Association between family behaviors and self-care activities among type-II diabetes mellitus patients at a teaching hospital in Kathmandu, Nepal

BACKGROUND: Self-care activities are associated with prognosis of type-II diabetes mellitus patients and include medication adherence, dietary adherence, physical activity, self-monitoring of blood glucose (SMBG), and appropriate foot care. The behaviors of a patient's family members can influence the patient's self-care activities, but little data exist on this association. The objective of this study was to assess the extent of the association between behaviors of family members of Type-II diabetes patients and the patients' self-care activities. MATERIALS AND METHODS: We conducted a cross-sectional study at a teaching hospital in Kathmandu, Nepal, and interviewed 411 outpatients with Type-2 diabetes mellitus. We used exploratory factor analysis to group family members' behaviors into 3 domains ("authoritarian," "supportive," and "planning" behaviors) and graded the level of the behavior into 3 categories ("high" vs. "medium" vs. "low") according to its ranking distribution in each domain. We assessed the association between domains of family behavior and self-care activities using multivariate logistic regression with Bonferroni correction. RESULTS: High (vs. low) level of supportive behavior was associated with compliance to SMBG (58% vs. 11%; adjusted odds ratio [OR] = 7.44; 95% confidence interval [CI]=2.41, 23.01). High (vs. low) level of planning behavior was associated with high level of foot care adherence (64% vs. 21%; adjusted OR = 6.03; 95% CI = 3.01, 12.11). CONCLUSIONS: We found associations between behaviors of diabetes patients' family members and the patients' own self-care behaviors. However, the incongruence between the family behavior measurement questions and the self-care of interest limited the implications of the findings.