Influential factors of spousal relationship quality in couples living with dementia – A narrative synthesis systematic review

Abstract

Aim The aim of this systematic review is to identify factors that influence relationship quality in couples living with dementia. Previous research has shown how maintaining a positive spousal relationship quality is important for quality of life and coping for both the caregiver and the person with dementia. Knowledge of influential factors could contribute to a deeper understanding of the value of a couple-centred clinical practice and research, within the field of dementia. Research design and methods Systematic procedures to database search, screening, data extraction and synthesis were followed. Qualitative, quantitative and mixed methods studies were included. A narrative synthesis was conducted through narrative summaries of included studies, thematic analysis and narrative descriptions of factors influencing relationship quality. Results 39 studies were included in the study: 28 qualitative, 8 quantitative and 3 mixed methods. Through the narrative synthesis, 20 factors were identified. The factors were grouped into two overarching themes: The world of us and The world outside of us, and further to six influencing factor categories: (1) Attitudes and strategies, (2) Behaviour and activities, (3) Emotional connectedness, (4) Activities and experiences outside of the home, (5) Social behaviour and roles, and (6) Belonging and safety. Discussion and conclusion The identified factors influence relationship quality in couples living with dementia on various levels. The findings of this review study should inform clinical, couple-centred dementia care practise and intervention studies, and further research should seek to gain deeper understandings of the individual factors and broader understandings of the correlations between factors.

The Influence of Home-Based Music Therapy Interventions on Relationship Quality in Couples Living with Dementia—An Adapted Convergent Mixed Methods Study

“…Relationship quality in couples living with dementia is a significant factor impacting well-being and quality of life for the person with dementia and their partner [ 2 ], and being in intimate relationships is defined as an important need for both persons with dementia living at home and their caregivers [ 3 ]. Life experiences associated with a dementia diagnosis may influence relationship quality in married or co-habiting couples [ 4 ]. As the symptoms of dementia worsen with disease progression, several factors may contribute positively or negatively to changes in relationship quality.…”

Characteristics and Correlates of Perceived Physical and Psychological Health Among Family Caregivers Living With Persons With Advanced Dementia

“…The findings from our study suggest that nurses and other frontline health care providers working closely with dementia dyads living at home together should take into account the family caregiver’s perceived relationship with the person with dementia throughout the care process. Factors that impact relationship quality 40 should be identified in future research to develop effective interventions for both family caregivers and persons with dementia.…”

“…Using existing data, we explored caregivers’ perceived relationships with their family members with dementia, but not vice-versa, despite the interconnectedness between dementia dyads. 37,40 Given that dementia dyads’ relationship perceptions about each other also affected important future plans and approaches to living with dementia, 37 the perceived relationship with family caregivers from the perspective of persons with dementia should also be included in future research.…”

The quality of family relationships in dementia: Mixed methods to unravel mixed feelings

“…Evidence on the benefits of psychosocial interventions in dementia is growing ( Cheng et al, 2019 ; Livingston et al, 2020 ; McDermott et al, 2019 ; Oyebode & Parveen, 2019 ), particularly of dyadic interventions ( Laver et al, 2017 ; Poon, 2019 ; Van’t Leven et al, 2013 ). To assume a more positive ‘couple-centred’ tone, these interventions should move beyond a narrow focus on behavioural ‘control’ (‘management’) to encompass wider aspects of life, including relationship quality ( Oyebode & Parveen, 2019 ; Stedje et al, 2023 ). Maintaining or improving dyadic relationships promotes quality of life ( Clare et al, 2014 ; Woods et al, 2014 ) and social health in dementia ( Dröes et al, 2017 ).…”