title: Marital interactions in the process of dietary change for type 2 diabetes.
abstract: OBJECTIVE
  To explore how couples adjust to dietary management of type 2 diabetes.
  
  
  METHODS
  Couples were interviewed, first together and then separately, during the first year after diagnosis and 1 year later.
  
  
  METHODS
  Qualitative interviews conducted in hospital classrooms using a semistructured interview guide.
  
  
  METHODS
  Couples (N = 20) with a recently diagnosed spouse who met the study criteria were purposefully selected from volunteers solicited from hospital-based diabetes classes.
  
  
  METHODS
  Processes used by the couple to address the prescribed diet.
  
  
  METHODS
  Thematic analysis of interview transcripts using grounded theory to identify patterns of adaptation processes used over time.
  
  
  RESULTS
  Three couple categories emerged (cohesive, enmeshed, and disengaged), representing adaptation to the diabetic diet. Initially, 5 couples were cohesive (teamwork approach), 7 were enmeshed (nondiabetic spouse responsible for the diet; spouse was dependent), and 8 were disengaged (spouses functionally separate; spouse was solely responsible for the diet management). A year later, the majority of couples were disengaged (n = 14), 1 couple remained cohesive, and 4 couples remained enmeshed. Themes of flexibility, roles, rules, and communication varied across categories.
  
  
  CONCLUSIONS
  Understanding categories of marital adjustment to the diabetic diet may improve nutrition-based diabetes interventions. Further study is needed to verify these findings in larger and more diverse populations.
authors.affiliation: Department of Food Science, The Pennsylvania State University, University Park, Pennsylvania, USA.
authors.forename: Daisy
authors.initials: D
authors.lastname: Miller
authors.forename: J Lynne
authors.initials: JL
authors.lastname: Brown
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001294:Attitude to Health; D003142:Communication; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008612:Menu Planning; D018454:Spouses / Q000523:psychology*