This study used an MFT perspective to examine a model of three bio-psychosocial constructs, seeking to depict key dimensions of what makes couples successful in managing the demanding self-care regimen of diabetes. The model includes a meaning and emotion-oriented construct called relationship with diabetes, a psychosocial relational construct of diabetes-specific partnering support, and their direct and indirect effects on an endogenous construct of success in diabetes management. Surveys from 118 adult couples with diabetes provided data to test the hypothesized path and measurement model. Correlational and multiple regression analysis examined variable relationships, factor analysis examined construct dimensionality, and structural equation modeling determined the model's goodness of fit. It was found that relationship with diabetes and partnering support are positively associated and have direct and indirect effects promoting successful diabetes management. The emotion component of relationship with diabetes was especially important to management success. The current quantitative study extends and tests grounded theory from a previous qualitative study. Outcomes from this study expand our current understanding of how couples manage chronic illness and highlight the importance of developing a multidisciplinary approach to diabetes research, education, and intervention.

LLU Discipline

Marital and Family Therapy


Counseling and Family Sciences


School of Behavioral Health

First Advisor

Wilson, Colwick

Second Advisor

Fox, Curtis A.

Third Advisor

Knudson-Martin, Carmen

Fourth Advisor


Fifth Advisor


Sixth Advisor

Riggs, Matt

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded

January 2012

Date (Title Page)




Library of Congress/MESH Subject Headings

Diabetes-Milletus; Interpersonal Relationships; Couples Therapy; Marriage Counseling;

Subject - Local

Bio-psychosocial Constructs; Couples; Diabetes Management; Partnering Support; Relationship with Diabetes



Page Count

276 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