Family involvement is helpful and harmful to patients' self-care and glycemic control

Objective: We assessed the relationships between supportive and obstructive family behaviors and patients' diabetes self-care activities and HbA(1C), and potential interaction effects and differences by demographic characteristics. Methods: In a cross-sectional study, 192 adults with type 2 diabetes completed the Diabetes Family Behavior Checklist-II, the Summary of Diabetes Self-Care Activities, and a glycemic control (HbA(1C)) test. Results: Participants reported similar rates of supportive and obstructive behaviors that were positively correlated (rho = 0.61, p < 0.001). In adjusted analyses, supportive family behaviors were,associated with adherence to different self-care behaviors (beta = 0.20 to 0.50, p < 0.05). whereas obstructive family behaviors were associated with less adherence to self-care behaviors (beta = -0.28 to -0.39, p < 0.01) and worse HbA(1C) (beta = 0.18, p < 0.05). Supportive behaviors protected against the detrimental effect of obstructive behaviors on HbA(1C) (interaction beta = -0.22, p < 0.001). Non-Whites reported more supportive and obstructive behaviors than Whites, but race did not affect the relationships between family behaviors and self-care or HbA(1C). Conclusion: Involving family members in patients' diabetes management may impede patients' self-care and compromise their glycemic control unless family members are taught to avoid obstructive behaviors. Practice implications: Our findings endorse interventions that help family members develop actionable plans to support patients' self-care and train them to communicate productively about diabetes management. (C) 2014 Elsevier Ireland Ltd. All rights reserved.