Family influences on self-management among functionally independent adults with diabetes or heart failure: do family members hinder as much as they help?

Author:

Rosland Ann-Marie1,Heisler Michele2,Choi Hwa-Jung3,Silveira Maria J.4,Piette John D.4

Affiliation:

1. Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA, , Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA

2. Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA, Robert Wood Johnson Clinical Scholars Program, University of Michigan, MI, USA, Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA

3. Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA, Robert Wood Johnson Clinical Scholars Program, University of Michigan, MI, USA

4. Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA

Abstract

Objectives: Among functionally independent patients with diabetes or heart failure, we examined family member support and family-related barriers to self-care. We then identified patient characteristics associated with family support and family barriers and how each was associated with self-management adherence. Methods: Cross-sectional survey of 439 patients with diabetes or heart failure (74% response rate). Results: 75% of respondents reported supportive family involvement in self-care; however, 25% reported frequent family-related barriers to self-care. Women reported family support less often (64% v. 77%) and family barriers to self-care more often (30% v. 21%) than men. 78% of respondents reported involved family members nagged or criticized them about illness care. In multivariate models, low health literacy, partnered status and higher family function were associated with higher family support levels, while female gender, older age, higher education, and more depression symptoms were associated with family barriers to self-care. Family barriers were associated with lower disease care self-efficacy (p<0.01), and both barriers and family support were associated with patients’ self-management adherence (both p<0.05). Discussion: Family members are highly involved in the self-care of these higher functioning patients. Interventions should help patients with chronic illness overcome family barriers to self-care and help families use positive and effective support techniques.

Publisher

SAGE Publications

Subject

Health Policy,General Medicine

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