Predictors of self-care behavior in adults with type 2 diabetes: an RRNeST study

Fourfactors have been linked with self-care behaviors in patients with type 2 diabetes: (1) patient demographics, (2) doctor-patient relationship, (3) stress, and (4) social context. This study determined the relationship of each of these factors on self-care behavior in diabetic family practice patients.

We conducted a cross-sectional survey of patients seeking care in the outpatient clinics of the Residency Research Network of South Texas (RRNeST), a network of six family practice residency programs affiliated with the University of Texas Health Science Center at San Antonio. A total of 397 consecutive adults with type 2 diabetes presenting for appointments with family medicine faculty and family practice residents over a 6-month time period were surveyed about various factors and their relationship to self-care behavior pertinent to diabetes.

Self-care was related to age, patient satisfaction with his/her doctor-patient relationship, personal stress, and family context. Social context, as reflected by the statement "My family understands my diabetes," was strongly associated with diet, exercise, and medication adherence. Multivariate analysis demonstrated that, after controlling for patient demographic characteristics andpatient satisfaction, personal stress and social context were strongly associated with self-care, especially diet.

Social context, specifically the family, is significantly associated with self-care behaviors. Attempts to improve self-care behavior should include thefamily members of the diabetic patient. Since family physicians often provide care to multiple members of the family, they are ideally positioned to implement these interventions.