Determinants of family support and its impact on self-care behavior among patients with type 2 diabetes in community settings: a cross-sectional analytical study
DOI:
https://doi.org/10.35816/jiksh.v15i2.332Keywords:
diabetes mellitus, Family Support, self care, Community Health, Health BehaviorAbstract
Introduction: Suboptimal adherence to self-care remains a persistent challenge in the management of type 2 diabetes mellitus (T2DM), particularly in community settings where daily disease control largely depends on patients’ behavioral practices. While family support is often considered influential, its relative contribution compared with other factors remains unclear. This study aimed to examine the determinants of family support and assess its impact on self-care behavior among patients with T2DM.
Research Methodology: A community-based, cross-sectional, analytical study was conducted involving 125 patients with T2DM, selected through purposive sampling. Data were collected using validated instruments assessing family support and self-care behavior. Statistical analysis included descriptive statistics, bivariate tests, and multivariable logistic regression to identify independent predictors, with a significance level set at p < 0.05.
Results: High family support was significantly associated with better self-care behavior (adjusted OR = 3.35; 95% CI: 1.65–6.80; p = 0.001). Higher educational level was also independently associated with improved self-care (AOR = 2.03; 95% CI: 1.01–4.09; p = 0.047). Other variables, including age, diabetes duration, and comorbidities, were not statistically significant in the adjusted model.
Conclusion: Family support is the strongest determinant of self-care behavior among patients with T2DM in community settings. Integrating family-based approaches into diabetes management programs may enhance adherence to self-care and improve long-term outcomes. Health policies should prioritize family-inclusive interventions as part of comprehensive diabetes care.
Downloads
References
Addala, A., Medina Peñaranda, R., Figg, L. E., Hanes, S., Garfias Silva, D., Ortega, H. I., Peña, D., Shaw, G. M., Chamberlain, L. J., Naranjo, D., Raymond, J. K., Maahs, D. M., & Hood, K. K. (2025). The Experience of Discrimination Impacts Technology Readiness and Psychosocial States of Minoritized Families Living With Type 1 Diabetes: Findings From the BEAD-T1D Pilot Study. Endocrine Practice, 31(11), 1426–1434. https://doi.org/10.1016/j.eprac.2025.06.023
Archer, M., & Llahana, S. (2026). Understanding factors influencing medication adherence in Type 2 diabetes guided by the COM-B behaviour change model and assessed using the Morisky scale: A systematic review. Primary Care Diabetes, 20(2), 165–177. https://doi.org/10.1016/j.pcd.2026.01.002
Bakhshi, F., Hamidifar, H., Esmaeilpour-bandboni, M., Mirhadian, L., & Kazemnejad Leili, E. (2024). Exploring medication adherence and self-care behaviors among diabetes patients in comprehensive rural health service centers in northern Iran. International Journal of Africa Nursing Sciences, 21, 100814. https://doi.org/10.1016/j.ijans.2025.100814
Cruz Neto, J., Alves Delmiro, A. R. D. C., Barbosa, L. P., Aquino, P. de S., da Silva, V. M., & de Oliveira Lopes, M. V. (2025). Self-management behaviors for the care transition of cardiac patients: A scoping review. Nursing Outlook, 73(6), 102581. https://doi.org/10.1016/j.outlook.2025.102581
Gomersall, S. R., Giguere, D. Y., Cotugno, J., Munro, J., Westbrook, W. J., Littlewood, R., Cairney, J., Winkler, E. A., van der Vliet, P. M., Goode, A. D., Alsop, T., & Healy, G. N. (2025). Development and Impact of a Community-Delivered, Multisectoral Lifestyle Management Service for People Living With Type 2 Diabetes (Logan Healthy Living): Protocol for a Pragmatic, Single-Arm Intervention Study. JMIR Research Protocols, 14, e69477. https://doi.org/10.2196/69477
Hodgson, W., Kirk, A., Lennon, M., Janssen, X., & Kennedy, D. (2026). Exploring the Integration of Consumer Activity Trackers Into a Community Weight Management Intervention to Support Physical Activity in Adults at Risk for or With Type 2 Diabetes: Mixed Methods Study Using the RE-AIM Framework. JMIR Diabetes, 11, e91073–e91073. https://doi.org/10.2196/91073
Iregbu, S., Walker, R. J., & Egede, L. E. (2026). Family influences on type 2 diabetes self-management: Perspectives of African American adults with food insecurity. Patient Education and Counseling, 146, 109501. https://doi.org/10.1016/j.pec.2026.109501
Kunhi, A. A., Arlappa, N., & Jaleel, A. (2026). Diabetes self-care, psychological distress, and quality of life among people with type 2 diabetes in low-income urban communities: An exploratory mixed-methods study in Hyderabad, India. Archives of Gerontology and Geriatrics Plus, 3(2), 100262. https://doi.org/10.1016/j.aggp.2026.100262
Liang, W., Chow, K. M., Ni, X., Tola, Y. O., & Lo, S. H. S. (2025). Effects of a nurse-led diabetes self-management programme for people with type 2 diabetes receiving insulin injection therapy: A randomised controlled trial with qualitative process evaluation. International Journal of Nursing Studies, 171, 105200. https://doi.org/10.1016/j.ijnurstu.2025.105200
Liska, J., Mical, M., Maillard, C., Dessapt, C., Bendig, E., Mai, D., Piette, J. D., De Geest, S., & Fontaine, G. (2024). Mapping the Cardiometabolic Patient Experience and Self-Care Behaviors to Inform Design, Implementation, and Persistent Use of Digital Health Care Solutions: Mixed Methods Study. JMIR Formative Research, 8, e43683. https://doi.org/10.2196/43683
Lu, S., Wu, Q., Wang, L., Liao, X., & Wei, D. (2026). Application of the behavior change wheel in supporting self-management among colorectal cancer survivors: A scoping review. Asia-Pacific Journal of Oncology Nursing, 13, 100916. https://doi.org/10.1016/j.apjon.2026.100916
Mezza, F., Lemmo, D., Bianco, A., Cuomo, A., & Freda, M. F. (2025). Understanding self-care behaviors in older adults with chronic diseases: The influence of personal views on aging and illness perceptions. Geriatric Nursing, 66, 103694. https://doi.org/10.1016/j.gerinurse.2025.103694
Muharram, F. R., Swannjo, J. B., Tahapary, D. L., Nasution, S. A., & Oceandy, D. (2025). Diabetes care performance in Indonesia: a serial cross-sectional analysis of behavioral, clinical, and laboratory outcomes from 2013 to 2023. The Lancet Regional Health - Western Pacific, 65, 101759. https://doi.org/10.1016/j.lanwpc.2025.101759
Pastakia, S. D., Clark, A., Lewis, K., Taugher, D., Adeoye-Olatunde, O., Byrd, K., Johnson, K., Gonzales, A. M., Tossoun, N., Cortez, D., Mata, A., Ward, C., Akana, P., Randall, R., & Ramirez, R. (2025). Impact of philanthropic investment on integrating social determinants of health into diabetes care at US federally qualified health centers. Dialogues in Health, 7, 100248. https://doi.org/10.1016/j.dialog.2025.100248
Plabon, S. B., Titu, M. F. S., Shiraj-Um-Monira, S., Saha, A., Shila, K. A., Makanjuola, B. D., & Olawade, D. B. (2026). Behavioural, cognitive, and computational risk factors for type 2 diabetes: A systematic review. Primary Care Diabetes. https://doi.org/10.1016/j.pcd.2026.03.006
Regeer, H., Huizing, A., Bilo, H. J. G., de Koning, E. J. P., Huisman, S. D., & van Empelen, P. (2026). Community and behavior maintenance: the association of community factors with behavior maintenance outcomes in people with type 2 diabetes participating in a group-based walking intervention. Social Science & Medicine, 388, 118730. https://doi.org/10.1016/j.socscimed.2025.118730
Saem, A., Bazrafshan Drissi, H., Sharifi, A., Kojuri, J., & Salehi, A. (2026). The association between social capital and self-care behaviors in patients with heart failure: A cross-sectional study. International Journal of Nursing Studies Advances, 10, 100478. https://doi.org/10.1016/j.ijnsa.2025.100478
Samadbeik, M., Garvey, G., Engstrom, T., Langham, E., & Sullivan, C. (2026). Digital health in managing type 2 diabetes among indigenous populations: a scoping review. International Journal of Medical Informatics, 207, 106206. https://doi.org/10.1016/j.ijmedinf.2025.106206
Suprapto, S., Andi Latif, S., Nurhanifah, D., Yunus, M., & Ajeng Wijayanti, L. (2025). How is Quality in Homecare Services Created? A Qualitative Study of Health Professional Perspectives. Jurnal Kesehatan Masyarakat, 21(2), 485–496. https://doi.org/10.15294/kemas.v21i2.31257
Syaharuddin, S., Suprapto, S., Arda, D., & Menga, M. K. (2025). Effect of health education on self-care behavior in patients with type 2 diabetes mellitus. Jurnal Ilmiah Kesehatan Sandi Husada, 14(2), 351–359. https://doi.org/10.35816/jiskh.v14i2.1323
Tang, Q., Yuan, M., Huang, Y., Feng, J., Dai, X., Fan, X., Gu, G., Lu, J., Liu, T., & Sun, L. (2026). Analysis of self-management behaviors and related factors in patients with postherpetic neuralgia: A multidimensional methodological study. Geriatric Nursing, 70, 103997. https://doi.org/10.1016/j.gerinurse.2026.103997
Thepwongsa, I., Nonjui, P., Muthukumar, R., & Sripa, P. (2025). Impact of Motivational Interviewing Education on General Practitioners’ and Trainees’ Learning and Diabetes Outcomes in Primary Care: Mixed Methods Study. JMIR Medical Education, 11, e75916–e75916. https://doi.org/10.2196/75916
Wagner, J., Bermúdez-Millán, A., & Feinn, R. S. (2026). Health-related social needs and self-Reported health among adults with type 1 diabetes in the 2022 Behavioral Risk Factor Surveillance System. Diabetes Research and Clinical Practice, 231, 113077. https://doi.org/10.1016/j.diabres.2025.113077
Wibowo, W., Suprapto, S., Kamaruddin, M. I., Nurlina, N., & Mangaya Takke, J. A. (2025). Disease Perception and Duration of Suffering with Self-Care Management in Patients with Diabetes Mellitus. Jurnal Ilmiah Kesehatan Sandi Husada, 14(1), 64–72. https://doi.org/10.35816/jiskh.v14i1.1248
Wu, X. V., Yap, X. Y., Feng, R. C., Tan, Y. Q., Dong, Y., Tan, P. C., Han, T. Y., Chao, F. F. T., Loh, L. X., & Tam, W. S. W. (2026). Effectiveness of a Community-Based eHealth Program on Self-Care, Cognition, and Health Outcomes of Older Adults With Chronic Diseases: A Multi-Site Cluster-Controlled Trial. Journal of the American Medical Directors Association, 27(1), 105956. https://doi.org/10.1016/j.jamda.2025.105956
Xu, W., Qin, J., Yang, Y., Xu, H., Wang, M., & Xing, Q. (2026). Impact of social and psychological factors on foot self-care in diabetic foot patients: Based on variable-centered and individual-centered analysis. Journal of Tissue Viability, 35(2), 100991. https://doi.org/10.1016/j.jtv.2026.100991
Yan, F., Peng, G., Sun, R., Zhang, Y., Qiao, P., Liu, M., Ma, Y., & Han, L. (2025). Identifying decision-making biases in self-care behaviours among patients with type 2 diabetes mellitus: A qualitative study from a behavioural economics perspective. International Journal of Nursing Studies, 171, 105182. https://doi.org/10.1016/j.ijnurstu.2025.105182
Zhang, X., Yang, D., Chen, S., Wang, L., Li, X., Wang, Z., Meng, M., Li, X., Jiang, H., Hao, Y., & Luo, J. (2026). Telehealth Intervention to Reduce Sedentary Behavior in Older Adults With Type 2 Diabetes: Development and Feasibility Study. Journal of Medical Internet Research, 28, e80827–e80827. https://doi.org/10.2196/80827
Zulfiah, Z., Kadang, Y., & Suprapto, S. (2025). Correlation Between Knowledge and Attitude Toward Treatment Adherence Among Patients with Type 2 Diabetes Mellitus in Makassar, Indonesia. Media Kesehatan Politeknik Kesehatan Makassar, 20(2), 304–309. https://doi.org/10.32382/medkes.v20i2.1709
Downloads
Published
How to Cite
Issue
Section
Citation Check
License
Copyright (c) 2026 M. Khalid Fredy Saputra, Hijrah Hijrah, Wawan Kurniawan, Anita Lontaan, Rasi Rahagia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Statement:
The authors retain the copyright of this work and grant Jurnal Ilmiah Kesehatan Sandi Husada the right of first publication. The work is simultaneously licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits use, distribution, and reproduction in any medium, provided the original author(s) and the initial publication in this journal are properly credited.
The authors are permitted to copy and redistribute the published version of the work, including posting it to an institutional repository or including it in a book, with acknowledgment of its initial publication in Jurnal Ilmiah Kesehatan Sandi Husada.
