Wahyu FEBRIANI, Yoyok Bekti PRASETYO
Eurasian Journal of Family Medicine - 2026;15(1):31-42
Aim: Nonadherence to self-management in type 2 diabetes mellitus remains a major challenge in primary care. Although family involvement is widely recognized as important, the relational mechanisms through which families influence adherence are not fully understood. This study explored strategies used by families to support adherence to type 2 diabetes mellitus management and the challenges encountered in daily caregiving. Methods: A qualitative descriptive design was conducted in a primary care setting in East Java, Indonesia. Primary caregivers of adults with type 2 diabetes mellitus were purposively recruited. Data were collected through in-depth semi-structured interviews and analyzed using thematic analysis to identify patterns of family-based regulation, relational dynamics, and barriers to adherence. Results: Family support operated through structured regulation of daily practices, including medication scheduling, dietary monitoring, and reminder systems. Emotional persuasion and warning-based communication were also used to reinforce perceived disease severity. Support extended beyond the household through peer and community networks. However, families reported persistent challenges, particularly dietary resistance, concealment of unhealthy behaviors, inconsistent lifestyle modification, and caregiver emotional fatigue. Fear-based strategies sometimes generated compliance pressure but also contributed to relational strain and hidden nonadherence. Conclusion: Family involvement in type 2 diabetes mellitus management is a dynamic and negotiated process shaped by communication patterns, social context, and emotional resilience. Interventions should move beyond supervision-based models toward autonomy-supportive, family-centered approaches within primary care.
