Review and Meta-analysis of Couple-Oriented Interventions for Chronic Illness
Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, USA. Annals of Behavioral Medicine
(Impact Factor: 4.2).
12/2010; 40(3):325-42. DOI: 10.1007/s12160-010-9216-2
Evidence continues to build for the impact of the marital relationship on health as well as the negative impact of illness on the partner. Targeting both patient and partner may enhance the efficacy of psychosocial or behavioral interventions for chronic illness.
The purpose of this report is to present a cross-disease review of the characteristics and findings of studies evaluating couple-oriented interventions for chronic physical illness.
We conducted a qualitative review of 33 studies and meta-analyses for a subset of 25 studies.
Identified studies focused on cancer, arthritis, cardiovascular disease, chronic pain, HIV, and Type 2 diabetes. Couple interventions had significant effects on patient depressive symptoms (d = 0.18, p < 0.01, k = 20), marital functioning (d = 0.17, p < 0.01, k = 18), and pain (d = 0.19, p < 0.01, k = 14) and were more efficacious than either patient psychosocial intervention or usual care.
Couple-oriented interventions have small effects that may be strengthened by targeting partners' influence on patient health behaviors and focusing on couples with high illness-related conflict, low partner support, or low overall marital quality. Directions for future research include assessment of outcomes for both patient and partner, comparison of couple interventions to evidence-based patient interventions, and evaluation of mechanisms of change.
Available from: Hiba Deek
- "This could be explained by the patients' dependence on the spouse. However , with the spouses' support, patients with heart failure had better lifestyle adaptation and medication adherence (Molloy et al. 2005, Martire et al. 2010). Moreover, married patients had significantly longer event-free survival than non-married patients, and those with a 'high quality marriage' had significantly better survival after four years of follow-up than their counterparts (Rohrbaugh et al. 2004). "
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ABSTRACT: Increasingly there is a focus on self-care strategies for both malignant and non-malignant conditions. Models of self-care interventions have focussed on the individual and less on the broader context of family and society. In many societies, decision-making and health seeking behaviours, involve family members. To identify elements of effective family-centred self-care interventions that are likely to improve outcomes of adults living with chronic conditions. Review paper. MEDLINE (Ovid), CINAHL, Academic Search Complete, PsychInfo and Scopus between 2000–2014. Quantitative studies targeting patient outcomes through family-centred interventions in adults were retrieved using systematic methods in January, 2015. Search terms used were: ‘family’, ‘spouse’, ‘carer’, ‘caregiver’, ‘chronic’, ‘chronic disease’, ‘self-care’, ‘self-management’ and ‘self-efficacy’. Reference lists were reviewed. Risk of bias assessment was performed using the Cochrane Collaboration's tool. Data were reported using a narrative summary approach. Ten studies were identified. Improvements were noted in readmission rates, emergency department presentations, and anxiety levels using family-centred interventions compared with controls. Elements of effective interventions used were a family-centred approach, active learning strategy and transitional care with appropriate follow-up. Involving the family in self-care has shown some positive results for patients with chronic conditions. The benefits of family-centred care may be more likely in specific socio-cultural contexts. The review has year limits and further research needs to identify support for both the patients and family caregivers.
- "Compared with mostly positive effects of individual planning on health-behavior change (Belanger-Gravel et al., 2013), effects of dyadic planning (Burkert et al., 2011) as well as collaborative implementation intentions (Prestwich et al., 2012, 2014) remain equivocal. In this, effects of social forms of planning on behavior change so far seem as inconsistent as effects of reactive strategies of social regulation, such as social support or social control that may work only for subgroups (Knoll et al., 2012; Martire, Stephens , & Schulz, 2011; Scholz et al., 2013) or produce only small effects when used as intervention strategies (Martire, Lustig, Schulz, Miller, & Helgeson, 2004; Martire et al., 2010). One possible explanation that has received comparatively little empirical attention so far concerns the notion that timing of the use of social regulation strategies may be important (Bodenmann, 2000). "
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ABSTRACT: Radical prostatectomy, a standard treatment for localized prostate cancer, is often followed by a recommendation to initiate and maintain pelvic floor exercise (PFE), to control postsurgery urinary incontinence. Previous studies showed that planning facilitated the uptake and maintenance of a new behavior. Whereas individual planning addresses the setting of plans by 1 person, dyadic planning refers to creating plans together with a partner on when, where, and how the individual target person will perform a behavior. Individual and dyadic planning of PFE, their development over time, and their associations with PFE were investigated.
In a correlational study, 175 prostate-cancer patients provided data at 1, 3, 5, and 7 months following the onset of incontinence. Individual planning of PFE by patients and dyadic planning of PFE between patients and their partners, PFE, and incontinence were assessed by patients' self-reports.
Two-level models with repeated assessments nested in individuals revealed stable levels of individual planning of PFE over time in patients with higher incontinence severity, whereas patients with receding incontinence showed decreases. Independent of incontinence severity, a curvilinear increase followed by a decrease of dyadic planning of PFE across time emerged. Sequential associations of both planning strategies with PFE were found. Whereas individual planning was steadily associated with PFE, associations between dyadic planning and PFE were nonsignificant in the beginning, but increased over time.
Findings point to the importance of individual planning for the adoption and maintenance of PFE, with dyadic planning being relevant for PFE maintenance only. (PsycINFO Database Record
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Available from: Carina Persson
- "Although research findings and system theories suggest that chronic illness has an impact on the family as a unit, the health care system is typically patient focused and family systems needs are notably unmet. Recently published reviews of family interventions        show that interventions provided by health care often are characterized as psychoeducational versus relationship focused. Additionally, interventions are mostly directed towards the individual family member or "
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ABSTRACT: Research shows that living with illness can be a distressing experience for the family and may result in suffering and reduced health. To meet families' needs, family systems intervention models are developed and employed in clinical contexts. For successful refinement and implementation it is important to understand how these models work. The aim of this study was therefore to describe the dialogue process and possible working mechanisms of one systems nursing intervention model, the Family Health Conversation model. A descriptive evaluation design was applied and 15 transcribed conversations with five families were analyzed within a hermeneutic tradition. Two types of interrelated dialogue events were identified: narrating and exploring. There was a flow between these events, a movement that was generated by the interaction between the participants. Our theoretically grounded interpretation showed that narrating, listening, and reconsidering in interaction may be understood as supporting family health by offering the families the opportunity to constitute self-identity and identity within the family, increasing the families' understanding of multiple ways of being and acting, to see new possibilities and to develop meaning and hope. Results from this study may hopefully contribute to the successful implementation of family systems interventions in education and clinical praxis.
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