Supporting family
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Diabetes self-management interventions may need to place greater emphasis on targeting family members’ communication skills and teaching them positive ways to influence patient health behaviors.31 Family members can feel distressed by their loved one’s diabetes28,32–34 due to limited knowledge about diabetes or not knowing how to support their loved one.12,27,35–37 Family may also have misconceptions, such as believing the patient knows more about diabetes than the patient actually reports or not understanding their loved one’s needs in diabetes management.27,38 Knowledge about the disease, strategies to alter family routines, and optimal ways to cope with the emotional aspects of the disease are some of the aspects of diabetes self-management that family members need.39 Educating family members about diabetes-care needs can help ease this strain by explaining why these changes are necessary, how these changes can best be implemented, and where to find additional information, such as healthy recipes or exercise routines.24 Effective family management can also reduce the strain that family members may experience when coping with altered lifestyles and disease progression.24 It is important to provide family members with information about the illness and possible treatment options, validate their experiences as providers of support, teach them various stress management skills, and help them plan for the future.31
Influencing family member outcomes
Carefully designed studies are needed to evaluate the benefits of diabetes self-management interventions for both the patient and the family member.40 How families manage chronic disease affects not only the patient’s health, but the health of others in the family as well.12 Assessing family members’ knowledge in diabetes self-care and perceived ability to support their loved one with diabetes may be important end points for diabetes self-care interventions. Family members may also benefit more directly by reducing their own psychological distress regarding their loved one’s diabetes and by improving their own health behaviors through attending health education programs.32,41,42 Furthermore, family members at high risk for diabetes may decrease their own likelihood of developing diabetes through improved lifestyle behaviors and weight loss. In a review of randomized controlled trials of chronic disease interventions, benefits for family members were rarely assessed.40