Living better together

Chronic Illness and RelationshipsBy Rebecca Gray PhD

Chronic Illness and Relationships By Rebecca Gray Ph.D.

Chronic illness Definition

Chronic illnesses are long-term conditions characterized by complex causes; multiple risks; long periods of latency (the time between exposure to the illness and feeling its affects); and impairment or disability. Common chronic physical illnesses include coronary heart disease, stroke, lung cancer, colorectal cancer, diabetes, arthritis, osteoporosis, asthma, chronic obstructive pulmonary disease, chronic kidney disease, hepatitis C, and oral diseases (State Government Victoria, 2012). Long-term mental health illnesses are also considered chronic illnesses, and include depression, schizophrenia and bipolar disorder.

A chronic illness requires the patient to adjust to living with the illness, and the therapy used to treat the condition. It can be stressful, as a chronic illness might affect the way you live, and how you see yourself and others (State Government Victoria, 2012; Townsend, Wyke and Hunt, 2006; Charmaz, 1991; Charmaz, 1983; Bury, 1982). It can also place pressure on your intimate and family relationships.

Chronic Pain Definition

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or experienced in terms of such damage (Merskey & Bogduk, 1994). Chronic pain refers to pain that has persisted for a period longer than three months (Merskey & Bogduk, 1994). This form of pain is now considered to be a disease in its own right (Tracey & Bushnell, 2009), rather than just being a symptom of some other condition, as it is often experienced for many months or years despite attempts to treat it with medications and other therapies.

Five key points

1) Bad relationships are bad for you. Although being in a relationship is, generally, better for your physical health than being alone, there is building empirical evidence that negative aspects of relationship functioning have indirect negative influences on health. This can be through depression and health habits, or direct influences on physiological mechanisms such as cardiovascular, endocrine and immune function (Martire, Schulz, Helgeson, Small and Saghafi, 2010). These issues become greater with advancing age (Umberson et al., 2006).

2) Bad relationships make it harder to manage health issues. The type and quality of the relationship also has a negative effect on the management of health issues. Couple characteristics with consistent effects on management of chronic illness include conflict, spouse criticism, and lack of congruence between patient and partner in disease beliefs and expectations (Fisher, 2006).

3) The ability of the partner to be supportive erodes over time. Another unfortunate consequence of an ongoing illness is that the partners’ ability to be supportive can be tested over time, and their critical and controlling behaviours may increase (Stephens, Martire, Cremeans-Smith, Druley, Wojno, 2006).

4) Caring for someone with a chronic illness also affects the carer’s wellbeing. Intimate partners often experience poorer psychological wellbeing, decreased satisfaction in their relationship with the patient, and burden associated with providing physical assistance (Martire and Schulz, 2011). Indeed, partners’ own physical health and self-care may be compromised over time (Fredman, Betrand, Martire, Hochberg, Harris, 2006; Lee, Colditz, Berkman and Kawachi, 2003; Schulz, Beach and Herbert et al., 2009).

5) Improving the relationship can improve your health. Relationship cohesion and quality has been linked to a whole set of positive health outcomes, such as improved survival rates in cancer (Weihs, Enright and Simmens, 2008). Couple focused support seems to improve treatment adherence in randomised controlled trials (Remien et al., 2005).

References

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Charmaz K. (1991). Good days bad days. New Brunswick: Rutgers University Press.

Charmaz K. Loss of self: a fundamental form of suffering in the chronically ill. Sociol Health Illness; 5: 168–95.

Merskey, H., & Bogduk, N. (1994). Classification of chronic pain, IASP Task Force on Taxonomy. Seattle, WA: International Association for the Study of Pain Press. (Also available online at www. iasp-pain. org).

Fisher L. (2006). Research on the Family and Chronic Disease Among Adults: Major Trends and Directions.

Families, Systems, & Health, Vol. 24, Issue 4, pp. 373–380

Fredman L, Bertrand RM, Martire LM, Hochberg M, Harris EL. (2006). Leisure-Time Exercise and Overall

Physical Activity in Older Women Caregivers and Non-Caregivers From the Caregiver-SOF Study.

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Lee S, Colditz GA, Berkman LF, Kawachi I. (2003). Caregiving and Risk of Coronary Heart Disease in U.S.

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Remien R, Stirratt M, Dolezal C, Dognin J, Wagner G, Carballo-Dieguez A, El-Bassel N, Jung T. (2005). Couple-Focused Support to Improve HIV Medication Adherence: A Randomized Controlled Trial. AIDS, Vol. 19, Issue 8, pp 807-814

Schulz R, Beach SR, Hebert RS, Martire LM, Monin JK, Tompkins CA, Albert SM. (2009). Spousal Suffering and Partner’s Depression and Cardiovascular Disease: The Cardiovascular Health Study. The American Journal of Geriatric Psychiatry, Vol. 17, Issue 3, pp. 246–254

State Government Victoria (2012) “Chronic Illness”. Retrieved June 4th, 2015, available at: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Chronic_illness?open

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Decreased Mortality in Women With Breast Cancer: Preliminary Evidence. Psychosomatic Medicine, Vol. 70, Issue 1: 117–124

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