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
Source: PubMed


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.

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    • "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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    • "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 [8] [9] [10] [11] [12] [13] [14] 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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