Many diabetes self-management behaviors (DSMB) take place in family settings, which highlights the importance of examining family-related factors associated with DSMB. Most current research has focused on the impact of family support on DSMB. Yet, how multiple family-related factors collectively affect DSMB remains unknown. The purpose of our study is to examine effects of positive family support, attitudinal familism, and perceived role demands associated with house chores and caregiving responsibilities on DSMB among a group of Chinese adults with type 2 diabetes mellitus (T2DM). A convenience sample of 210 patients with T2DM was recruited from a community health center in Beijing, China. Instruments included Diabetes Self-management Scale, Self-efficacy Scale for Patients with T2DM, Perceived Role Demands Scale, Attitudinal Familism Scale, and Diabetes Family Behavior Checklist-II. Findings from structural equation modelling showed that attitudinal familism, perceived role demands associated with house chores and caregiving responsibilities, and self-efficacy had direct impacts on DSMB. Attitudinal familism and positive family support both also had indirect effects on DSMB through self-efficacy (X2=3.31, p>0.05; RMSEA=0.022, CFI=0.998, SRMR=0.013). The indirect effect of positive family support on DSMB was 0.24, Bootstrap standard error=0.13, z=5.08, p<0.001; The indirect effect of attitudinal familism on DSMB was 0.15, Bootstrap standard error=0.04, z=3.44, p<0.01. Our findings suggest that it will be beneficial to improve patients’ self-efficacy in order to achieve optimal DSMB, especially for those who have less family support and lower attitudinal familism scores. It also indicates that more perceived role demands associated with house chores and caregiving responsibilities leads to less adherence to DSMB, and this relationship cannot be mediated by self-efficacy. Other strategies should be developed to help those with heavy role demands to achieve optimal DSMB.


K. Lin: None. L.T. Quinn: None.

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