The relationship between marital quality and adherence to the diabetes care regimen

Diabetes is a chronic illness that requires significant behavior change through adherence to, and maintenance of, a complex health care regimen. Social support has been found to be a factor that influences adherence.

This article reports a cross-sectional and prospective assessment of the relationship between marital quality (i.e., intimacy and adjustment) and self-reported adherence to the diabetes care regimen.

Seventy-eight insulin-treated adults with diabetes were assessed at Time 1 (T1) when they completed two marital quality measures and a measure of adherence to the diabetes care regimen. Sixty participants were contacted 2 years later (Time 2; T2), and the self-care measure was readministered. Blood glucose (sugar) control was assessed by hemoglobin A1c. Demographic data (age, gender, type and duration of diabetes, years married, other medical problems, family history of diabetes, years of education) were gathered from charts and questionnaires. Linear regression analyses were used to assess the ability of the two marital measures at T1 to predict adherence to self-care at T2, controlling for confounding baseline variables.

Results showed that both of the marital quality measures predicted many aspects of self-care at T1. Dietary self-care related to marital intimacy and adjustment, as did adherence to exercise and to doctor's recommendations. Neither adherence to blood glucose testing nor blood glucose control was related to marital quality. Prospective analyses showed that neither marital quality measure at T1 was a prospective predictor of aspects of adherence to self-care at T2.

Future efforts to improve self-care should explore the value of interventions that target the spouse and/or the couple's relationship.