Table 2.

Summary of the included studies

Author and title	Country of origin	Aim of study, design and data	Sample size and characteristics	Main results
Trief et al. [41]. Describing support: a qualitative study of couples living with diabetes	USA	To learn about support from couples who deal with diabetes daily Grounded Theory and telephone interviews	40 patients (55% type 2 diabetes) and 32 spouses. Mean age patient and spouse 49 years	Three broad topics on spousal behaviour and diabetes management: (1) being helpful, especially regarding diet, general support and reminders, (2) being non-helpful, including nagging, wrong diet, poor communication and conflicts, (3) couple interaction as teamwork, independence, emotional support
Sandberg et al. [42]. “He said, She said”: the impact of gender on spousal support in diabetes management	USA	To examine how gender is related to support for couples coping with diabetes Grounded Theory and individual interviews	40 patients (55% type 2 diabetes) and 32 spouses. Mean age patient and spouse 49 years	Both males and females recognised the importance of spousal support. Males used more authoritative language, females more accommodating and collaborative. Females preferred verbal support, males instrumental. Females identified own nagging, males silent
Stephens et al. [45]. Spouses’ attempt to regulate day-to-day dietary adherence among patients with type 2 diabetes	USA	To investigate daily dietary adherence in older adults with type 2 diabetes as a function of spouses’ diet related support and control Quantitative study using diaries and questionnaires	126 couples where one partner had type 2 diabetes. Mean age 66 years	Spousal dietary support increased patient adherence, whereas persuasion and pressure decreased adherence. Support decreased distress and pressure increased distress and decreased adherence
Houston-Barrett et al. [43]. Couple’s relationship with diabetes: means and meanings for management success	USA	To develop a theory about dyadic constructs and their interactions with success in diabetes management Grounded Theory and dyadic interviews	25 couples, one with type 2 diabetes, mean age men 57 and women 55 years	Relationships with diabetes: (1) transforming, (2) accepting, (3) rejecting. Couple’s relationship to diabetes determines success. Focus on emotion and meaning leads to growth, accept or rejection
Dimitraki et al. [44]. The association of type 2 diabetes patient and spouse illness representation with their well-being: a dyadic approach	Greece	To examine type 2 diabetes in patients and spouses in relation to physical and psychological well-being Quantitative study using questionnaires	84 couples where one partner had type 2 diabetes. Mean age patients 65 and spouse 63 years	Synergy between patient and spouse; patients had anxiety and depression when spouse perceived diabetes as unpredictable. Spouses had anxiety when patient perceived diabetes less burdensome