Associations between having an informal caregiver, social support, and self-care among low-income adults with poorly controlled diabetes

Author:

Bouldin Erin D12,Trivedi Ranak B34,Reiber Gayle E12,Rosland Ann-Marie56,Silverman Julie B127,Krieger James28,Nelson Karin M127

Affiliation:

1. Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System, Seattle, WA, USA

2. Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA

3. Center for Innovation to Implementation, Health Services Research & Development, VA Palo Alto Health Care System, Palo Alto, CA, USA

4. Department of Psychiatry and Behavioral Sciences, Stanford University, Menlo Park, CA, USA

5. Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, MI, USA

6. Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, MI, USA

7. Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA

8. Action for Healthy Food, Seattle, WA, USA

Abstract

Objective To determine whether the presence of an informal caregiver and the patient’s level of social support are associated with better diabetes self-care among adults with poorly controlled diabetes. Methods Cross-sectional study using baseline data from 253 adults of age 30–70 with poorly controlled diabetes. Participants who reported receiving assistance with their diabetes from a friend or family member in the past month were classified as having a caregiver. We used multivariate linear and logistic regression models to evaluate the associations between having a caregiver and level of social support with five self-reported diabetes self-care behaviors: diet, foot checks, blood glucose monitoring, medications, and physical activity. Results Compared to participants with no informal caregiver, those with an informal caregiver were significantly more likely to report moderate or high medication adherence (OR = 1.93, 95% CI: 1.07–3.49, p = 0.028). When we included social support in the model, having a caregiver was no longer significantly associated with medication adherence (OR = 1.50, 95% CI: 0.80–2.82), but social support score was (OR = 1.22, 95% CI: 1.03–1.45, p = 0.023). Discussion Among low-income adults with poorly controlled diabetes, having both an informal caregiver and high social support for diabetes may have a beneficial effect on medication adherence, a key self-care target to improve diabetes control.

Publisher

SAGE Publications

Subject

Health Policy,General Medicine

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