Family and disease management in African-American patients with type 2 diabetes

OBJECTIVE - The aim of this project is to specify features of family life that are associated with disease management in African Americans with type 2 diabetes. RESEARCH DESIGN AND METHODS - A total of 159 African-American patients with type 2 diabetes were assessed on three domains of family life (structure/organization, world view, and emotion management) and three key dimensions of disease management (morale, management behaviors, and glucose regulation). Analyses assessed the associations of family I factors with disease management. RESULTS - Multivariate tests for the main effects of three family variables were significantly related to the block of disease management variables for morale (F = 3.82; df = 12,363; P < 0.0001) and behavior (2.12; 9,329; P < 0.03). Structural togetherness in families was positively related to diabetes quality of life (DQOL)-Satisfaction (P < 0.01). High family coherence a world view that life is meaningful and manageable, was positively associated with general health (P < 0.05) and DQOL-Impact (P < 0.05) and negatively associated with depressive symptoms (P < 0.001). Emotion management, marked by unresolved family conflict about diabetes, was related to more depressive symptoms (P < 0.001), lower DQOL-Satisfaction (P < 0.01), and lower DQOL-Impact (P < 0.001). No family measures were related to HbA(1c) levels. CONCLUSIONS - The family domain of emotion management demonstrates the strongest associations with diabetes management in African-American patients, followed by family beliefs. Patient morale is the aspect of disease management that seems most related to family context.