THE FAMILY AND TYPE-2 DIABETES - A FRAMEWORK FOR INTERVENTION

Four broad groups of factors have been linked with self-management beh avior in type 2 diabetes over time: (1) characteristics of patients, ( 2) amount and management of stress, (3) characteristics of providers a nd provider-patient relationships, and (4) characteristics of the soci al network/context in which disease management takes place. Of these f our, social network/context has received the least amount of study and has been described in terms not easily applicable to intervention. In this paper, we identified the social network/context of diabetes mana gement as residing within the family. We defined the family for clinic al purposes, reviewed the literature concerning what is known about th e link between properties of the family context of care and outcomes i n type 2 diabetes and other chronic diseases, and identified areas of family life that are relevant to diabetes management. This information was then used to demonstrate how a family context of care can serve a s a clinical framework for integrating all four groups of factors that affect disease management Implications of this approach for practice and research are described.