The role of family support in diabetes self-management among rural adult patients

Aims and objectives: This study aimed to investigate the role of the family in supporting diabetes self-management and explore the possible mechanisms between family and diabetes self-management among rural patients in China.

Background: The prevalence of Type 2 diabetes mellitus (T2DM) is growing rapidly in rural areas of China, where healthcare resources remain relatively poor and family members play an important role in chronic disease self-management.

Design: This was a multicentre cross-sectional study.

Methods: A total of 276 adults with T2DM were recruited from nine county hospitals in China. Diabetes self-management, family support, family function, and family self-efficacy were evaluated using the mature scales. A theoretical model was built based on the social learning family model and previous studies and then verified using a structural equation model. The STROBE statement was used to standardise the study procedure.

Results: Family support and general family factors, including family function and self-efficacy, were positively correlated with diabetes self-management. Family support fully mediates the relationship between family function and diabetes self-management and partially mediates the relationship between family self-efficacy and diabetes self-management. The model explained 41% of the variability in diabetes self-management and had a good model fit.

Conclusion: General family factors can explain nearly half of the change in diabetes self-management in rural areas of China, while family support is a mediator between general family factors and diabetes self-management. Family self-efficacy, a potential intervention point of family based diabetes self-management education, can be improved by building special lessons for family members.

Relevance to clinical practice: This study emphasises the role of family in diabetes self-management and proposes suggestions for diabetes self-management intervention among patients with T2DM in rural areas of China.

Patient or public contribution: Patients and their family members completed the questionnaire which was used for data collection.