Strategies of Dyadic Coping and Self-Regulation in the Family Homes of Chronically Ill Persons: A Qualitative Research Study Using the Emotional Map of the Home Interview Method

An Exploration of Common Dyadic Coping Strategies: A Perspective from Pakistani Couples Living with Chronic Conditions

This qualitative study was conducted to explore the common dyadic coping (DC) efforts of married couples, with a chronically ill partner. The sample for the study consisted of twelve couples chosen from Gujrat, Pakistan. The semi-structured interviews were conducted with the help of an interview guide and analyzed using thematic analysis (Braun and Clarke, 2006). The following four major themes were emerged: "common problem-focused DC," "common emotion-focused DC," "common religious DC," and "combined pattern of intimate relationships." The findings indicated that partners are not preferring relational coping resources for problem- and emotion-focused DC. However, the majority of couples participate in religious DC process in a complementary way to cope with stressful situation in the result of chronic illness. The study also indicated various indigenous factors, for example, socioeconomic status, family culture, lack of physical resource, and religious standpoints contributing in the lack of connectivity and sexual intimacy. To conclude, the results revealed that future research is required to investigate the patient and partner's relationship in greater depth, focusing on above-mentioned contextual factors.

'A whirlwind of everything': The lived experience of adolescents with co-occurring chronic pain and mental health symptoms

BACKGROUND

Co-occurring chronic pain and mental health issues are prevalent in adolescents, costly to society and can lead to increased risk of complications throughout the lifespan. While research has largely examined paediatric chronic pain and mental health in isolation, little is known about the unique challenges faced by adolescents who experience these co-occurring symptoms. This idiographic study examined the lived experience of adolescents with co-occurring chronic pain and mental health symptoms to identify salient issues for this population.

METHODS

Semi-structured telephone interviews were conducted with seven adolescents (11-19 years) self-reporting diagnoses of both pain and mental health issues for a duration of 3 months or longer. Participants were recruited from UK-based schools, pain clinics and charities. Interview transcripts were analysed using interpretative phenomenological analysis.

RESULTS

Analyses generated two themes 'a whirlwind of everything' and 'putting up fronts', which describe how the experience of co-occurring chronic pain and mental health symptoms typically disrupted adolescents' ability to regulate their physical, psychological and social wellbeing and identity. Adolescents described their symptom experience as like an internal storm over which they had no control. Such experiences required adolescents to embrace a variety of symptom management strategies, with adolescents reporting deliberate efforts to minimize their symptoms to external individuals.

CONCLUSION

Co-occurring pain and mental health symptoms may be experienced in similar ways to individually experienced pain or mental health symptoms, but together, the experience may be both more difficult to manage and more socially isolating.

SIGNIFICANCE

Adolescents with co-occurring chronic pain and mental health symptoms describe the experience as if there was a storm inside of them disrupting their sense of physical, emotional and social wellbeing. This inner chaos interferes with their self-identity and relationships with others. Challenges articulating their experiences, and negative encounters associated with their symptoms, further impact feelings of isolation and difficulties accessing support.

Finding a Secure Place in the Home during the First COVID-19 Lockdown: A Pattern-Oriented Analysis

In challenging times, home is frequently the primary basis of environmental self-regulation processes, individual and relational coping, and well-being. This study aimed to identify multiple types of security experiences at home during the first lockdown period of the COVID-19 pandemic. We used data from 757 Hungarian adults who completed the online, modified form of the Emotional Map of the Home Interview method in 2020 after the outbreak of the COVID-19 pandemic. Participants imagined their homes, chose the place of security in their homes and rated their personal experiences (i.e., experiences of agency, communion, self-recovery, and distress) related to these places. Latent profile analysis of personal experiences revealed four types of relational-environmental self-regulation in secure places: "security in active self-recovery," "security in detachment," "security in doing and feeling good enough," and "security in stress and compensation." Profile membership was predicted by age, gender, and indices of psychological support and well-being. Results suggest that finding psychological security in the home is a multifaceted phenomenon that may be partly affected by the perception of the broader social-ecological context. Identifying subpopulations vulnerable to the challenges of the pandemic may help researchers and practitioners provide better support in times of local and global crises.

Striving for autonomy in everyday diabetes self-management-qualitative exploration via grounded theory approach

OBJECTIVES

The rapid worldwide increase in the incidence of diabetes significantly influences the lives of individuals, families and communities. Diabetes self-management requires personal autonomy and the presence of a supportive social environment. These attributes can considerably ameliorate the outcomes of the chronic condition. However, little is known about individual variations in overcoming the illness-related challenges and in the achievement of autonomy in daily activities. This paper seeks to bridge this knowledge gap.

DESIGN

This qualitative study used the grounded theory approach. Semi-structured interviews were conducted, and the data collection and data analysis probed participant experiences of autonomy through the self-management of their daily socio-physical environments.

SETTING

Participants were recruited from the outpatient ward of a university clinic in Hungary.

PARTICIPANTS

The study was conducted with 26 adult patients with type 2 diabetes mellitus (15 females and 11 males aged between 26 and 80 years; M=62.6 years; SD=13.1). The inclusion criteria were: T2D diagnosis at least 1 year before the beginning of the study; prescribed insulin injection therapy; aged over 18 years; native Hungarian speaker and not diagnosed with dementia or any form of cognitive impairment.

RESULTS

The study established three principal aspects of the active construction of personal autonomy in diabetes self-management: coping strategies vis-à-vis threats posed by the symptoms and the treatment of the disease; autonomous ways of creating protective space and time and relationship processes that support everyday experiences of self-directedness.

CONCLUSIONS

The results of this study confirm the validity of the self-determination theory in diabetes self-management. They also imply that pathways towards constructing everyday experiences of self-directedness in participants lead through self-acceptance, supporting family relationships and a doctor-patient relationship characterised by partnership. The tentative empirical model of pathways towards patients' experience of self-directedness can serve as a framework for future research, patient-centred clinical practice, and education.

Partner support and goal outcomes during COVID-19: A mixed methods study

During the COVID-19 pandemic, people have been stuck indoors with their partners for months. Having a supportive partner is likely to be especially important during this time when access to outside sources of support is limited. The present mixed-methods study aimed to investigate how partner support is associated with goal outcomes during COVID-19. The survey participants (n = 200) completed a daily diary for a week and five weekly longitudinal reports, and 48 participants attended a semi-structured interview. The quantitative results showed that higher relational catalyst support (i.e., support for growth opportunities) predicted better goal outcomes; qualitative analyses revealed partners use direct and indirect forms of emotional and instrumental support toward goal pursuit. This is important because most studies to date have not differentiated between direct and indirect forms of support. Overall, the findings suggest that having a supportive partner is important for not only surviving, but also thriving through the pandemic.

Disability as an Interpersonal Experience: A Systematic Review on Dyadic Challenges and Dyadic Coping When One Partner Has a Chronic Physical or Sensory Impairment

Chronically disabling health impairments affect an increasing number of people worldwide. In close relationships, disability is an interpersonal experience. Psychological distress is thus common in patients as well as their spouses. Dyadic coping can alleviate stress and promote adjustment in couples who face disabling health impairments. Much research has focused on dyadic coping with cancer. However, other health problems such as physical and sensory impairments are also common and may strongly impact couple relationships. In order to promote couples' optimal adjustment to impaired health, the identification of disability-related relationship challenges is required. Furthermore, ways in which dyadic coping with these challenges may benefit couples could inform researchers and practitioners how to support couples in coping with health impairments. Accordingly, the aims of this study were to systematically review dyadic challenges and dyadic coping when one partner has a chronically disabling physical or sensory impairment. Out of 873 articles identified through database searches, 36 studies met inclusion criteria. The disability-related dyadic challenges identified in the review were changed roles and responsibilities within the couple, altered communication, compromised sexual intimacy, and reduced social participation. These challenges were reported to burden both partners and the couple relationship. Dyadic adjustment benefitted from a we-perspective, i.e., when couples viewed the disability as a shared challenge and engaged in conjoint dyadic coping. The results suggest that patient/care recipient and partner/caregiver roles should be de-emphasized and that disability should be recognized as an interpersonal experience.

The relationship between dyadic coping and dyadic adjustment among HIV-serodiscordant couples

Living within an HIV-serodiscordant relationship has been recognized as a stressful experience for both HIV-infected and HIV-uninfected partners. However, no study has examined the association between dyadic coping (DC) and dyadic adjustment of such couples. In this study, we analysed the association between DC (positive, negative, and common DC) and dyadic adjustment (consensus, satisfaction, cohesion) among HIV-serodiscordant couples, considering individual and cross-partner effects. This cross-sectional study included a sample of 44 HIV-serodiscordant different-sex couples, in a relationship for an average of 16.46 years. The self-reported measures included the Dyadic Coping Inventory and the Revised Dyadic Adjustment Scale. For HIV-infected partners, their own common DC was significantly associated with cohesion, and a cross-partner effect of common DC on satisfaction was found. For HIV-uninfected partners, individual effects of common DC on all dyadic adjustment subscales and a cross-partner effect of common DC on cohesion were found. Additionally, their own and their HIV-infected partners' negative DC were significantly associated with cohesion and satisfaction, respectively. These findings suggest that the perception of common DC has a particularly important role in explaining the different components of dyadic adjustment of both partners facing HIV-serodiscordancy, whereas negative DC is linked to the adjustment of HIV-uninfected partners.