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SocietyofBehavioralMedicine2014

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SocietyofBehavioralMedicine2014

  1. 1. RESEARCH POSTER PRESENTATION DESIGN © 2012 www.PosterPresentations.com Type 2 diabetes (T2D) is the 7th leading cause of death in the United States and is associated with an array of health problems, including heart and kidney disease, neuropathy, and lower limb amputations (Center for Disease and Control, 2011). Prevention of these problems largely depends on effective disease self-management. Persons with T2D need to alter their diet, exercise, and typically take medication to control blood glucose levels. As social environment is an important determinant of diabetes self-management, we enrolled 70 couples (49% male; 51% white; mean age 55; mean A1c 6.81) that included one person with newly diagnosed T2D (mean diagnosis 1.33 years ago) in a study to examine partner influence on patients’ management of diabetes. Race and sex differences were examined. Evidence that communal coping (i.e., perception of diabetes as a joint problem rather than an individual problem) was more common for males than females with T2D. Males chose greater overlap among two concentric circles to represent the couples’ approach to diabetes. Using audiotaped recordings of coping interviews to analyze pronoun usage, there were no significant sex or race differences observed. However, in videotaped couple conversations about coping with diabetes, trained observers rated the lowest level of communal coping among couples in which the patient was female and black (p < .05). When asked how involved they would like their partners to be in regards to diabetes management, females were more likely than males, and whites were more likely than blacks to report that they desired greater partner involvement in their diabetes care (p’s < .05). This study also suggests that males perceive partners to be more supportive, more overprotective, and more unsupportive than females, indicating that female partners may be more involved in diabetes management than male partners. These findings are important because partner involvement in diabetes care was related to better diabetes self-management. ABSTRACT   Goal 1: To examine whether there are sex differences in communal coping with diabetes and support from partner. Hypothesis 1: Literature suggests that women provide more social support to partners than men (Goldzweig et al., 2009), so we hypothesize that men will report greater communal coping and greater partner support than women. Goal 2: To examine whether there are differences between African American and Caucasian couples in communal coping with diabetes and support from partner Hypothesis 2: We view this goal as exploratory and do not make specific predictions. Goal 3: To examine whether sex and race interact to predict communal coping and partner support. Hypothesis 3: We predict that the sex difference will be larger among African American couples than Caucasian couples due to African American men’s greater reliance on their wives for support (Allen, Griffith, & Gaines, 2013). OBJECTIVES   Demographics RESULTS   Race Comparisons on Demographic Variables •  Marital status: 81% of Caucasians married; 39% of African Americans married •  Not only are Caucasians more likely than African Americans to be married, but Caucasians’ relationships are longer than those of African Americans (277 months vs. 145 months) •  However, marital status interacts with race to predict relationship length CONCLUSION   ACKNOWLEDGEMENTS   1  Carnegie  Mellon  University,  2  University  of  PiKsburgh  Medical  Center,  3  VA  PiKsburgh  Healthcare  System     Vicki  S.  Helgeson,  Ph.D.1,  Shaquille  Charles1    Mary  Korytkowski,  M.D.2,  &  Leslie  Hausmann,  Ph.D.3     Couples’  Communal  Coping  in  PaGents  with  Newly  Diagnosed     Type  2  Diabetes:  A  Focus  on  Sex  and  Race   METHODS   Participants •  70 adults diagnosed with Type 2 diabetes and their spouse/partner from the Greater Pittsburgh Area Study criteria •  Participants must be married or living together •  Only one individual diagnosed with Type 2 diabetes within the past two years Recruitment •  Participants were recruited from the community Ø  Churches Ø  Health fairs Ø  ADA Diabetes Expo Ø  Physician offices Ø  Advertising (bus, newspaper) Procedure In-home visits that consisted of: •  Interview •  Videotaped 8-minute conversation •  Hba1c, blood pressure and weight measurements Instruments COMMUNAL COPING VARIABLES •  3-item Communal Coping Self-Report: e.g, “When problems related to your diabetes arise, how much do you and your spouse work together to solve them? (1=none of the time, 2=a little of the time, 3=some of the time, 4=most of the time, 5=all of the time). •  Diabetes Responsibility Preferred: “When issues arise about diabetes, whose responsibility WOULD YOU LIKE IT TO BE?” (1=completely my responsibility, 2=mostly my responsibility, 3=both of our responsibility, 4=mostly my spouse’s responsibility, 5=completely my responsibility) •  Concentric Circle Measure: “Please look at these pictures and tell me which one best describes how you and your spouse deal with diabetes.” •  Communal Coping Situation (Video): The extent to which the current situation being discussed appears to be a joint problem, from the patient’s point of view. “We statements” may be indicative of communal coping (e.g. “we watch what we eat; we exercise; we took that class”). •  Audiotaped Coping Interview: Used LIWC software to identify the proportion of pronouns that are first person plural (WE) and first person singular (I) SOCIAL SUPPORT VARIABLES Illness-Specific Supportive and Unsupportive Interactions and Perceived Responsiveness scale (4 point scale; 0=none, 1=a little, 2=some, 4=most) In the past month, how often did your spouse… •  Emotional Support: “Was your spouse there for you by giving you his/her undivided attention” •  Overprotective: “Try to do everything for you” •  Instrumental Support: “Help you figure out how to take care of diabetes” •  Avoidant: “Encourage you to stop dwelling on your problems” •  Unsupportive Interactions: “Criticize how you take care of diabetes” 1.   2.   3.   4.   5.   6.   7.   1. Goldzweig, G; Hubert, A; Walach, N; Brenner, B; Perry, S; Andritsch, E; Baider, L. Gender and psychological distress among middle- and older-aged colorectal cancer patients and their spouses: an unexpected outcome. Crit Rev Oncol Hematol. 2009; 70(1):71-82. 2. Allen, Julie Ober; Griffith, Derek M.; Gaines, Henry C. “She looks out for the meals, period”: African American men's perceptions of how their wives influence their eating behavior and dietary health. Health Psychology, Vol 32(4), Apr 2013, 447-455. doi: 10.1037/a0028361 3. Centers for Disease Control and Prevention. National Diabetes Fact Sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011. •  In terms of self-report and pronoun usage, there are no significant race or sex differences in communal coping. •  According to concentric circles, males perceive a greater level of communal coping when dealing with diabetes compared to females. •  According to videotape raters, the least amount of communal coping occurs when the patient is an African American female. •  In terms of preferences, African Americans prefer less communal coping compared to Caucasians. There is also a trend indicating that women desire a greater level of communal coping then men. •  Men identify significantly more instrumental support from their partners than women do. •  There is a trend indicating that the sex difference in instrumental support perception is greater among Caucasians than African Americans. •  Men perceive their partners as significantly more overprotective than women find their partners to be. •  African Americans identify more avoidant behavior in partners in comparison to Caucasians. •  Men perceive marginally more unsupportive interactions than women. REFERENCES   •  Male patients perceive greater communal coping but desire less, while female patients perceive less communal coping but desire more •  Men identify their partners as more supportive and more overprotective compared to women •  Female partners appear to be more involved overall than male partners •  African American patients see partners as more avoidant than Caucasian patients Tiona Jones Gianna Swetz Katilyn Mascatelli +  =  p  <  .10;  *  =  p  <  .05;  **  =  p  <  .01;  ***  =  p  <  .001     +  =  p  <  .10;  *  =  p  <  .05;  **  =  p  <  .01;  ***  =  p  <  .001     •  Marital status demographics indicates that married couples have longer relationships than unmarried couples among Caucasians, but the opposite is true for African Americans •  Despite race differences in marital status, no race differences on relationship satisfaction •  No race or sex differences on education or years since diagnosis •  All Sex*Race analyses controlled for marital status

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