Spousal pressure and persuasion and diet adherence in patients with type 2 diabetes: The role of patients' self-efficacy
Abstract
Older patients with Type 2 diabetes have a heightened risk of stroke and heart disease, which are leading causes of death among older persons (CDCP, 2011). A central goal for public health is to enhance patients' ability to properly manage chronic illnesses such as diabetes, often with assistance from others (Institute of Medicine, 2008; Weiner, Helfrich, Savitz, & Swiger, 2007). Spouse involvement in diabetes management among older patients is the focus of this study since day-to-day management of diabetes often is shared between married patients and their spouses (Beverly, Miller, & Wray, 2008; Franks, Hemphill, Seidel, Stephens, Rook, & Salem, 2012; Stephens, Franks, Rook, Iida, Hemphill, & Salem, 2013). The primary aim of this study is to determine whether patients' diet-related self-efficacy mediated associations between spousal diet-related pressure and persuasion and patients' diet adherence and non-adherence. A second aim of this study is to explore change in patients' self-efficacy and diet adherence by examining whether spousal pressure and persuasion at baseline is associated with change in patients' diet-related self-efficacy and dietary adherence and non-adherence over one month. This study did not establish diet-related self-efficacy as a mediator of the associations between spousal control (pressure and persuasion) and patients' diet adherence and non-adherence contemporaneously or prospectively. Only patients' and spouses' reports of spousal diet-related persuasion were associated with patients' diet non-adherence contemporaneously as hypothesized. Future research should continue to delineate the mechanisms and conditions under which specific strategies of spouse involvement influence patient health behaviors, particularly in the context of chronic illnesses such as Type 2 diabetes. Such research potentially could shape how healthcare providers work with patients and their spouses in managing chronic illness in ways that enhance both psychological well-being and health behaviors that optimize healthy functioning and illness management.
Degree
Ph.D.
Advisors
Franks, Purdue University.
Subject Area
Public health|Clinical psychology
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