Investigators at the Maine Medical Center found that diabetes patients who had family members participate with them in a six-week chronic disease self-management group did not improve their blood sugar control, contrary to expectations. In this pilot study, the primary pre- and post-treatment measure was participants' hemoglobin A1c rates (HbA1c), a measure of how well blood sugar is controlled, in 197 diabetes patients who were randomly assigned to attend a six-week workshop either with or without their spouse or other family member. Secondary measures included health status, health behaviors, self-efficacy and use of medical services.

Key Findings

• Contrary to the investigators' expectations, there was a trend toward post-treatment improvement in HbA1c levels associated with participation in the patient-only group.
• Investigators found that participants were more affected by perceived criticism of family members than by the presence of family members in the workshop with respect to post treatment levels of HbA1c, health status and self-efficacy.

Key Conclusions

• The results indicate that family dynamics play a much stronger role than the mere presence or absence of family members during typical group medical visits. In diabetes, where life-style modification is essential, physicians need to assess family relationship patterns, educate patients as to how this affects their health and recommend counseling resources if indicated.
• In cases where relationship difficulties appear to be a stressor, the physician can educate the patient about the evidence showing that patterns of criticism affect overall physical and mental health and suggest resources to help them. This type of intervention might improve patients' overall health.

Funding

The Robert Wood Johnson Foundation (RWJF) supported the study with a $56,887 grant between June 2002 and December 2005.