title: Analysis of social networks supporting the self-management of type 2 diabetes for people with mental illness.
abstract: BACKGROUND
  People with mental illness have been identified as being more likely to experience type 2 diabetes and the complications arising from this, necessitating more complex chronic illness self-management. Social support has been identified as a significant factor in the successful adoption of lifestyle change for people with type 2 diabetes, however people with mental illness often have impoverished social networks leading to greater reliance upon professional care givers. This study maps the support provided by formal (paid and professional carers) and informal networks to people with mental illness and type 2 diabetes, comparing the experiences of people with a spouse with those without one.
  
  
  METHODS
  Interviews were conducted with 29 clients of a community nursing service with mental health problems who receive professional support to self-manage type 2 diabetes. Participants were asked to complete an egocentric social network map which involved mapping the people and services who support them to manage their health. Demographic data was collected as was data about co-morbidities and service use within the last 6 months. Network maps were supplemented by a series of open-ended questions about self-management practices, who supports these practices and what support they provide.
  
  
  RESULTS
  Participants identified small social networks with few friendship ties. These networks had diminished due to illness. For people with a spouse, this person provided significant support for chronic illness self-management performing a range of daily care and illness management tasks. People without a spouse were more reliant on professional and paid care givers for daily care and illness management. People without a spouse also demonstrated greater reliance upon weak social ties for emotional support and social connection and often developed friendships with formal caregivers.
  
  
  CONCLUSIONS
  Spousal support reduces the need for professional services. In the absence of a spouse, participants were more reliant upon paid and professional carers and weaker social ties for chronic illness support and social connection leading to greater vulnerability of loss of support.
authors.affiliation: School of Nursing & Midwifery, Flinders University, GPO Box 2100, Adelaide, 5001, Australia. Mikaila.Crotty@flinders.edu.au.
authors.forename: Mikaila M
authors.initials: MM
authors.lastname: Crotty
authors.affiliation: School of Nursing & Midwifery, Flinders University, GPO Box 2100, Adelaide, 5001, Australia. Julie.Henderson@flinders.edu.au.
authors.forename: Julie
authors.initials: J
authors.lastname: Henderson
authors.affiliation: Discipline of Public Health, Flinders University, GPO Box 2100, Adelaide, 5001, Australia. Paul.ward@flinders.edu.au.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Ward
authors.affiliation: School of Nursing & Midwifery, Flinders University, GPO Box 2100, Adelaide, 5001, Australia. Jeffrey.Fuller@flinders.edu.au.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Fuller
authors.affiliation: Faculty of Health Sciences, University of Southampton, Building 67, Highfield Campus, University Road, S017 1BJ, Hampshire, UK. A.E.Rogers@soton.ac.uk.
authors.forename: Anne
authors.initials: A
authors.lastname: Rogers
authors.affiliation: RDNS South Australia, Keswick, SA, 5035, Australia. ProfessorDebbie.Kralik@silverchain.org.au.
authors.forename: Debbie
authors.initials: D
authors.lastname: Kralik
authors.affiliation: RDNS South Australia, Keswick, SA, 5035, Australia. Sue.Gregory@rdns.org.au.
authors.forename: Sue
authors.initials: S
authors.lastname: Gregory
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2; D019468:Disease Management; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged; D036301:Qualitative Research; D012648:Self Care; D012944:Social Support; D018454:Spouses