The first diabetes educator is the family: using illness representation to recognize a multigenerational legacy of diabetes.

PURPOSE: This article proposes a framework for understanding multigenerational legacies of diabetes, which will assist with designing educational interventions for individuals with a known family history of type 2 diabetes. BACKGROUND/RATIONALE: Diabetes is a chronic illness that has an associated hereditary predisposition. Family members at risk in subsequent generations may be influenced by the prior generation's experiences. Multigenerational legacies and stories shape a family's health beliefs and response to illness and transmit patterns of adaptation across generations. METHOD: A review of the literature from 1984 to 2004 was conducted to identify evidence of legacies of chronic illness. OUTCOME: Family-systems-illness-disability Model and Theory of Illness Representation were used to guide the development of a framework of multigenerational legacies of diabetes. INTERPRETATION/CONCLUSION: A framework for understanding the influence of illness representation on multigenerational legacy of type 2 diabetes is presented. IMPLICATIONS FOR NURSING PRACTICE: Clinicians are in need of a useful framework that can provide direction as they attempt to understand the effect of a family history of diabetes on the health behavior of the next generation of family members with diabetes. This framework could serve to guide them as they probe for information relevant to the influence of recollections about the family member's experience with diabetes on an individual's health behavior.