No Statement Always Very often Sometimes Rarely Never
5 4 3 2 1 1 Praise the patient for following his/her 4 diet 2 Nag the patient about testing his/her 1 blood 3 Suggest things that might help the 4 patient take insulin on time 4 Criticize the patient for not exercising 1 regularly 5 Help the patient decide if changes 4 should be made based on blood testing results 6 Nag the patient about not following 1 his/her diet 7 Argue with the patient about his/her 1 diabetes self-care activities 8 Encourage the patient to participate 5 in sports activities 9 Plan family activities so that they will 4 fit in with his/her diabetes self-care schedule 10 Congratulate the patient for sticking 4 to his/her diabetes self-care schedule 11 Criticize the patient for not recording 1 the results of blood tests 12 Eat at the same time that the patient 4 does 13 Exercise with the patient 4 14 Let the patient sleep late rather than 1 getting him/her up to take his/her insulin 15 Buy the patient things containing 3 sugar to carry in case of an insulin reaction 16 Eat foods that are not part of the 1 patient’s diabetic diet Total score 44 (Positive family support)
Note: a. 9 – 45: Positive summary score b. 7 – 35: Negative summary score