Links of Communal Coping in Couples with Diabetes to Self-care Behavior

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): Type 2 diabetes is a public health problem of great significance. The key determinant of whether health complications ensue is patient self-management. However, the self-care regimen for diabetes is complex and the health care system has limited resources to assist patients. Thus, it is not a surprise that self-care is poor. The present application recognizes that patient self-care takes place in a social context and aims to explore the impact of partner behaviors on patient self-care, self-efficacy, and mental and physical health. We propose to enroll 220 persons who have been diagnosed with type 2 diabetes in the past 2 years and their partners. Half of the couples will be African-American, and half will be Caucasian. Within these two groups, half will consist of female patients and half will consist of male patients. We hypothesize that communal coping in couples will lead to better patient self-care, while maintaining high levels of patient self-efficacy and good mental health. We hypothesize that partner supportive behaviors will mediate these relations. We will explore racial and gender differences in communal coping and supportive behavior as well as whether relations of communal coping and partner behavior are differentially related to outcomes due to race and gender. We propose to use multiple methods to assess independent and dependent variables. Methods include: (1) survey instruments that assess communal coping, patient and partner behavior, patient self-care, self- efficacy, and mental health; (2) a dyadic interview measure of communal coping; (3) a laboratory observational study in which couples discuss the way patients manage their disease so that raters can code the videotaped interactions for communal coping, supportive and unsupportive behavior, and affect; (4) an extension of the laboratory study in which patients view the videotapes, recall thoughts and feelings at key points, and raters code the behavior that precipitated the reactions; (5) in person assessments of physical health parameters; and (6) a 14-day ecological momentary assessment (EMA) study that consists of patients/partners completing a brief survey about patient-partner interactions at the end of each day. During the EMA study, three 24-hour dietary recall interviews will be performed, and patients/partners will wear accelerometers to capture activity and energy expenditure. Couples will be contacted six months later to repeat the survey, physical health assessment, and 24-hour recall interviews. The results of this study can be used to design a couples' intervention aimed at maximizing behaviors that help and minimizing behaviors that hinder self-care.