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Family Diabetes Matters: A View from the Other Side

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ABSTRACT

BACKGROUND

Typically, chronic disease self-management happens in a family context, and for African American adults living with diabetes, family seems to matter in self-management processes. Many qualitative studies describe family diabetes interactions from the perspective of adults living with diabetes, but we have not heard from family members.

OBJECTIVE

To explore patient and family perspectives on family interactions around diabetes.

DESIGN

Qualitative study using focus group methodology.

PARTICIPANTS & APPROACH

We conducted eight audiotaped focus groups among African Americans (four with patients with diabetes and four with family members not diagnosed with diabetes), with a focus on topics of family communication, conflict, and support. The digital files were transcribed verbatim, coded, and analyzed using qualitative data analysis software. Directed content analysis and grounded theory approaches guided the interpretation of code summaries.

RESULTS

Focus groups included 67 participants (81 % female, mean age 64 years). Family members primarily included spouses, siblings, and adult children/grandchildren. For patients with diabetes, central issues included shifting family roles to accommodate diabetes and conflicts stemming from family advice-giving. Family members described discomfort with the perceived need to police or “stand over” the diabetic family member, not wanting to “throw diabetes in their [relative’s] face,” perceiving their communications as unhelpful, and confusion about their role in diabetes care. These concepts generated an emergent theme of “family diabetes silence.”

CONCLUSION

Diabetes silence, role adjustments, and conflict appear to be important aspects to address in family-centered diabetes self-management interventions. Contextual data gathered through formative research can inform such family-centered intervention development.

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Acknowledgements

This research was supported by the National Institutes of Health grant K01DK080079. Dr. Cené’s work on this project was supported by award number KL2RR025746 from the National Center for Research Resources, a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research. We are indebted to the community recruiters and participants from Durham, Raleigh, Siler City, Magnolia, and Fuquay Varina, NC who took the time to share their views of families living with diabetes. The authors also acknowledge the editorial assistance of Dr. Claire Viadro.

A portion of this study was presented in oral abstract form at the International Society for Behavioral Nutrition and Physical Activity annual meeting in Melbourne, Australia, 15–18 June, 2011.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Author information

Authors and Affiliations

  1. Department of Nutrition, Gillings School of Global Public Health, School of Medicine, and Center for Health Promotion and Disease Prevention, University of North Carolina, 1700 Martin Luther King Jr. Blvd., Room 250, UNC-CH, CB#7426, Chapel Hill, NC, 27599-7426, USA

    Carmen D. Samuel-Hodge PhD, MS, RD

  2. Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA

    Crystal W. Cene MD, MPH

  3. Division of Endocrinology and Metabolism, Department of Medicine, Duke University Medical Center, Durham, NC, USA

    Leonor Corsino MD, MHS

  4. Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA

    Chelsea Thomas MPH

  5. Sarah W. Stedman Nutrition and Metabolism Center, Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, NC, USA

    Laura P. Svetkey MD, MHS

Authors
  1. Carmen D. Samuel-Hodge PhD, MS, RD
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  2. Crystal W. Cene MD, MPH
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  3. Leonor Corsino MD, MHS
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  4. Chelsea Thomas MPH
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  5. Laura P. Svetkey MD, MHS
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Corresponding author

Correspondence to Carmen D. Samuel-Hodge PhD, MS, RD.

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Samuel-Hodge, C.D., Cene, C.W., Corsino, L. et al. Family Diabetes Matters: A View from the Other Side. J GEN INTERN MED 28, 428–435 (2013). https://doi.org/10.1007/s11606-012-2230-2

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  • DOI: https://doi.org/10.1007/s11606-012-2230-2

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