Managing Type 2 diabetes as a couple: The influence of partners' beliefs on diabetes distress over time.

AIMS Partners and spouses have an important role in supporting healthy self-care in adults with Type 2 diabetes. While evidence has shown that the beliefs held by people with diabetes influence emotional wellbeing, little is known about the long-term impact of partners' illness beliefs on diabetes distress. METHODS Persons with Type 2 diabetes (pwt2d) and their partners completed a questionnaire at baseline (N = 75 couples) and 12 months later (N = 45 couples). Measures included demographic/clinical parameters, the Revised Illness Perception questionnaire, and the Diabetes Distress Scale. A repeated measures ANOVA was used to examine change in measures over time. Multiple regression and moderation analysis were used to explore the indirect influence of partners beliefs on diabetes distress at baseline and follow-up. RESULTS Illness perceptions and diabetes distress in pwt2d and partners did not change overtime. Partners' beliefs about the controllability, chronicity, and predictability of symptoms of diabetes moderated the relationship between the corresponding pwt2d beliefs and diabetes distress. These indirect effects were observed across both time points. CONCLUSIONS Conflicting illness perceptions about the controllability and chronicity of diabetes, and congruous negative perceptions about diabetes symptoms among couples sustain distress overtime. Targeting the beliefs of couples to improve communication and understanding may reduce diabetes distress.

[1]  W. Polonsky,et al.  Assessing psychosocial distress in diabetes: development of the diabetes distress scale. , 2005, Diabetes care.

[2]  W. Polonsky,et al.  When Is Diabetes Distress Clinically Meaningful? , 2012, Diabetes Care.

[3]  M. Dempster,et al.  Psychological adjustment to Type 2 diabetes and relationship quality , 2011, Diabetic medicine : a journal of the British Diabetic Association.

[4]  David C. Smith,et al.  Randomized clinical trial of a family intervention for prostate cancer patients and their spouses , 2007, Cancer.

[5]  R. Glasgow,et al.  Patient age: a neglected factor when considering disease management in adults with type 2 diabetes. , 2011, Patient education and counseling.

[6]  M. Dempster,et al.  Illness perceptions among carer-survivor dyads are related to psychological distress among Oesophageal cancer survivors. , 2011, Journal of psychosomatic research.

[7]  M. Jokela,et al.  Psychosocial factors associated with work disability in men and women with diabetes: a pooled analysis of three occupational cohort studies , 2016, Diabetic medicine : a journal of the British Diabetic Association.

[8]  Keith Petrie,et al.  The Revised Illness Perception Questionnaire (IPQ-R) , 2002 .

[9]  M. Dempster,et al.  Diabetes distress, illness perceptions and glycaemic control in adults with type 2 diabetes , 2018, Psychology, health & medicine.

[10]  B. Cleal,et al.  Diabetes and depression in Denmark 1996–2010: national data stratified by occupational status and annual income , 2017, Diabetic medicine : a journal of the British Diabetic Association.

[11]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[12]  E. Berry,et al.  Illness perception clusters and relationship quality are associated with diabetes distress in adults with Type 2 diabetes , 2017, Psychology, health & medicine.

[13]  K. Khunti,et al.  Comparison of illness representations dimensions and illness representation clusters in predicting outcomes in the first year following diagnosis of type 2 diabetes: Results from the DESMOND trial , 2011, Psychology & health.

[14]  A. Strömberg,et al.  Dyads affected by chronic heart failure: a randomized study evaluating effects of education and psychosocial support to patients with heart failure and their partners. , 2012, Journal of cardiac failure.

[15]  I. C. Team.  Type 2 Diabetes in Adults: Management , 2015 .

[16]  R. Glasgow,et al.  A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with Type 2 diabetes , 2008, Diabetic medicine : a journal of the British Diabetic Association.

[17]  E. Karademas,et al.  The Association of Type 2 Diabetes Patient and Spouse Illness Representations with Their Well-being: A Dyadic Approach , 2014, International Journal of Behavioral Medicine.

[18]  J. F. Ybema,et al.  Effects of a brief intervention program for patients with cancer and their partners on feelings of inequity, relationship quality and psychological distress , 2004, Psycho-oncology.

[19]  L. Cronbach.  Coefficient alpha and the internal structure of tests , 1951 .

[20]  W. Polonsky,et al.  Poor medication adherence in type 2 diabetes: recognizing the scope of the problem and its key contributors , 2016, Patient preference and adherence.

[21]  Understanding Type 2 Diabetes , 2009, The Diabetes educator.

[22]  L. Fisher,et al.  Health and Psychosocial Outcomes of a Telephonic Couples Behavior Change Intervention in Patients With Poorly Controlled Type 2 Diabetes: A Randomized Clinical Trial , 2016, Diabetes Care.

[23]  W. Polonsky,et al.  Emotional Distress in the Partners of Type 1 Diabetes Adults: Worries About Hypoglycemia and Other Key Concerns. , 2016, Diabetes technology & therapeutics.

[24]  M. Kodali,et al.  Self Care Activities, Diabetic Distress and other Factors which Affected the Glycaemic Control in a Tertiary Care Teaching Hospital in South India. , 2013, Journal of clinical and diagnostic research : JCDR.

[25]  N. Sharpe,et al.  Causal attributions in patients and spouses following first-time myocardial infarction and subsequent lifestyle changes , 2000 .

[26]  M. G. Pereira,et al.  Partners’ representations of diabetes as mediators between patients’ representations and adherence to self-care behaviors, in type 2 diabetes , 2016, Psychology, health & medicine.

[27]  E. Berry,et al.  Exploring the effectiveness of couples interventions for adults living with a chronic physical illness: A systematic review. , 2017, Patient education and counseling.

[28]  G. Nefs,et al.  Diabetes‐specific emotional distress in people with Type 2 diabetes: a comparison between primary and secondary care , 2014, Diabetic medicine : a journal of the British Diabetic Association.

[29]  D. Russell,et al.  Cancer Distress Reduction with a Couple-Based Skills Training: A Randomized Controlled Trial , 2012, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[30]  P. Allison.  CHANGE SCORES AS DEPENDENT VARIABLES IN REGRESSION ANALYSIS , 1990 .

[31]  A. Beck,et al.  Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation , 1988 .

[32]  D. Meltzer,et al.  How patients with diabetes perceive their risk for major complications. , 2000, Effective clinical practice : ECP.

[33]  Janet L. Stewart,et al.  Helping patients with localized prostate carcinoma manage uncertainty and treatment side effects , 2002, Cancer.

[34]  R. Glasgow,et al.  Diabetes Distress but Not Clinical Depression or Depressive Symptoms Is Associated With Glycemic Control in Both Cross-Sectional and Longitudinal Analyses , 2009, Diabetes Care.

[35]  M. Diefenbach,et al.  Patient and spouse illness beliefs and quality of life in prostate cancer patients , 2013, Psychology & health.

[36]  Jeffrey S. Gonzalez,et al.  Distress and type 2 diabetes-treatment adherence: A mediating role for perceived control. , 2015, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[37]  A. Searle,et al.  Illness representations among patients with type 2 diabetes and their partners: relationships with self-management behaviors. , 2007, Journal of psychosomatic research.