Family and disease management in African-American patients with type 2 diabetes.
OBJECTIVE
The aim of this project is to specify features of family life that are associated with disease management in African Americans with type 2 diabetes.


METHODS
A total of 159 African-American patients with type 2 diabetes were assessed on three domains of family life (structure/organization, world view, and emotion management) and three key dimensions of disease management (morale, management behaviors, and glucose regulation). Analyses assessed the associations of family factors with disease management.


RESULTS
Multivariate tests for the main effects of three family variables were significantly related to the block of disease management variables for morale (F=3.82; df=12,363; P <0.0001) and behavior (2.12; 9,329; P <0.03). Structural togetherness in families was positively related to diabetes quality of life (DQOL)-Satisfaction (P <0.01). High family coherence, a world view that life is meaningful and manageable, was positively associated with general health (P <0.05) and DQOL-Impact (P <0.05) and negatively associated with depressive symptoms (P <0.001). Emotion management, marked by unresolved family conflict about diabetes, was related to more depressive symptoms (P <0.001), lower DQOL-Satisfaction (P <0.01), and lower DQOL-Impact (P <0.001). No family measures were related to HbA1c levels.


CONCLUSIONS
The family domain of emotion management demonstrates the strongest associations with diabetes management in African-American patients, followed by family beliefs. Patient morale is the aspect of disease management that seems most related to family context.
Chesla
Catherine A
CA
Department of Family Health Care Nursing, University of California, San Francisco, CA 94143-0606, USA. kit.chesla@nursing.ucsf.edu
Fisher
Lawrence
L
Mullan
Joseph T
JT
Skaff
Marilyn M
MM
Gardiner
Phillip
P
Chun
Kevin
K
Kanter
Richard
R
D044383:Black People; D002140:California; D003220:Conflict, Psychological; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D004522:Educational Status; D004644:Emotions; D005190:Family; D005260:Female; D006304:Health Status; D006801:Humans; D007182:Income; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009013:Morale; D011788:Quality of Life; D012959:Socioeconomic Factors; D001741:Black or African American