The Marital Relationship and Psychosocial Adaptation and Glycemic Control of Individuals With Diabetes
- Paula M. Trief, PHD1,
- Christine L. Himes, PHD2,
- Rebecca Orendorff, BS1 and
- Ruth S. Weinstock, MD, PHD134
- 1State University of New York (SUNY) Upstate Medical University
- 2Syracuse University
- 3Joslin Diabetes Center at Syracuse
- 4Veterans Administration Medical Center, Syracuse, New York
Abstract
OBJECTIVE—To explore the relationship between marital relationship domains (i.e., intimacy and adjustment) and glycemic control and psychosocial adaptation to diabetes.
RESEARCH DESIGN AND METHODS—A total of 78 insulin-treated adults with both type 1 and type 2 diabetes were assessed on a single occasion. They completed two marital quality measures (Spanier Dyadic Adjustment Scale and Personal Assessment of Intimacy in Relationships Scale) and four quality-of-life measures (Diabetes Quality of Life Scale, Medical Outcomes Study Health Survey, Problem Areas in Diabetes Scale, and Positive and Negative Affect Scale). Glycemic control was assessed by HbA1c. Demographic data (age, sex, type and duration of diabetes, years married, other medical conditions, family history, disability, and years of education) were gathered from the chart and questionnaires.
RESULTS—Concerning psychosocial adaptation, both of the marital quality measures were predictors of aspects of adaptation. Better marital satisfaction was related to higher levels of diabetes-related satisfaction and less impact, as well as less diabetes-related distress and better general quality of life. Higher levels of marital intimacy were related to better diabetes-specific and general quality of life. Concerning glycemic control, there was a nonsignificant trend for marital adjustment scores to relate to HbA1c (P = 0.0568).
CONCLUSIONS—For insulin-treated adults with diabetes, quality of marriage is associated with adaptation to diabetes and other aspects of health-related quality of life. The suggestive finding that marital adjustment may relate to glycemic control warrants further study. Future work should also explore the impact of couples-focused interventions on adaptation, adherence, and glycemic control.
- BG, blood glucose
- DAS, Spanier Dyadic Adjustment Scale
- DCCT, Diabetes Control and Complications Trial
- DQOL, Diabetes Quality of Life Scale
- MCS, Mental Composite Scores
- PAID, Problem Areas in Diabetes Scale
- PAIR, Personal Assessment of Intimacy in Relationships
- PANAS, Positive and Negative Affect Schedule
- PCS, Physical Composite Scores
- SF-36, Medical Outcomes Study Health Survey
Footnotes
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Address correspondence and reprint requests to Paula M. Trief, PhD, Department of Psychiatry, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210. E-mail: triefp{at}upstate.edu.
Received for publication 9 January 2001 and accepted in revised form 3 May 2001.
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