Association between family behaviors and self‑care activities among type‑II diabetes mellitus patients at a teaching hospital in Kathmandu, Nepal

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.

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.

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).

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.