When “we” are stressed: A dyadic approach to coping with stressful events
Abstract
The couple, from its formation and throughout its life cycle, is faced with several sources of stress, from daily stressors (minor stress; e.g., everyday family demands, neighborhood hassles, etc.) to critical transitions (major stress; e.g., the transition to parenthood, divorce, illness, etc.). Although in the past stress and coping were considered as mere individual processes, it is now well recognized that, when the stress and coping processes unfold within the couple relationship, a dyadic approach to both stress and coping is essential. Stress can impact both partners at the same time (e.g., financial strain) or only one member of the couple. Nonetheless, even when only one individual is experiencing stress within a couple and communicates such stress to the partner, in fact, both partners are affected by the stressful circumstance and the stress can be considered dyadic (though indirectly). Coping strategies as well could be carried out both at the individual level (e.g., individual coping) and at the dyadic level (e.g., dyadic coping). Specifically, dyadic coping is conceptualized as the interpersonal process of managing stressful events as a couple with the purpose of restoring the individual’s well-being as well as the couple’s relationship quality. The present book is a collection of theoretical and empirical chapters focused on the relevance of a dyadic approach to couples coping with stress. A dyadic perspective is evident in both the conceptualization of stress and coping as well as in the methodology (e.g., dyadic research design and dyadic analytical methods) presented in the different chapters. The book is divided into three sections. The first section is focused on some of the most recent theoretical and methodological issues in couples’ coping. The second section of the book comprises three chapters on how a dyadic approach can be adopted to study couples dealing with daily stressors and family transitions. The third section of the book comprises two chapters adopting a dyadic approach to the study of couples coping with illness. Finally, the fourth section of the book includes three chapters presenting dyadic interventions aimed at helping partners cope together more efficiently. Highlights include: -How couples cope with different stressors -New trends in dyadic coping research -A description of intervention programs for couples dealing with stress The book is an ideal source of reference for relationship researchers, psychologists, mental health counselors, social workers, and advanced students who work with couples dealing with stress.
... Based on the literature on stress in close relationships (Bertoni, Donato, & Molgora, 2018;Bodenmann, 1997Bodenmann, , 2005Hilpert et al., 2016), we assumed that not only individual aspects, but also the way the partner is supportive or unsupportive toward the patient can be associated to the level of patient activation in the treatment. In addition, this study analyzes the role of different forms of partner support, both positive and negative. ...
The literature assumes that activating patients in the treatment is associated with positive health-related outcomes, such as clinical indicators in the normal range, high medication adherence, and low emergency department utilization. In the cardiac population, patient activation, that is the patient’s knowledge, skills, confidence, and behaviors needed for managing one’s own health and health care, has been less investigated. In addition, limited attention has been given to the role of the partner as an informal caregiver. However, the patient in the care process is rarely alone, and the partner may play a key role in this process. The goal of this dyadic study (N = 100 heterosexual couples with one partner suffering from an acute cardiac event) is to analyze how individual factors (patients’ anxiety, depression, medication adherence, pessimistic perception of illness) and the couple’s relationship functioning (e.g., different kinds of partner support and dyadic coping) are associated with patient activation. The results showed that patient activation is not a mere question of age. It is positively related to medication adherence and to the partner’s support patient activation. It is negatively correlated with the patient’s psychological distress, pessimistic perception of illness, and to the partner’s hostility. The need for a dyadic approach to both research and intervention with this population is discussed.
Cardiac patients show alarming levels of nonadherence to medications. It is important to consider also patient activation levels. Furthermore, the partner could have a supporting role in these processes. The aim of this study was to investigate the mediating role of patient health self-efficacy (HSE) in the link between dyadic coping (DC) and two self-management outcomes (i.e., medication adherence and patient activation) across the first six months of cardiac disease. One hundred couples completed two self-report questionnaires during the hospitalization for cardiac disease and six months after discharge. A longitudinal and dyadic research design was adopted.
Cross-sectional analyses at T0 revealed that patient-provided and perceived positive DC and common DC are positively associated with HSE, which in turn is positively associated with medication adherence. HSE mediated the association between patient positive and common DC styles, with the only exception of Patient-provided positive DC, and patient activation. Conversely, patient-provided and perceived negative DC are negatively associated with HSE, which in turns is positively associated with medication adherence and patient activation. Prospective analyses showed that only patient-perceived negative DC at discharge is negatively associated with HSE at T1, which in turns is positively associated with patient activation over time. These results suggest to consider patient perceived and provided DC as antecedents of self-management outcomes via patient HSE. Furthermore, our results recommend to pay particular attention to negative DC, whose negative consequences are manifested also over time, planning interventions targeting partners’ awareness of their own DC style.
Managing cardiac illness is not easy because it dramatically disrupts people’s daily life and both the patient and his/her spouse are at risk for experiencing distress, which, in turn, may affect the support provided by the partner as caregiver. The partner, in fact, is the main source of support, but his/her support may sometimes be inadequate. In addition, dyadic coping (i.e., the way partners cope together against stress and support each other in times of difficulty) could likely be a moderating factor. The main aim of the present study was to examine the role that dyadic coping (DC, in terms of positive, negative, and common dyadic coping responses) plays in moderating the link between patient and partner cardiac illness-related distress (in terms of anxiety and depression) and partner support (in terms of overprotection, hostility, and partner support for patient engagement). The study included 100 married couples faced with cardiac illness who completed a self-report questionnaire.We analyzed our data in PROCESS using multiple regressions in order to assess the moderating effects of DC responses in the relationship between the couple’s cardiac illness-related distress and partner support. With regard to patient distress, results showed that higher levels of patient anxiety and depression were linked with ineffective partner support (i.e., overprotection and hostility). With regard to partner distress, higher levels of partner depression were linked with hostility; higher levels of partner depression and anxiety were associated with less partner support for patient engagement. Moreover, the association between distress and partner support was moderated by the quality of DC. In particular, low positive DC represented a risk factor for both the patient and the partner during a cardiac illness, as low positive DC exacerbated the link between patient and partner distress and less effective partner support styles. Also, higher levels of negative DC were risky for couples: The association between distress and less adequate partner supportive behaviors was stronger in the case of higher negative DC. These results imply a need for psychosocial interventions for couples in cardiac illness, especially for couples lacking relational competences, such as positive dyadic coping.
Riassunto La malattia cardiaca ha un impatto notevole sul corpo, sulla psiche e sulle relazioni. La cura non dovrebbe ridursi solo ad esclusivo ripristino delle funzionalità dell'organo in una logica del tutto ortopedico-meccanicistica. Valorizzare il ruolo del partner nella costruzione di una rete di supporto, è centrale, in quanto persona più prossima al malato. La presenza di un partner rappresenta inoltre un fattore protettivo per una migliore compliance e gestione dei sintomi, nonché delle ricadute, riducendo anche il tasso di mortalità. È da precisare che il partner si trova ad affrontare una situazione nuova e talvolta onerosa, spesso senza sapere come essere realmente supportivo. Inoltre l'esperienza di malattia è stressante anche per chi sostiene il malato. Il sostegno del partner in un processo di empowerment e di engagement relazionale attorno al malato può rappresentare un'importante pista di sviluppo nella promo-zione della salute. Si discutono anche le implicazioni clinico-terapeutiche per gli interventi rivolti alla coppia.
Parole chiave: supporto del partner; malattia cardiaca; patient engagement; caregiving.
ResearchGate has not been able to resolve any references for this publication.