title: Patients' intentions to inform relatives about Type 2 diabetes risk: the role of worry in the process of family risk disclosure.
abstract: OBJECTIVE
  Patients with Type 2 diabetes may play a role as intermediary between medical professionals and at-risk relatives to promote diabetes prevention in their family. This study aimed to further our understanding of factors that influence the decisional process of familial risk disclosure in patients with diabetes.
  
  
  METHODS
  In a cross-sectional study, patients with Type 2 diabetes (n = 546) filled in a questionnaire assessing family risk perception, worry, personal beliefs regarding diabetes prevention, diabetes-related family communication, intention and perceived ability to inform relatives about familial risk of diabetes. Data were analysed using hierarchical logistic regression and multiple mediation analyses.
  
  
  RESULTS
  Sixty per cent of the patients were willing to inform their relatives about familial diabetes risk; 61% reported high family risk perception and 41% had positive control beliefs with regard to preventive options in relatives. A majority (69%) did not express serious concern about relatives developing diabetes. Worry about relatives, knowing what to tell, whom to notify, and communication about diabetes in general appeared to facilitate family risk disclosure. Unexpectedly, high family risk perception in itself did not significantly increase patients' intentions to inform relatives; rather, risk perception appeared to exert an indirect effect through worry and beliefs about diabetes prevention.
  
  
  CONCLUSIONS
  Worry in patients with diabetes appears to be a key factor in the process of family risk disclosure. When professionals guide their patients in this process, they should not only provide risk information, but also address worries and emphasize opportunities for diabetes prevention.
authors.affiliation: Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: S C M
authors.initials: SC
authors.lastname: van Esch
authors.forename: M D
authors.initials: MD
authors.lastname: Nijkamp
authors.forename: M C
authors.initials: MC
authors.lastname: Cornel
authors.forename: F J
authors.initials: FJ
authors.lastname: Snoek
mesh_terms: D001007:Anxiety / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D003142:Communication; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D030881:Disclosure; D005192:Family Health; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D033182:Intention; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010465:Perception; D012307:Risk Factors; D011795:Surveys and Questionnaires