Familial roles of older African-American women with type 2 diabetes: testing of a new multiple caregiving measure.

OBJECTIVE This study describes the development and validation of a new multiple caregiving (MC) measure and examines how familial caregiving relates to family composition and psychosocial factors among older African-American women with type 2 diabetes. RESEARCH DESIGN AND METHODS The study sample included 345 African-American women with type 2 diabetes who participated in two lifestyle behavior interventions. A new 12-item survey of caregiving perceptions was tested for internal reliability and construct validity of two empirically defined scales (MC-role and MC-barriers). Multiple caregiving (MC) constructs were validated by using baseline measures of diabetes quality of life, social support, stress, diabetes competence, and self-care barriers. Correlational, analysis of variance, and multivariate analyses were used to examine the associations among familial MC variables and psychosocial and household factors. RESULTS Surveys were completed by 299 (87%) participants who were an average of 60 years of age, with 10 years of diagnosed diabetes and 11 years of education. Both MC-role and MC-barriers scores were positively associated with putting the family's needs first, difficulty saying "no" to family, and the number of adults living in the household. MC-barriers were associated negatively with quality of life, and positively with stress, barriers to diabetes self-care, and negative perceptions of diabetes competence. In a multivariate model, age and difficulty saying "no" to family seeking help were significant independent predictors of MC-barriers. CONCLUSIONS Findings suggest that a better understanding of African-American women with diabetes in the context of family and caregiving roles may be important to identifying culturally meaningful strategies to improve self-care behaviors.