Family Interventions to Improve Diabetes Outcomes for Adults. The management of diabetes among adults is critically dependent on the self-care practices of the individual patients (Powers et al., 2016). If the condition is mismanaged, the patient may develop complications such as cardiovascular diseases, retinopathy, nephropathy, amputations and event a premature death. Under usual circumstances, the diabetes cases are identified, and the patient engages in various management strategies.
These interventions may entail follow up care at healthcare centers and being part of the many phases of self-care such as healthy dieting, physical activities, adherence to the prescribed medications and glucose monitoring using the glucometers (Kitsiou et al., 2017). According to Baig et al., (2015), family members are in a position to play a role in assisting the patient undergoes the above process with relatively much ease that can improve the outcome of diabetes management. In the past, various studies had tested the family-based interventions among adults having diabetes. This recognition prompted their systematic review of family-based interventions for adults with diabetes on articles published from 1994 to 2014 while assessing the impact on the outcome of diabetes management.
Regarding the analysis of the contribution of the family towards diabetes among adults with type 2 diabetes, Baig et al.,(2015) recognized the relationship between diabetes self-care activities and the family and social settings. Since the majority of the disease management occurs in the family, taking care of this family surrounding is vital in ensuring success in the management of the condition (Grey et al., 2015).
In one way or the other, the family members actively participate in supporting or caring for patients having diabetes. From the article review, one of the studies that had over 5000 adults who were diagnosed with diabetes emphasized on the essential nature of friends, family, and colleagues of the patient in the wellbeing as well as the self-management. The determined activities which the family can take part in encompass providing the patient with social and emotional support which is crucial in coping with the condition and provision of the technical assistance driven towards assisting the patient to inject insulin or even maintain the apportionments at the follow-up clinic. The authors also found out that by engaging the family members in the educational intervention were likely to lead to marked changes geared towards healthy family practices and results in proper diabetes self-management.
Besides the advantages of the family involvement, the negative influences from the family were also determined. This determination was based on the behaviors of the family members that would be harmful and detrimental to the management of diabetes. The review determined the family structure, their beliefs, and problem-solving skills or even there absence to be critical as they can contribute to increased stress to the patient and thwart the disease management. In cases where there exist established family routines, conflicts erupt to accommodate changes required for management of diabetes (Chew, Mohd-Sidik & Shariff-Ghazali, 2015).
Baig et al., (2015) used various databases ranging from Pub Med, CINAHL and PsycINFO to search for articles concerning the family-based interventions on management of diabetes and published between January 1994 and October 2014. The included studies hand to have been done in the USA, published in either Spanish or English and geared towards improving diabetes treatment process.
From the review, 26 unique studies were identified. They were described in 46 articles that were all focused on the family-based interventions in addressing the diabetes management. Concerning study design, 13 out of the 26 studies used a randomized controlled study design with 11 using pre-post design. One study only indicated post-intervention measures with another one assigning individuals to various arms depending on their areas of stay.
The findings from the studies indicated different clinical outcomes. 19 out of the 26 studies mentioned significant improvement on A1c, 7 noting improvement from baseline to post-intervention with others also reporting improvement from baseline up to 5 months post the period of intervention. 11 studies also indicated improvements in blood pressure outcomes three of which showed short-term improvement, two showing improvement at 12 months and one demonstrating improvement f the diastolic pressure after 24 months of intervention.
Regarding patient psychosocial outcomes, three studies reported a decrease in depressive symptoms with one recording marked improvements from diabetes stress. Four studies dwelt on quality of life and recorded marked improvement after family interventions.
With 13 studies focused on diabetes knowledge among patients, 12 noted an improvement in knowledge among patients whose families were integrated into the education programs. Dietary habits also improved in the diabetic patients as indicated by 11 out of the 15 studies that assessed the dieting of patients. Only 5 out of 12 studies that dwelled on physical activities demonstrated better exercise activities among the patients.
By taking into account that the majority of the activities surrounding management of diabetes among adults happening within the family setups, involving the family in the self-care management of the condition is a crucial aspect to ensure success is obtained. With the identified studies indicating the varied impact on the management of diabetes, the bottom-line remained improvement. These improvements revolved around physical activity, better dietary habits, enhanced knowledge of the patient as well as adherence to treatment and appointments in the follow-up clinics.
Baig, A. A., Benitez, A., Quinn, M. T., & Burnet, D. L. (2015). Family interventions to improve
diabetes outcomes for adults. Annals of the New York Academy of Sciences, 1353(1), 89-
Chew, B. H., Mohd-Sidik, S., & Shariff-Ghazali, S. (2015). Negative effects of diabetes–related
distress on health-related quality of life: an evaluation among the adult patients with type
2 diabetes mellitus in three primary healthcare clinics in Malaysia. Health and quality of
life outcomes, 13(1), 187.
Grey, M., Schulman-Green, D., Knafl, K., & Reynolds, N. R. (2015). A revised self-and family
management framework. Nursing outlook, 63(2), 162-170.
Kitsiou, S., Paré, G., Jaana, M., & Gerber, B. (2017). Effectiveness of mHealth interventions for
patients with diabetes: an overview of systematic reviews. PloS one, 12(3), e0173160.
Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., … & Vivian,
- (2015). Diabetes self-management education and support in type 2 diabetes: a joint
position statement of the American Diabetes Association, the American Association of
Diabetes Educators, and the Academy of Nutrition and Dietetics. Journal of the Academy
of Nutrition and Dietetics, 115(8), 1323-1334.