title: Diabetes literacy and informal social support: a qualitative study of patients at a diabetes centre.
abstract: OBJECTIVE
  To explore the resources that patients diagnosed with type 2 diabetes drew upon to manage the disease in their daily lives.
  
  
  BACKGROUND
  Type 2 diabetes is a disease affecting Australian adults at a rate described as an 'epidemic'. Treatment usually focuses on patient self-management, which may require daily blood sugar monitoring, oral medications or injectable therapies, and regulating diet and exercise. Health research studies of patient self-management, including those involving type 2 diabetes, have focused largely on individual-centred definitions, though a number of studies, in particular qualitative studies, have indicated the positive role of social relationships and informal social networks.
  
  
  METHODS
  Exploratory, qualitative.
  
  
  METHODS
  The project focused on 26 patients attending a diabetes centre for clinical consultations with centre staff including doctors, diabetes educators, podiatrists and dietitians. The consultations were observed and audio recorded, followed by semi-structured, audio-recorded interviews with the patients and separate interviews with the consulting professional staff.
  
  
  RESULTS
  Overwhelmingly the patients drew on informal social networks of support to manage the disease. Spouses were significant, sometimes presenting with the patient as a 'team' approach to managing the disease. Sons and daughters also played a significant support role, especially interpreting during consultations and explaining health information. In some cases neighbours and also local community organisations provided informal support. Only two patients claimed not to use informal social support.
  
  
  CONCLUSIONS
  Informal social support in patients' self-management of type 2 diabetes was found to be an important factor to be considered by clinicians. The study suggested the need for a more deliberate or pro-active policy to involve patients' family and other informal social networks in treatment programs.
  
  
  CONCLUSIONS
  Clinicians may need document and incorporate informal social support in the development and implementation of patient management plans.
authors.affiliation: Faculty of Arts and Social Sciences, University of Technology Sydney, Broadway, NSW, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Black
authors.affiliation: Faculty of Arts and Social Sciences, University of Technology Sydney, Broadway, NSW, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Maitland
authors.affiliation: Diversity Health, Prince of Wales Hospital, Randwick, NSW, Australia.
authors.forename: Julieanne
authors.initials: J
authors.lastname: Hilbers
authors.affiliation: Department of Endocrinology and Diabetes, Prince of Wales Hospital, Randwick, NSW, Australia.
authors.forename: Kirsty
authors.initials: K
authors.lastname: Orinuela
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000451:nursing / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012648:Self Care; D012944:Social Support
keywords: diabetes literacy; health literacy; informal social support; self-management; social networks; type 2 diabetes