Spouses of adults with type 2 diabetes often provide social support to reduce patients’ distress and facilitate healthy behaviors and social control to discourage patients’ unhealthy behaviors. Yet, it is unclear how spouses’ support and control affect patients’ daily management of diabetes through physical exercise; daily physical exercise can be especially challenging for older adults with diabetes. The aims of this dyadic, daily diary study were to investigate 1) Direct associations between spouses’ exercise support and exercise control and patients’ daily physical exercise, 2) Patients’ daily emotional responses as mediators of the direct associations, and 3) Patients’ gender as a moderator of the direct and mediated associations.
Older adult couples (N = 70) were recruited from physicians’ offices, diabetes education centers, senior citizen organizations, and through newspaper and radio advertisements. To be eligible, adults had to be diagnosed with type 2 diabetes, be at least 55 years old, be in a marriage or marriage-like heterosexual relationship, and reside with the spouse in the community. The non-diabetic spouse had to be the primary source of assistance with the patient’s diabetes management. Patients and spouses independently completed laptop diaries (once an evening for 7 days) and paper questionnaires. Patients also wore an activity monitoring device on the wrist throughout the diary period.
Multilevel modeling analyses were used to test the direct, mediated, and moderated associations between spouses’ exercise support and exercise control and patients’ physical exercise. On days in which spouses provided exercise support, patients engaged in more physical exercise. On days in which spouses provided exercise control, patients engaged in less physical exercise. Patients’ emotional responses on a given day did not mediate the association between either spouses’ exercise support or exercise control and patients’ physical exercise. For female patients, however, spouses’ exercise support on a given day was associated with a decline in physical exercise from that day to the next day. Overall, findings suggest that spouses’ attempts to support or control their partner’s physical exercise can influence how much patients exercise, and by extension, how well they manage their diabetes on a given day.