Perceived Spousal Criticism, Self-Efficacy, and Adherence to Diet and Exercise Self-Care Behaviors in Adults with Type 2 Diabetes

Objective : The primary aim of the current study was to assess the relationships between perceived spousal criticism and dietary and exercise self-care adherence in adults with type 2 diabetes and to determine if self-efficacy mediated this relationship. Research Design and Methods : This study used a cross-sectional survey design. Potential participants were mailed self-report questionnaire packets that included measures of perceived spousal criticism, adherence to diet and exercise, self-efficacy, depressive symptoms and positive and negative affect. Results : The total sample (N=90) was predominantly White (90.0%) and female (53.3%). The mean age was 59.8 years (S.D. 10.6) and 44.4% of participants reported completing a high school degree or less. The majority of participants reported using oral hypoglycemic agents to treat their diabetes (50.0%). Within the sample, low levels of perceived spousal criticism were observed across four different measures. Each measure of perceived spousal criticism was negatively related to patient self-efficacy (r = -.30 to r = -.45), but most were not associated with patient self-care adherence. One measure of perceived spousal criticism was negatively correlated with dietary adherence (r = -.22), but the mediational model could not be tested because this relationship was no longer significant once age was accounted for in the analyses. Conclusion : Although low levels of perceived spousal criticism were found within this sample, there was a relationship between higher levels of perceived criticism and lower levels of patient self-efficacy. Knowledge about the relationship between perceived spousal criticism and patient self-efficacy could be useful in designing education and intervention programs for patients and spouses of patients with type 2 diabetes.