Abstract
AIM: To identify patterns of dyadic engagement in type 2 diabetes care, describe their characteristics, and explore their association with glycated haemoglobin. BACKGROUND: In chronic conditions, patient self-care and caregiver contribution should be considered a dyadic phenomenon. However, patterns of dyadic engagement in type 2 diabetes care have not yet been identified. DESIGN: Multicentre observational cross-sectional study. METHODS: Patient self-care and caregiver contribution were assessed using the Self-Care of Diabetes Inventory and the Caregiver Contribution to Self-Care of Diabetes Inventory. Patterns of dyadic engagement in type 2 diabetes care were identified by latent class analysis. Associations between patient-caregiver characteristics and class membership were estimated using multinomial regression. The association between classes and glycated haemoglobin levels was assessed using linear regression. RESULTS: 251 dyads of patients with type 2 diabetes and their primary informal caregivers were enrolled. Patients were mostly male (55%, median age 72) and caregivers mostly female (71%, median age 64). Three patterns of dyadic engagement were identified: 'equally engaged-low care' (14%), 'mostly patient engaged-middling care' (25%), and 'equally engaged-high care' (61%). Patient characteristics (sex, education, self-efficacy) and caregiver characteristics (burden, chronic diseases) were associated with pattern membership. Membership in the 'mostly patient engaged-middling care' and 'equally engaged-high care' patterns was associated with decreased glycated haemoglobin compared to 'equally engaged-low care'. CONCLUSION: The three identified patterns of dyadic engagement in type 2 diabetes showed differences in patient and caregiver characteristics and were associated with glycated haemoglobin. IMPACT: The study identified and described patterns of dyadic engagement in type 2 diabetes care. The three identified patterns showed differences in characteristics and in patient glycemic control. Healthcare professionals should consider these patterns for tailoring interventions focused on both dyad members. REPORTING METHOD: STROBE checklist was followed. PATIENT CONTRIBUTION: Patients and their informal caregivers were recruited to participate in the study.