A Postcard From Italy: Challenges and Psychosocial Resources of Partners Living With and Without a Chronic Disease During COVID-19 Epidemic

Psychosocial resources and psychopathology among persons with neuromuscular disorders during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic substantially affected the lives of persons with inherited neuromuscular disorders (INMD), causing disruption in clinical and support services. While several studies have investigated mental health, distress and psychosocial resources in the general population during the pandemic, little is known about the experience of persons with INMD.

METHODS

This study was aimed to fill this gap by jointly investigating both psychopathological symptoms and psychosocial resources - specifically, resilience and perceived social support - among persons with INMD during the pandemic, taking into account demographic and clinical factors. Between April and December 2020, 59 participants with INMD (aged 15-59, 71.2% M) completed a questionnaire collecting demographic and clinical data, the Multidimensional Scale of Perceived Social Support, the Resilience Scale for Adults, and the Achenbach System of Empirically Based Assessment.

RESULTS

Overall, participants showed good levels of resilience and perceived social support. A minority of participants reported clinically relevant psychopathological symptoms, 28.81% for anxiety and depression. Most psychopathological symptoms were negatively correlated with resilience (-0.347 < r < - .420), but not significantly associated with social support. Consistent with previous studies, regression analyses highlighted that participants with Duchenne muscular dystrophy were more prone to report anxious and depressive symptoms (B = 1.748, p = .028, OR = 5.744), and participants with myotonic dystrophy, attention problems (B = 2.339, p = .006, OR = 10.376). Resilience emerged as a potential predictor of lower anxious-depressive symptoms (B=-1.264, p = .012, OR = 0.283).

CONCLUSIONS

The findings suggest the importance to investigate psychosocial resources in addition to psychopathology among persons with INMD, and to design interventions supporting resilience as a protective factor for mental health promotion.

The Impact of the COVID-19 Pandemic on Patients With CKD: Systematic Review of Qualitative Studies

RATIONALE & OBJECTIVE

COVID-19 disproportionately affects people with comorbidities, including chronic kidney disease (CKD). We describe the impact of COVID-19 on people with CKD and their caregivers.

STUDY DESIGN

A systematic review of qualitative studies.

SETTING & STUDY POPULATIONS

Primary studies that reported the experiences and perspectives of adults with CKD and/or caregivers were eligible.

SEARCH STRATEGY & SOURCES

MEDLINE, Embase, PsycINFO, CINAHL searched from database inception to October 2022.

DATA EXTRACTION

Two authors independently screened the search results. Full texts of potentially relevant studies were assessed for eligibility. Any discrepancies were resolved by discussion with another author.

ANALYTICAL APPROACH

A thematic synthesis was used to analyze the data.

RESULTS

Thirty-four studies involving 1,962 participants were included. Four themes were identified: exacerbating vulnerability and distress (looming threat of COVID-19 infection, intensifying isolation, aggravating pressure on families); uncertainty in accessing health care (overwhelmed by disruption of care, confused by lack of reliable information, challenged by adapting to telehealth, skeptical about vaccine efficacy and safety); coping with self-management (waning fitness due to decreasing physical activity, diminishing ability to manage diet, difficulty managing fluid restrictions, minimized burden with telehealth, motivating confidence and autonomy); and strengthening sense of safety and support (protection from lockdown restrictions, increasing trust in care, strengthened family connection).

LIMITATIONS

Non-English studies were excluded, and inability to delineate themes based on stage of kidney and treatment modality.

CONCLUSIONS

Uncertainty in accessing health care during the COVID-19 pandemic exacerbated vulnerability, emotional distress, and burden, and led to reduced capacity to self-manage among patients with CKD and their caregivers. Optimizing telehealth and access to educational and psychosocial support may improve self-management and the quality and effectiveness of care during a pandemic, mitigating potentially catastrophic consequences for people with CKD.

PLAIN-LANGUAGE SUMMARY

During the COVID-19 pandemic, patients with chronic kidney disease (CKD) faced barriers and challenges to accessing care and were at an increased risk of worsened health outcomes. To understand the perspectives about the impact of COVID-19 among patients with CKD and their caregivers, we conducted a systematic review of 34 studies involving 1,962 participants. Our findings demonstrated that uncertainty in accessing care during the COVID-19 pandemic exacerbated the vulnerability, distress, and burden of patients and impaired their abilities for self-management. Optimizing the use of telehealth and providing education and psychosocial services may mitigate the potential consequences for people with CKD during a pandemic.

Family Resilience and Dyadic Coping during the Outbreak of the COVID-19 Pandemic in Italy: Their Protective Role in Hedonic and Eudaimonic Well-Being

The COVID-19 pandemic outbreak has dramatically worsened people's psychological well-being. Our aim was to examine for the first time the concurrent and longitudinal relations of family resilience with hedonic and eudaimonic well-being, and the moderating role of socio-demographics. For people having a romantic partner, we also explored whether family resilience and dyadic coping were uniquely related to well-being. One cross-sectional study (N = 325) and one 10-week follow-up study (N = 112) were carried out during the outbreak of the COVID-19 pandemic (April-May 2020) in Northern Italy. Adult participants completed an online questionnaire in both studies. Correlation, multivariate regression, and moderation analyses were carried out with IBM SPSS version 28 and its PROCESS macro. Significance of differences in correlation and regression coefficients was tested through Steiger's procedure, Wald test, and SUEST method. Family resilience was found to relate more strongly to eudaimonic (versus hedonic) well-being concurrently and to hedonic (versus eudaimonic) well-being longitudinally. The concurrent or longitudinal relations with hedonic well-being were generally stronger for females, part-time workers, and people undergoing multiple stressors. For people having a romantic partner, family resilience was concurrently associated with well-being independently of dyadic coping, whereas dyadic coping was longitudinally related to well-being independently of family resilience. Family resilience was found to protect, in the short term, the psychological well-being of people facing the pandemic outbreak. Its protective role mainly concerned hedonic well-being and was more pronounced for more vulnerable people. For persons having a romantic partner, however, dyadic coping seemed to have equal, if not greater, positive short-term effects.

Mental well-being and patient activation during the first eight months of the COVID-19 pandemic in Denmark - a cohort study among 710 Danish adults with chronic conditions

BACKGROUND

COVID-19 has highlighted the importance of patient activation in managing chronic conditions and promoting resilience during times of crisis. Patient activation refers to an individual's knowledge, skills, and confidence in managing their own health and healthcare. Previous research has shown that people with higher levels of patient activation are better prepared to navigate the challenges of chronic illness and are more likely to engage in healthy behaviors. However, the impact of patient activation on COVID-19-related concerns and mental well-being among people with chronic conditions during the pandemic remains unclear. This study aims to investigate the possible role of patient activation in shaping COVID-19-related concerns and to describe changes in mental well-being among Danish adults with one or more chronic conditions during the early months of the pandemic.

METHODS

Danish adults with chronic conditions (e.g. diabetes, coronary heart disease, obstructive pulmonary lung disease, cancer) who had participated in a municipal health education program prior to the COVID-19 outbreak were asked to participate in this prospective questionnaire study in May 2020 and November 2020. Sociodemographic (sex, age, living status, educational attainment, employment status) and disease-related information (diagnosis, one or more chronic conditions) along with the Patient Activation Measure were collected before the outbreak and were obtained from a clinical database used for monitoring and evaluation of municipal health education programs. In contrast, the two questionnaires collected six months apart consisted of single items related to concerns about COVID-19 and the WHO-5 well-being index.

RESULTS

A total of 710 people with chronic conditions (mean age 60.9 years; 55.8% female) participated at both time points. In bivariate analyses, patient activation was associated with COVID-19-related concern and well-being. At follow-up, participants experienced a significant decrease in well-being. The decrease was associated with poorer well-being measured six months earlier, a greater perception that it had become more challenging to take care of one's health due to the pandemic, and finally, feeling lonely. The association between patient activation and well-being ceased to be significant in the multivariate regression model.

CONCLUSIONS

A considerable proportion of people with chronic conditions participating in this study have been mentally burdened during COVID-19. Although lower levels of patient activation were associated with greater COVID-19-related concerns, it did not have a significant impact on mental well-being over time.

Did COVID-19 affect rural households' subjective well-being? A social survey from rural China

Improving rural households' subjective well-being is an important element of economic and social revitalization in the post-epidemic period. Based on the survey data obtained from rural households in Hubei Province, the center of the outbreak in China, and its surrounding areas, this paper explores the impact mechanisms of the COVID-19 epidemic on subjective well-being from both economic and sociological perspectives with the help of structural equation modeling. The results show that COVID-19 significantly influenced rural households' subjective well-being in China. Furthermore, COVID-19 indirectly affected their subjective well-being by influencing optimism. The negative impact is moderated by government intervention and income resilience. Therefore, strengthening the emergency management capacity of local governments and encouraging the diversification of rural households' income sources are important strategies to effectively resolve epidemic shocks and improve the level of well-being.

The long wave of COVID-19: a case report using Imagery Rehearsal Therapy for COVID-19-related nightmares after admission to intensive care unit

Introduction

The COVID-19 pandemic caused several psychological consequences for the general population. In particular, long-term and persistent psychopathological detriments were observed in those who were infected by acute forms of the virus and need specialistic care in the Intensive Care Unit (ICU). Imagery rehearsal therapy (IRT) has shown promising results in managing nightmares of patients with different traumas, but it has never been used with patients admitted to ICUs for severe COVID-19 despite this experience being considered traumatic in the literature.

Methods

The purpose of this case study is to describe the application of a four-session IRT for the treatment of COVID-related nightmares in a female patient after admission to the ICU. A 42-year-old Caucasian woman who recovered from a pulmonary rehabilitation program reported shortness of breath, dyspnea, and everyday life difficulties triggered by the long-COVID syndrome. She showed COVID-related nightmares and signs of post-traumatic symptoms (i.e., hyperarousal, nightmares, and avoidance of triggers associated with the traumatic situation). Psychological changes in the aftermath of a trauma, presence, and intensity of daytime sleepiness, dream activity, sleep disturbances, aspects of sleep and dreams, and symptoms of common mental health status are assessed as outcomes at the baseline (during the admission to pneumology rehabilitation) at 1-month (T1) and 3-month follow-up (T2). Follow-up data were collected through an online survey.

Results

By using IRT principles and techniques, the patient reported a decrease in the intensity and frequency of bad nightmares, an increase in the quality of sleep, and post-traumatic growth, developing a positive post-discharge.

Conclusion

Imagery rehearsal therapy may be effective for COVID-19-related nightmares and in increasing the quality of sleep among patients admitted to the ICU for the treatment of COVID-19. Furthermore, IRT could be useful for its brevity in hospital settings.

COVID-19 Pandemic and Lockdown: Associations With Personality and Stress Components

The present study examines the role of personality traits, interpersonal relationships, and sociodemographic factors on perceived stress, related to COVID-19, and compliance with measures to mitigate its spread. Data were collected in the midst of the 'first wave' lockdown, with the survey completed in full by 963 participants. We measured stress, directly related to the pandemic, rather than general stress, and were able to distinguish between symptoms of emotional, behavioural, cognitive, physical stress, and alienation with high concordance. We included personality scoring with standardized T-scores, allowing for cross-study comparison, and a broader questionnaire on the participants' support for COVID-19 mitigation measures. Results of the multiple regression models indicated that low emotional stability and introversion, and high conscientiousness, common conflicts with loved ones, and some demographics (female gender, middle age, chronic health problems) correspond to elevated stress. Conscientiousness was positively associated with total stress and some of its components, whereas opposite results were found for emotional stability. Extraversion was negatively correlated to total stress, its emotional and physical components, and alienation. Surprisingly, increased stress was not related to greater measure adherence. The present results shed light on how personality, interpersonal relationships, and sociodemographic factors influence people's stress response during a pandemic.

Workers' individual and dyadic coping with the COVID-19 health emergency: A cross cultural study

The aim of this study was to examine workers' psychological distress during the COVID-19 pandemic as a function of their individual coping, dyadic coping, and work-family conflict. We also tested the moderating role of gender and culture in these associations. To achieve this aim, we run HLM analyses on data from 1521 workers cohabiting with a partner, coming from six countries (Italy, Spain, Malta, Cyprus, Greece, and Russia) characterized by various degrees of country-level individualism/collectivism. Across all six countries, findings highlighted that work-family conflict as well as the individual coping strategy social support seeking were associated with higher psychological distress for workers, while the individual coping strategy positive attitude and common dyadic coping were found to be protective against workers' psychological distress. This latter association, moreover, was stronger in more individualistic countries.

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

Cardiac patients show alarming levels of nonadherence to medications. It is important to consider also patient activation levels. Furthermore, the partner could have a supporting role in these processes. The aim of this study was to investigate the mediating role of patient health self-efficacy (HSE) in the link between dyadic coping (DC) and two self-management outcomes (i.e. medication adherence and patient activation) across the first 6 months of cardiac disease. One hundred couples completed two self-report questionnaires during the hospitalisation for cardiac disease and 6 months after discharge. A longitudinal and dyadic research design was adopted. Cross-sectional analyses at T0 revealed that patient-provided and perceived positive DC and common DC are positively associated with HSE, which in turn is positively associated with medication adherence. HSE mediated the association between patient positive and common DC styles, with the only exception of Patient-provided positive DC, and patient activation. Conversely, patient-provided and perceived negative DC are negatively associated with HSE, which in turns is positively associated with medication adherence and patient activation. Prospective analyses showed that only patient-perceived negative DC at discharge is negatively associated with HSE at T1, which in turns is positively associated with patient activation over time. These results suggest to consider patient perceived and provided DC as antecedents of self-management outcomes via patient HSE. Furthermore, our results recommend to pay particular attention to negative DC, whose negative consequences are manifested also over time, planning interventions targeting partners' awareness of their own DC style.

Love in the time of COVID-19: A systematic mapping review of empirical research on romantic relationships one year into the COVID-19 pandemic

The COVID-19 pandemic has affected nearly every area of daily life, including romantic relationships. With the pandemic still ongoing, this study reviewed the existing scholarly literature to document the status of empirical research on how COVID-19 has affected couples during its first year. Studies were identified through searching five databases as well as sources of gray literature. Overall, 42 studies on committed romantic relationships during the first year of the pandemic were identified. The mapping process revealed four main themes: (1) relationship quality; (2) sexuality; (3) couple daily adjustment; and (4) intimate partner violence. The findings suggest that the way romantic relationships were affected by the pandemic depends on a variety of demographic, individual, and couple-level factors. Implications include a call for both the development of evidence-based interventions that consider the current findings and further research to continue exploring the clinical implications of future findings to promote healthy intimate relationships during the ongoing global pandemic.

Harmful Stress-Related Couple Processes During the COVID-19 Pandemic and Lockdown: A Longitudinal Dyadic Perspective

In March 2020, the World Health Organization declared the disease caused by SARS-CoV-2 coronavirus “pandemic.” To reduce the risk of contamination, many countries have ordered a lockdown characterized by social distancing and restrictive isolation measures. While the lockdown has proven to be quite effective in terms of physical health, little is known about its impact on couple satisfaction in a dyadic perspective. The current research was a 4-waves longitudinal study (i.e., from March to July 2020) with the objective to examine the trajectory of couple satisfaction during the lockdown with a dyadic perspective (N = 108 couples), including the presence (or absence) of children at home, the number of hours spent together, and the duration of the relationship as time-invariant predictors and the partner’s couple satisfaction trajectory as a time-varying covariate. Results showed positive intraindividual changes in couple satisfaction during the lockdown, especially an increase in partners’ effectiveness for resolving couple conflicts and a decrease in partners’ aggressiveness. Partners had also perceived the influence of the lockdown as more and more positive over time on couple and family functioning. Finally, the couple satisfaction of both partners changed in tandem during the lockdown: The perception of the couple relationship seems to similarly evolve between partners.

Adherence to hemodialysis and medical regimens among patients with end-stage renal disease during COVID-19 pandemic: a cross-sectional study

Background

Adherence of patients with End-Stage Renal Disease (ESRD) to Hemodialysis (HD), prescribed medications, diet and fluid restrictions is essential to get the desirable outcome and prevent complications. During COVID-19 pandemic, ESRD patients became more concerned with attending the HD sessions and following the protective measures because of the potential for increased susceptibility to COVID-19. The aim of this study was to evaluate the impact of the pandemic on patients' adherence to HD and medical regimens.

Methods

Two hundred five ESRD patients on HD were interviewed with the ESRD Adherence Questionnaire (ESRD-AQ) and the Fear-of-COVID-19 Scale (FCV-19S). Clinical and laboratory correlates of adherence were retrieved from patients' records.

Results

Self-reported adherence to HD showed that 19.5% were not adherent to HD during the pandemic compared to 11.7% before the pandemic (p < 0.001), with a significant agreement with the actual attendance of HD sessions (Kappa = 0.733, p < 0.001). Twenty-five patients (12.2%) had a history of COVID-19. The FCV-19S had a mean score of 18.8 and showed significant positive correlations with the pre-dialysis phosphorus and potassium. Multivariate analysis showed that the main predictors of non-adherence were the history of COVID-19, understanding and perception scores, and the Fear-of-COVID score.

Conclusions

The COVID-19 pandemic adversely affected the adherence of ESRD patients to HD and medical regimen. Strategies to mitigate patients' fears of COVID-19 and improve their understanding and perceptions of adherence to HD and medical regimen should be adopted in HD centers during the pandemic.

Drop in well-being of ARMD patients under treatment with anti-VEGF injections during the COVID-19 pandemic

Purpose

Patients with age-related macular degeneration (ARMD) are required to follow a treatment protocol that requires regular follow-ups. The COVID-19 pandemic has created an additional burden for patients with ARMD under treatment with anti-vascular endothelial growth factor (anti-VEGF) injections, since patients face a congestion of the health system and closing of the outpatient services. This study examines the impact of the uncertainty regarding patients’ treatment on their sense of well-being.

Methods

This is a longitudinal cohort study of eighty patients who were followed during the year following the outbreak of the COVID pandemic. Patients reported their sense of well-being with the WHO-5 questionnaire and their perception and fears for the impact of the pandemic on their ongoing ARMD treatment.

Results

There was a significant drop in mental well-being during the pandemic that paralleled the self-reported impact of the pandemic on ARMD treatment. Patients who reported a higher impact of COVID-19 on their treatment had experienced a higher drop in mental wellbeing compared to those who hadn’t, with female gender being an additional risk factor. Objective measurements of visual acuity did not factor in the drop of sense of well-being.

Conclusions

The high initial level of uncertainty regarding ARMD patients’ long-term course was further exacerbated when exposed to additional uncertainties during the pandemic regarding their standard of care. Planning ahead for continuation of services and close contact with patients during similar health emergencies is of paramount importance.

Perceived Changes in Family Life During COVID-19: The Role of Family Size

OBJECTIVE

The current study was aimed at exploring Italian parents' perceived negative and positive changes in family life during the COVID-19 pandemic, taking into account the role of the stage of the family life and family size.

BACKGROUND

During the emergency of the COVID-19 pandemic, millions of families drastically changed their daily life and routines. Little evidence exists on how family characteristics, such as family size or presence of children, are related to families' experience of family change.

METHOD

A large sample of 1,407 Italian parents (70.1% mothers) filled in an anonymous online survey during the third week of the lockdown period (between March 30 and April 7, 2020).

RESULTS

Results showed that parents reported perceiving more positive changes than negative ones, especially in terms of feeling more emotionally close to their children and spending more fun time with them. Interestingly, parents with two or more children reported more positive changes in family life compared with parents who had one child, showing a greater relational regenerative capacity in the face of COVID-19 lockdown.

CONCLUSION AND IMPLICATIONS

Investing in family relationships, especially for larger families, is an effective coping strategy to deal with traumatic situations and promote positive family changes in stressful situations.

Couples' experiences managing young-onset dementia early in the COVID-19 pandemic

BACKGROUND AND OBJECTIVES

The COVID-19 pandemic created unexpected stressors for society, and could disproportionately impact more vulnerable groups. One such group is couples facing young-onset dementia (YOD), who experience pandemic-induced stressors alongside ongoing YOD-related stressors (e.g., progressive symptoms, increased caregiving needs). Using a qualitative design, our objective was to characterize the experiences of couples living with YOD early in the COVID-19 pandemic and the impact on couples' relationship and wellbeing.

RESEARCH DESIGN AND METHODS

Couples (N = 23) of persons with YOD and their spousal caregivers participated in a one-hour live video, joint interview during the early COVID-19 pandemic. We used a hybrid inductive-deductive coding approach to thematic analysis to extract findings within two a-priori domains: (1) psychosocial stressors experienced during the early pandemic and (2) the impact of early pandemic stressors on couples' relationships and wellbeing.

RESULTS

Thematic analyses revealed 6 main themes: (1) increased caregiving responsibilities, (2) increased uncertainty, (3) increased social isolation and disruptions in social support and medical care, (4) loss of meaningful activities and routines, (5) changes to the couple's relationship, and (6) heightened emotional distress.

DISCUSSION AND IMPLICATIONS

The COVID-19 pandemic exacerbated relationship strain and distress among couples managing This population may face negative outcomes due to the dual-impact of YOD- and pandemic-related stressors. It is imperative to provide timely resources and psychosocial support to couples facing YOD to mitigate the negative impact of such stressors on individual health and wellbeing and the couples' relationship together.

Narrative Analysis of the Impact of COVID-19 on Patients with Chronic Obstructive Pulmonary Disease, Their Caregivers, and Healthcare Professionals in Italy

Purpose

The COVID-19 pandemic has disrupted many lives, including those of people suffering from chronic obstructive pulmonary disease (COPD) and their caregivers. The main aim of this study was to use narrative medicine, a validated approach promoting quality of care to explore how the COVID-19 pandemic impacted the quality of care, quality of life, psychological factors and social factors of people affected by COPD and their caregivers and healthcare professionals (HCPs). A secondary aim was to explore the role of telemedicine in combating isolation and providing access to care.

Methods

A cross-sectional observational narrative medicine study was conducted between July and November 2020 across Italy. An online semi-structured questionnaire with a narrative plot was completed by 146 participants (79 COPD patients, 24 caregivers, and 43 HCPs). Narrations were analyzed with descriptive statistics and evaluated using NVivo 11 software to break down the text and identify recurring themes and major semantic clusters.

Results

During the first lockdown, 58.22% of responses from COPD patients indicated terror, fear and/or apprehension; at reopening, this figure was 35.44%. Among caregivers, these figures were 100% at first lockdown and 45.83% at reopening. The metaphors most commonly used by patients to describe COPD and COVID-19 were monster and murderer, respectively. Patients described their homes more often as clean and lonely than as offering no shelter. The narratives of 42 COPD patients (45.2%) described coping. Only 12.6% of COPD patients reported regular access to medical visits during lockdown, while 59.1% of general practitioners and pulmonologists reported using telemedicine, which was perceived as satisfactory by both patients and caregivers.

Conclusion

It is relevant to aim for a multidisciplinary and multilevel system of care that empowers telemedicine and integrates specific psychological support programs for COPD patients and their caregivers.

Impacts of COVID-19 Pandemic on Psychological Well-Being of Older Chronic Kidney Disease Patients

COVID-19 pandemic has been a major global issue, its eventual influences on the population welfare, global markets, public security, and everyday activities remain uncertain. Indeed, the pandemic has arisen a significant global threat. Its psychological impact is predicted to be severe and enduring, but the absolute magnitude is still largely unclear. Chronic kidney disease (CKD) is a complication markedly contributes to the mortality of COVID-19 cases, meanwhile several studies have demonstrated the high frequency and seriousness of the COVID-19 in CKD patients receiving dialysis. Importantly, the influence of COVID-19 among CKD patients without dialysis is still largely unexplored. Thus, we systemically summarized how mental health affects the spreading of COVID-19 to virtually worldwide, covering perspectives from several countries across a wide range of fields and clinical contexts. This review aims to provide the latest details and reveal potential concerns on the public health including psychological well-being of the older patients with CKD.

Positive and Negative Impacts of the COVID-19 Pandemic on Relationship Satisfaction in Male Couples

Little is known about the impact of the coronavirus pandemic and control measures on gay, bisexual, and other men who have sex with men (GBMSM) couples. The goal of this study was to investigate individual-level relationship satisfaction during the COVID-19 pandemic in a sample of 209 coupled GBMSM in the United States. We analyzed reported happiness and feelings about a relationship's future and assessed the odds of changing relationship happiness and investment associated with pandemic-related life changes (pandemic-related employment change; COVID-19 illness; high-risk of severe illness), using logistic and multinomial logit models. Fifty-five percent of participants (N = 114) reported that their relationship happiness had not changed during the pandemic, but 30% (N = 62) reported increased relationship happiness. 25% (N = 53) reported they had become more invested in their relationship's future during the pandemic, and only one participant reported decreased investment. The odds of increased relationship investment was significantly associated with pandemic-related employment change (adjusted odds ratio (aOR), 95% confidence interval (CI): 2.19 [1.04, 4.61]) and increased sex during the pandemic (aOR: 4.38 [1.55, 12.41]). Those with a pandemic-related employment change also had significantly higher odds of increased relationship happiness than those without a change (aOR: 2.10 [1.01, 4.35]). COVID-19 cases that reported being at higher risk of serious COVID-19 disease had higher odds of decreased relationship happiness than high-risk non-cases (aOR: 6.58 [1.10, 39.39]). Additional research in this area is warranted to minimize the long-term impacts of the pandemic on coupled GBMSM.

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

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.

Together Against COVID-19 Concerns: The Role of the Dyadic Coping Process for Partners' Psychological Well-Being During the Pandemic

The situation caused by the 2019 coronavirus disease (COVID-19) has been representing a great source of concern and a challenge to the psychological well-being of many individuals around the world. For couples in particular, this extraordinary rise in concern, combined with the stress posed by the virus containment measures, such as prolonged cohabitation and lack of support networks, may have increased the likelihood of couple problems. At the same time, however, COVID-19 concerns may have been a stimulus to activate couples’ stress management processes. A couple’s resource, which may have an important role in dealing with COVID-19 concerns and stress, is dyadic coping, i.e., the process through which partners face stress together. Drawing on a sample of 1,823 Italian individuals involved in a couple relationship, the current study tested a serial mediation model in which concerns about COVID-19 predicted psychological well-being, through both explicit stress communication and perceived partner dyadic coping responses. In addition, the study explored whether this dyadic coping process functioned the same way in satisfied and dissatisfied couples. Results showed that concerns about the situation related to COVID-19 significantly threatened individuals’ psychological well-being. However, these concerns positively predicted explicit stress communication, which in turn positively predicted perceived partner’s dyadic coping responses, which finally positively predicted psychological well-being. In addition, in the group of dissatisfied individuals, the association between explicit stress communication and perceived partners’ dyadic coping responses was not significant. The present study adds to the research on couples’ coping by testing for the first time the whole theoretical model of dyadic coping and does so during a global emergency situation. The study also suggests key components of preventive interventions for individuals in couples.