Purpose The purpose of this study was to examine social support and its relationship to diabetes-specific quality of life and selfcare behaviors in African Americans with type 2 diabetes.
Methods The study followed a cross-sectional, observational design and recruited 89 African American adults, age 40 and older (mean = 60, SD = 10.5), diagnosed with type 2 diabetes. Participants completed measures assessing dia- betes-specific quality of life, self-care behaviors (healthy eating, physical activity, self-monitoring of blood glucose, foot care, medication and/or insulin use), demographic background, and diabetes-related social support. Diabetes-related social support variables included amount of social support received, satisfaction with support, positive support behavior, negative support behavior, and primary source of support.
Results Stepwise regressions, controlling for demographic variables, were conducted to identify predictors of diabetes-specific quality of life and selfcare behaviors from the diabetes-related social support variables. Satisfaction with support was a predictor for improved diabetes-specific quality of life (r = –.579, P < .001) and blood glucose monitoring (r = .258, P < .05). Positive support behavior was a predictor for following a healthy eating plan (r = .280, P < .05), spacing out carbohydrates evenly throughout the day (r = .367, P < .01), and performing physical activity at least 30 minutes per day (r = .296, P < .05). Negative support behavior was a predictor for not taking medication as recommended (r = –.348, P < .01).
Conclusions Findings indicate that social support plays a role in diabetes-specific quality of life and self-management practices. Social support encompasses multiple dimensions that differentially influence specific diabetes health-related outcomes and behaviors.
Get full access to this article
View all access options for this article.
References
1.
National Institute of Diabetes and Digestive and Kidney Diseases.National Diabetes Statistics Fact Sheet: General Information and National Estimate on Diabetes in the United States, 2005. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health; 2005.
2.
Norris SL, Lau J., Smith SJ, Schmid CH, Engelgau MMSelf-management education for adults with type 2 diabetes: a meta-analysis of the effect on glycemic control. Diabetes Care. 2002;25:1159-1171.
3.
Norris SL, Engelgau MM, Venkat Narayan KMEffectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes Care. 2001;24:561-587.
4.
Norris SL, Nichols PJ, Caspersen CJ, et al. Increasing diabetes self-management education in community settings: a systematic review. Am J Prev Med.2002;22(suppl):39-66.
5.
Padgett D., Mumford E., Hynes M., Carter R.Meta-analysis of the effects of educational and psychosocial interventions on management of diabetes mellitus. J Clin Epidemiol. 1988;41:1007-1030.
6.
Deakin T., McShane CE, Cade JE, Williams RDRR.Group based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst Rev.2005;(2):CD003417.
7.
Wendel CS, Shah JH, Duckworth WC, Hoffman RM, Mohler MJ, Murata GHRacial and ethnic disparities in the control of cardiovascular disease risk factors in Southwest American veterans with type 2 diabetes: the Diabetes Outcomes in Veterans Study. BMC Health Serv Res. 2006;6:58.
8.
Bonds DE, Zaccaro DJ, Karter AJ, Selby JV, Saad M., Goff DCEthnic and racial differences in diabetes care. Diabetes Care . 2003;26:1040-1046.
9.
Weatherspoon LJ, Kumanyika SK, Ludlow R., Schatz D.Glycemic control in a sample of black and white clinic patients with NIDDM. Diabetes Care. 1994;17:1148-1153.
10.
Harris MI, Eastman RC, Cowie CC, Flegal KM, Eberhardt MSRacial and ethnic differences in glycemic control of adults with type 2 diabetes . Diabetes Care. 1999;22:403-408.
11.
Brown AF, Gregg EW, Stevens MR, et al. Race, ethnicity, socio-economic position, and quality of care for adults with diabetes enrolled in managed care. Diabetes Care. 2005;28:2864-2870.
12.
Heisler M., Smith DM, Hayward RA, Krein SL, Kerr EARacial disparities in diabetes care processes, outcomes, and treatment intensity . Med Care. 2003;41:1221-1232.
13.
Schneider EC , Zaslavsky AM, Epstein AMRacial disparities in the quality of care for enrollees in Medicare managed care. JAMA. 2002;287:1288-1294.
14.
Oster NV, Welch V., Schild L., Gazmararian JA, Rask K., Spettell C.Differences in self-management behaviors and use of preventive services among diabetes management enrollees by race and ethnicity. Dis Manag . 2006;9:167-175.
15.
Taylor SEHealth Psychology. 4th ed. Boston : McGraw-Hill; 1999.
16.
Glasgow RE, Toobert DJSocial environment and regimen adherence among type II diabetic patients . Diabetes Care. 1988;11:377-386.
17.
Wang CY, Fenske MMSelf-care of adults with non-insulin dependent diabetes mellitus: influence of family and friends. Diabetes Educ. 1998 ;22:465-470.
18.
Sousa VD, Zauszniewski JA, Musil CM, McDonald PE, Milligan SETesting a conceptual framework for diabetes self-care management. Res Theory Nurs Pract. 2004;18:293-316.
19.
Whittemore R., D'Eramo Melkus G., Grey M.Metabolic control, self-management and psychosocial adjustment in women with type 2 diabetes . J Clin Nurs. 2005;14:195-203.
20.
Wen LK, Shepherd MD, Parchman MLFamily support, diet, and exercise among older Mexican Americans with type 2 diabetes. Diabetes Educ. 2004;30:980-993.
21.
MacLean D., Lo R.The non-insulin-dependent diabetic: successes and failure in compliance . Aust J Adv Nurs. 1998;15:33-42.
22.
Toljamo M., Hentinen M.Adherence to self-care and social support. J of Clin Nurs . 2001;10:618-627.
23.
Wilson W., Ary DV, Biglan A., Giasgow RE, Toobert MAPsychosocial predictors of self-care behaviors (compliance) and glycemic control in non-insulin-dependent diabetes mellitus. Diabetes Care . 1986;9:614-622.
24.
Garay-Sevilla ME, Nava LE, Malacara JM, et al. Adherence to treatment and social support in patients with non-insulin dependent diabetes mellitus. J Diabetes Complications. 1995; 9:81-86.
25.
Albright TL , Parchman M., Burge S.; the RRNEST Investigators.Predictors of self-care behavior in adults with type 2 diabetes: an RRNest study. Fam Med. 2001;33:354-360.
26.
Griffith LS , Field BJ, Lustman PJLife stress and social support in diabetes: association with glycemic control. Int J Psychiatry Med. 1990;20:365-372.
27.
Ford ME, Tilley BC, McDonald PESocial support among African American adults with diabetes: Part 2 . A review. J Natl Med Assoc. 1998;90:425-432.
28.
Ford ME, Tilley BC, McDonald PESocial support among African American adults with diabetes: Part 1 . Theoretical framework. J Natl Med Assoc. 1998;90:361-365.
29.
Murphy DJ, Williamson PS, Nease DESupportive family members of diabetic adults. Fam Pract. 1994;14:323-331.
30.
Belgrave FZ , Moorman Lewis D.The role of social support in compliance and other health behaviors for African Americans with chronic illness. J Health Soc Policy. 1994;5:55-68.
31.
Uzoma CU, Felman RHL.Psychosocial factors influencing inner city black diabetic patients' adherence with insulin. Health Educ. 1989;20:29-32.
32.
Butler FR, Secundy MG, Romberg EEHealth care utilization patterns of hypertensive and diabetic African Americans elderly. J Cult Divers. 1994;1:74-78.
33.
McDonald PE , Wykle ML, Misra R., Suwonnaroop N., Burant CJPredictors of social support, acceptance, health-promoting behaviors, and glycemic control in African-Americans with type 2 diabetes. J Natl Black Nurses Assoc. 2002;13:23-29.
34.
Chlebowy DO , Garvin BJSocial support, self-efficacy, and outcome expectations: impact on self-care behaviors and glycemic control in Caucasians and African American adults with type 2 diabetes. Diabetes Educ. 2006;32:777-786.
35.
Blumer H.Symbolic Interactionism: Perspective and Method. Berkeley : University of California Press; 1969.
36.
Lewis FMPerspectives on models of interpersonal health behaviors In: Glanz K, Rimer BK , Marcus Lewis F, eds. Health Behavior and Health Education: Theory, Research & Practice. 3rd ed. San Francisco: Jossey-Bass; 2002:265-273.
37.
Polonsky WH , Fisher L., Earles J., et al. Assessing psychosocial distress in diabetes: development of the Diabetes Distress Scale. Diabetes Care. 2005;28:626-631.
38.
Toobert DJ, Hampson SE, Glasgow REThe summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000;23:943-950.
39.
Gallant MPThe influence of social support on chronic illness self-management: a review and directions for research. Health Educ Behav. 2003;30:170-195.
40.
Aalto AM, Uutela A., Aro ARHealth related quality of life among insulin-dependent diabetics: disease-related and psychosocial correlates. Patient Educ Couns. 1997;30:215-225.
41.
Skelly AH, Burns DSSocial support: conceptualization, issues, and complexities. In: Mensing C, ed. The Art and Science of Diabetes Self-Management Education. Chicago: American Association of Diabetes Educators;2006:91-112.
42.
Sherbourne CD, Hays RD, Ordway L., DiMatteo MR, Kravitz RLAntecedents of adherence to medical recommendations: results from the medical outcomes study . J Behav Med. 1992; 15: 447-468.
43.
Mercado FJ, Vargas PNDisease and the family: differences in metabolic control of diabetes mellitus between men and women. Women Health. 1989;15:111-121.
44.
Quakenbush PA , Brown SA, Duchin SPThe influence of demographic and treatment variables on the health beliefs of adults with diabetes. Diabetes Educ. 1996;22:231-236.
45.
Rubin RR, Peyrot M.Men and diabetes: psychosocial and behavioral issues. Diabetes Spectrum. 1998;11:81-87.
46.
Kvam SH, Lyons JSAssessment of coping strategies, social support, and general health status in individuals with diabetes mellitus. Psychol Rep . 1991;68:623-632.
47.
Cagle CS, Appel S., Skelly AH, Carter-Edwards L.Mid-life African-American women with type 2 diabetes: influence on work and the multicaregiver role. Ethn Dis. 2002;12:555-566.
48.
Carter-Edwards L., Skelly AH, Cagle CS, Appel SJ "They care but don't understand": family support of African-American women with type 2 diabetes . Diabetes Educ . 2004;30:483-501.
49.
Samuel-Hodge CD, Skelly AH, Headen S., Carter-Edwards L.Familial roles of older African-American women with type 2 diabetes: testing of a new multiple caregiving measure. Ethn Dis. 2005 ;15:438-443.
50.
Heisler M., Bouknight RR, Hayward RA, Smith DM, Kerr EAThe relative importance of physician communication, participatory decision making, and patient understanding in diabetes self-management. J Gen Intern Med. 2002;17:243-252.
