Resolving disease management problems in European-American and Latino couples with type 2 diabetes: the effects of ethnicity and patient gender.
The management of type 2 diabetes requires major life style changes. How patients and family members resolve disagreements about disease management affects how well the disease is managed over time. Our goal was to identify differences in how couples resolved disagreements about diabetes management based on ethnicity and patient gender. We recruited 65 Latino and 110 European-American (EA) couples in which one spouse had type 2 diabetes. Couples participated in a 10-minute videotaped, revealed differences interaction task that was evaluated with 7 reliable observer ratings: warm-engagement, hostility, avoidance, amount of conflict resolution, off-task behavior, patient dominance, and dialogue. A series of 2 x 2, Ethnicity x Sex ANOVAs indicated significant effects for Ethnicity and for the Ethnicity x Sex interaction, but not for Sex. Latino couples were rated as significantly more emotionally close, less avoidant, less hostile toward each other, and had less dominant patients than EA couples; however, Latino couples achieved significantly less problem resolution and were more frequently off-task than EA couples. These findings were qualified by patient gender. The findings highlight important differences
Fisher
L
L
Department of Family & Community Medicine, Box 0900, UCSF, San Francisco, CA 94143, USA. fisher@itsa.ucsf.edu
Gudmundsdottir
M
M
Gilliss
C
C
Skaff
M
M
Mullan
J
J
Kanter
R
R
Chesla
C
C
D000328:Adult; D000704:Analysis of Variance; D003625:Data Collection; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000628:therapy*; D019468:Disease Management; D005060:Europe / Q000208:ethnology; D005191:Family Characteristics / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D012648:Self Care / Q000523:psychology*; D012737:Sex Factors; D014481:United States