This dissertation was a secondary analysis of data gathered from 114 couples who had one spouse with type 2 diabetes. Diabetes management was the outcome variable. The predictor variables in this analysis included the couples' causal attribution, religiosity, and congruence regarding the aforementioned. The major theories framing this study were the Family Systems theory and the family stress models. Support was found also in the middle ranged Family Resilience Framework. From a systems approach, families affect, and are affected by, the management of a chronic disease such as type 2 diabetes. The Family Resilience Framework suggests that the family's belief system, which includes the causes attributed to the disease, the religious coping and practices of the family, and the sharing of those beliefs, contributes to disease management. Structural Equation Modeling was used to test the relationships and pathways between causal attribution, religiosity, and shared beliefs and diabetes management. These models controlled for age, socio-economic status, gender and race/ethnicity for each of the spouses. This study found significant impact on type 2 diabetes management by both the causal attribution of the person with diabetes and the amount of causal attribution that was shared by the couple. Other findings included moderate pathway strength between the amount of shared religiosity and management, in addition to a moderate path between the SES of the couple and management. Implications for theory, research and practice were noted from this study.

LLU Discipline

Family Studies


Counseling and Family Sciences


School of Science and Technology

First Advisor

Fox, Curtis A.

Second Advisor

Wilson, Colwick M.

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded

January 2011

Date (Title Page)




Library of Congress/MESH Subject Headings

Diabetes Mellitus, Type 2 -- Therapy

Subject - Local

Causal attribution; Religiosity; Family Resilience Framework



Page Count

111 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses & Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives