Daily illness appraisal and collaboration in couples with type 1 diabetes

Dyadic coping theories posit that spousal involvement may benefit illness management through collaborative and supportive (C&S) strategies and shared illness appraisals. Illness appraisals have only been examined as individual differences rather than fluctuating daily as individuals manage the difficult Type 1 diabetes regimen. The study examined how daily illness appraisals of individuals with Type 1 diabetes and their spouses were linked to spouses' daily C&S strategies and whether C&S strategies were most beneficial for daily diabetes outcomes when they occurred in the context of shared illness appraisals.

Couples (N = 199) in which one person had Type 1 diabetes (M age patients = 46.81; 52.3% female; spouses = 46.40, 47.5% female) completed a 14-day diary assessing illness appraisals (ranging from nonshared through shared) and spouses' C&S strategies. Patients reported daily self-regulation failures, self-care behaviors, and perceived coping effectiveness. Daily blood glucose was gathered from glucometers.

Multilevel models indicated both within-person and between-person effects of patients' and spouses' illness appraisals on C&S strategies with higher shared illness appraisals associated with greater C&S strategies. Greater shared illness appraisals were associated with fewer self-regulation failures and better self-care. C&S strategies were associated with lower self-care and higher blood glucose levels. Appraisal interacted with C&S strategies such that C&S strategies were associated with more self-regulation failures, lower self-care, and lower perceived coping effectiveness when patients reported lower shared appraisals.

Results suggest that C&S strategies may be more detrimental for diabetes management when individuals view diabetes as less shared. (PsycInfo Database Record (c) 2020 APA, all rights reserved).