Kanter
R A
RA
Lutz
C P
CP
D000328:Adult; D001290:Attitude; D015992:Body Mass Index; D002140:California; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation*; D004644:Emotions; D005060:Europe / Q000208:ethnology; D005190:Family; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006304:Health Status; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D011788:Quality of Life; D018454:Spouses; D044465:White People
D006442:Glycated Hemoglobin