Table 3.

Categories of family interactions when living with diabetes

Supportive	Non-supportive
Impact of practical actions
Family assistance with grocery shopping, cooking, sharing and learning about diet plan [41–43] Adherence to dietary guidelines, timing the meals according to insulin, preparing meals at home, assisting with medications, assisting with checking blood sugar level [41, 42]	Spouse and patient buy or prepare non-healthy food, feel obliged to eat unhealthy food prepared by either the patient or spouse [41, 42]
Impact of emotional involvement
Thinking of the others’ needs and concerns [41] Being cooperative [41] Making the other feel like a person [41] Positive attitude toward diabetes [41, 43] Acknowledge need for independence [41] Being calm [41] Acknowledge need for privacy [42] Take responsibility [44] Acknowledge responsibility for shared management [45] Have a shared construction of meaning [44] Be partners and work together [44]	Partner refusing to share burden with spouse, expecting patient to manage tasks alone rather than together, refusing to accept requirements and consequences of diabetes, focusing solely on problems [41, 43] Being scared and nervous [41] Prefer to remain uninvolved [44] Perceive diabetes as unpredictable and burdensome [45]
Impact of communication content
Acting as a sounding board, talking nicely, reminding to check blood glucose, take medication, bring snacks, taking time to listen [41] Console, encourage, be there, reminding [42] Partners recognise the need of help in crisis situation [41] Asking how the other feels [43]	Nagging, criticising, constant controlling reminders, poor communication [41, 42] Being silent, ignoring the other, not communicating about difficulties, conflicts not relating to diabetes [41, 42] Most talk is about difficulties [44] Spouses get annoyed, aggravated and angry, difficult receiving help when hypoglycaemic-get agitated [41] Use persuasion or challenge food choices [43] Express irritation or doubt food choices [43] Telling each other what to feel [41, 42] Both preoccupied with reminders vs. nagging [41, 42]