Dyadic appraisal and coping with illness among older Chinese adults with type 2 diabetes mellitus: a qualitative study

Abstract

Introduction
Diabetes management permeates patients’ daily routines and interacts with their living context. Less is known about how older Chinese couples view their supportive roles and the allocation of the management responsibility between them.


Objectives
To explore dyadic appraisal, coping and the barriers to diabetes management shared by older Chinese couples.


Methods
A qualitative study of older couples where at least one partner had type 2 diabetes mellitus was implemented in four communities of Guangzhou, China. Four focus groups containing 11 couples, and ten in-depth interviews with individual couples were conducted sequentially. All of the data were coded with Nvivo 11 using thematic analysis.


Results
The majority of the older couples interviewed appraised diabetes as a shared problem, taking part in monitoring and altering each other’s health status and behaviour. Limited knowledge and a lack of accurate information about diabetes negatively impacted the patients’ self-management and their spouse’s ability to support them. A female dominated-care pattern was evident that female spouses, regardless of their health status, were actively involved in or fully responsible for managing their husband’s health. Older couples’ management practices were also shaped by family responsibilities and their living environment.


Conclusions
Our study provides first-hand evidence of older Chinese couples’ daily interactions and the main barriers to diabetes management. It is vital to provide health education directly to older couples to empower them to access adequate mutual support when managing chronic diseases.