The Association Between Cardiac Illness-Related Distress and Partner Support: The Moderating Role of Dyadic Coping

Abstract

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.

Yes, I can (with you)! Dyadic coping and self‐management outcomes in cardiovascular disease: The mediating role of health self‐efficacy

“…evidence indicates that cardiac patients in a satisfying marriage showed better health-management (Rapelli et al, 2021), are more likely to adhere to medical prescriptions (Maeda et al, 2013) and to be more assiduous in their attendance at cardiac rehabilitation (White-Williams et al, 2013), while, conversely, negative partner support decreases the patient's adherence both cross-sectionally (O'Bertos et al, 2020) and longitudinally (George-Levi et al, 2016).…”

“…In the illness context, positive and common DC are associated with lower depression in both partners coping with breast cancer (Rottmann et al., 2015), improved physical well‐being in women with breast cancer (Feldman & Broussard, 2006) and in men with prostate cancer (Berg et al., 2011) and better adherence rates among patients with diabetes (Johnson et al., 2013; Trump et al., 2018). Accumulating evidence indicates that cardiac patients in a satisfying marriage showed better health‐management (Rapelli et al., 2021), are more likely to adhere to medical prescriptions (Maeda et al., 2013) and to be more assiduous in their attendance at cardiac rehabilitation (White‐Williams et al., 2013), while, conversely, negative partner support decreases the patient's adherence both cross‐sectionally (O’Bertos et al., 2020) and longitudinally (George‐Levi et al., 2016). Regarding patient activation, only a few contributions (Bertoni et al., 2015, 2017; Rapelli, Donato, Bertoni, Spatola, et al., 2020) show that when the partner is sufficiently close to the patient and respects his/her autonomy, patient activation is high; conversely, overprotection and hostility decrease the patient's autonomous efforts to be actively engaged in his/her care (Bertoni et al., 2017; Joekes et al., 2007).…”

“We-Diseases” and Dyadic Decision-Making Processes: A Critical Perspective

“…This evidence is coherent with the Systemic Transactional Model (STM) [23, 24] that recognizes a mutual interdependence between romantic partners on stress management and adjustment, in which both partners are engaged in shared problem solving, behaviors, and emotion regulation. As suggested by Rapelli et al [25, 26], dyadic coping might be an adaptive strategy to face with the difficulty and uncertainty of the disease. Consistently, the STM permits to better understand in which way cancer decision-making might be considered starting to a dyadic perspective.…”

Dyadic Coping in Couples Facing Chronic Physical Illness: A Systematic Review

“…Furthermore, as demonstrated in a cardiac population, partner hostility is negatively associated with patient engagement with the treatment (Rapelli et al, 2020 ). Additionally, for cardiac patients, not only high levels of negative DC but also low levels of positive DC were detrimental to the patient (Rapelli et al, 2021 ). Nevertheless, there is a need for a thorough overview of chronic illnesses that vary in terms of their timeline, consequences, level of control, and effects on identity coupled with in-depth consideration of the temporal process within DC in the context of chronic illness (Berg and Upchurch, 2007 ).…”