Document Type : Original Article


Department of Epidemiology, Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand


BACKGROUND: Self‑care activities are associated with prognosis of type‑II diabetes mellitus
patients and include medication adherence, dietary adherence, physical activity, self‑monitoring of
blood glucose (SMBG), and appropriate foot care. The behaviors of a patient’s family members can
influence the patient’s self‑care activities, but little data exist on this association. The objective of this
study was to assess the extent of the association between behaviors of family members of Type‑II
diabetes patients and the patients’ self‑care activities.
MATERIALS AND METHODS: We conducted a cross‑sectional study at a teaching hospital
in Kathmandu, Nepal, and interviewed 411 outpatients with Type‑2 diabetes mellitus. We used
exploratory factor analysis to group family members’ behaviors into 3 domains (“authoritarian,”
“supportive,” and “planning” behaviors) and graded the level of the behavior into 3 categories (“high”
vs. “medium” vs. “low”) according to its ranking distribution in each domain. We assessed the
association between domains of family behavior and self‑care activities using multivariate logistic
regression with Bonferroni correction.
RESULTS: High (vs. low) level of supportive behavior was associated with compliance to SMBG (58%
vs. 11%; adjusted odds ratio [OR] =7.44; 95% confidence interval [CI] =2.41, 23.01). High (vs. low)
level of planning behavior was associated with high level of foot care adherence (64% vs. 21%;
adjusted OR = 6.03; 95% CI = 3.01, 12.11).
CONCLUSIONS: We found associations between behaviors of diabetes patients’ family members
and the patients’ own self‑care behaviors. However, the incongruence between the family behavior
measurement questions and the self‑care of interest limited the implications of the findings.


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