title: Setbacks in diet adherence and emotional distress: a study of older patients with type 2 diabetes and their spouses.
abstract: OBJECTIVE
  We investigated patients' difficulties in managing their diet (i.e. diet setbacks) and associations with change in disease-specific and general emotional distress (diabetes distress and depressive symptoms) among patients with type 2 diabetes and their spouses.
  
  
  METHODS
  Data for this study were collected in couples' homes (N=115 couples) using structured interviews and self-administered questionnaires at three time points: baseline (T1), six months after baseline (T2) and 12 months after baseline (T3).
  
  
  RESULTS
  Patients' diet setbacks were associated with an increase in their diabetes distress in the shorter-term (over six months). Patients' diet setbacks were not associated with longer-term change in diabetes distress or with change in depressive symptoms at either time point (six months or one year). In contrast, spouses' perceptions of patients' diet setbacks were associated with increases in their own diabetes distress at both time points (over six months and one year), and also with an increase in their depressive symptoms in the longer-term (over one year).
  
  
  CONCLUSIONS
  Findings reveal detrimental consequences of patients' diet nonadherence for emotional well-being that extend to the well-being of their spouses.
authors.affiliation: Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA. mmfranks@purdue.edu
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Franks
authors.forename: Rachel C
authors.initials: RC
authors.lastname: Hemphill
authors.forename: Amber J
authors.initials: AJ
authors.lastname: Seidel
authors.forename: Mary Ann Parris
authors.initials: MA
authors.lastname: Stephens
authors.forename: Karen S
authors.initials: KS
authors.lastname: Rook
authors.forename: James K
authors.initials: JK
authors.lastname: Salem
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000451:nursing* / Q000523:psychology*; D004032:Diet; D005260:Female; D019983:Guideline Adherence; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological