Abstract
BackgroundMultimorbidity is challenging not only for the patient but also for the romantic partner. Strategies for interpersonal emotion regulation like disclosing to the partner are supposed to play a major role in the psychosocial adjustment to multimorbidity. Research has often focused on disease-related disclosure, even though disclosing thoughts and feelings related to mundane, everyday life occurrences might also play a role in coadjustment. The current dyadic study aimed at investigating the association between these two types of interpersonal regulation strategies and adjustment disorder symptoms, following the new ICD 11 criteria in multimorbid patients and their partners.MethodsShortly after being hospitalized due to an acute health crisis, N = 28 multimorbid patients (average age 70 years) and their partners filled in questionnaires on disclosure in the couple, adjustment disorder criteria of the ICD 11 (“preoccupation,” “failure to adapt”), and sleep problems.ResultsBoth patients and their partners did show similarly high levels of preoccupation and failure to adapt indicating adjustment problems to the complex health situation. The adjustment symptoms of both partners correlated between r = 0.22 and 0.45. Regression based on Actor-Partner Interdependence-Models revealed that own mundane disclosure was related to less adjustment symptoms in the patients. Beyond that, a partner effect was observed, revealing a negative association between partners’ illness-related disclosure and the patients’ level of preoccupation. For the partners, mundane disclosure of the partner was associated with less preoccupation, failure to adapt, and reported sleep problems above and beyond own disclosure reports. Furthermore, there was an actor effect of disease-related disclosure on less sleep problems for the partners.ConclusionThese results support an interpersonal view on adjustment processes to physical disease. Disclosure as a way of regulating the relationship and emotional responses might play a relevant role here, which seems to be different for patients and their partners. Further research is needed to shed more light on the differential role of disease-related and mundane everyday disclosure for psychosocial adjustment in couples confronted with health challenges.
Highlights
Multimorbidity—commonly defined as the co-occurrence of two or more chronic conditions—is the most frequent disease pattern in the adult population in high-income countries (Fortin et al, 2012; Tinetti et al, 2012)
This study aims at investigating the adjustment of couples facing an acute health crisis in the context of multimorbidity and the role of disclosure
Regarding the patients’ data, the independent variable everyday disclosure correlated with a medium effect size and p-values of p = 0.001 and p = 0.04 with the dependent variables preoccupation and failure to adapt
Summary
Multimorbidity—commonly defined as the co-occurrence of two or more chronic conditions—is the most frequent disease pattern in the adult population in high-income countries (Fortin et al, 2012; Tinetti et al, 2012). Health care costs (Lehnert et al, 2011) and the individual burden of multimorbidity (Fortin et al, 2004; Vancampfort et al, 2017) increase with every single additional disease (McPhail, 2016). It is to expect that the partner has a central role in the adjustment to medical incidences and in the context of multimorbidity where long-term management of multiple diseases is one of the greatest health-related challenges patients face. Strategies for interpersonal emotion regulation like disclosing to the partner are supposed to play a major role in the psychosocial adjustment to multimorbidity. The current dyadic study aimed at investigating the association between these two types of interpersonal regulation strategies and adjustment disorder symptoms, following the new ICD 11 criteria in multimorbid patients and their partners
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