The effectiveness of couple-based interventions on the marital outcomes of women with genital and breast cancer and their partners: a systematic review and meta-analysis.

BACKGROUND: Breast cancer and genital cancer are known as cancers that affect people's relationships with their partners. Women with such cancers are emotionally vulnerable and need more support from their partners. The present systematic review and meta-analysis evaluated the effectiveness of couple-based interventions on the marital outcomes of patients with these cancers and their intimate partners. METHODS: To perform this systematic review, Google Scholar and databases such as PubMed, Web of Science, Cochrane, Scopus, SID (Scientific Information Database), and Magiran were searched systematically. The reviewed studies included randomized controlled trials and quasiexperimental studies in which the intervention group, couple-based interventions, and the control group received routine care, general education or no intervention for cancer treatment. In this study, the included participants were patients with breast cancer or genital cancer and their intimate partners. The primary outcomes considered in this study included patients' marital adjustment, patients' marital satisfaction, patients' marital intimacy, and patients' marital relationships. The secondary outcomes were partners' marital adjustment, partners' marital satisfaction, partners' marital intimacy, and partners' marital relationships. A meta-analysis was performed with Review Manager v. 5.3 software (The Nordic Cochrane Centre, Cochrane Collaboration, 2014; Copenhagen, Denmark). The intervention impacts on continuous outcomes were measured using standardized mean differences (SMDs) with 95% confidence interval because of the use of various scales to evaluate the outcomes. The quality of evidence presented in the included studies was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In the subgroup analysis, the studied outcomes were divided into two parts (theory-based and non-theory-based) in terms of the theoretical context of couple-based interventions. RESULTS: From a total of 138 retrieved studies, 14 trials were eligible for inclusion in the study. The results of the meta-analysis showed that the patient's marital satisfaction increased significantly with couple-based interventions (SMD 0.46, 95% confidence interval 0.07 to 0.85; 7 trials, 341 patients, very low certainty) compared to the control group, but the evidence was uncertain. However, there were no significant differences between the groups in the partner's marital satisfaction, the patient's and partner's marital adjustment, and the patient's and partner's marital intimacy. Additionally, the results of the subgroup analysis showed that the couple-based interventions significantly increased the patient's marital adjustment (SMD 1.96, 95% CI 0.87 to 3.06; 4 trials, 355 patients, very low certainty), the partner's marital adjustment (SMD 0.53, 95% CI 0.20 to 0.86; 4 trials, 347 partners, very low certainty), the patient's marital satisfaction (SMD 0.89, 95% CI 0.35 to 1.43; 2 trials, 123 patients, very low certainty), and the partner's marital satisfaction (SMD 0.57, 95% CI 0.20 to 0.94; 2 trials, 123 partners, very low certainty) compared to the control group in theory-based studies. In. However, in non-theory-based studies, the results of the meta-analysis revealed no significant differences between the intervention and control groups. CONCLUSIONS: The results of this study demonstrated the impact of couple-based interventions on the marital outcomes of patients with breast and genital cancers. Because of the very low confidence in the evidence, high-quality randomized trials with a sufficient sample size should be conducted considering the proper theoretical context.

Factors effecting on health-promoting behaviors in iranian pregnant women and their husbands: the actor-partner interdependence model (APIM).

INTRODUCTION: Pregnancy is an important period of life for women and their husbands as the couple's health is essential. The present study evaluated the impact of some factors (marital adjustment with depressive symptoms) on health-promoting behaviors in pregnant women and their husbands based on the actor-partner interdependence model (APIM). MATERIALS AND METHODS: This descriptive study examined 211 couples (pregnant women and their husbands) in pregnancy clinics of Babol University of Medical Sciences using a convenience sampling method. The participants completed Spanier's Dyadic Adjustment Scale (DAS) (1979), Edinburgh Postnatal Depression Scale (EPDS) (1987), and Walker's Health Promoting Lifestyle Profile II (HPLPII) questionnaire (1997). The relationships between women and their husbands were also evaluated using structural equation modeling with R software according to the Lavaan (latent variable analysis) package based on APIM-SEM. RESULTS: The pregnant women's marital adjustment positively affected their health-promoting behaviors (ß = 0.456, 95% Cl: 0.491-0.998, p < 0.001) and their husbands' (ß = 0.210, 95% Cl: 0.030-0.726, p = 0.048). Pregnant woman's depressive symptoms also negatively affected their health-promoting behaviors (ß=-0.088, 95% Cl: -0.974-0.074, P = 0.236) and their husbands' health-promoting behaviors (ß=-0.177, 95% Cl: -0.281 - -0.975, P = 0.011). Furthermore, the husband's marital adjustment only positively affected his studied behaviors (ß = 0.323, 95% Cl: 0.0303-0.895, P < 0.001) but did not affect the pregnant woman's health behaviors. The husband's depressive symptoms had a negative impact on his studied behaviors (ß = 0.219, 95% Cl: -0.122 - -0.917, P = 0.001) and did not affect the pregnant woman's depressive symptoms. Our findings confirmed the mediating role of depressive symptoms in pregnant women and their husbands on the association of marital adjustment and health-promoting behaviors. According to the actor-partner study, a pregnant woman's marital adjustment scores positively affected her studied behaviors and her husband (ß = 0.071, 95% Cl: 0.042-0.278, P = 0.015) by decreasing her depression score. Therefore, the husband's marital adjustment score positively affected his studied behaviors by decreasing his depression score (ß = 0.084, 95% Cl: -0.053 -0.292, P = 0.005), and it did not affect his wife's health-promoting behaviors. DISCUSSION AND CONCLUSION: These findings suggest healthcare providers, obstetricians, and psychologists evaluate the husbands' symptoms of depression and health-promoting behaviors in the routine pregnancy care of pregnant women. They also pay great attention to marital adjustment as a determinant of reducing depressive symptoms in pregnant women and their husbands.

Differences in social support, emotion invalidation, psychological needs, cognitive emotion regulation in maritally adjusted and maladjusted women in Pakistan: A matched pairs design.

The present study aimed to find out differences of social support, perceived emotion invalidation, psychological needs, and use of adaptive and maladaptive cognitive emotion regulation strategies in maritally adjusted and maladjusted after controlling for age, education, employment status, and depressive symptomatology. The cross-sectional study uses a matched pairs design. The sample was divided into two groups; maritally adjusted and maladjusted women (n = 40 pairs) on basis of scores obtained on revised-dyadic adjustment scale. Forty maritally adjusted women were matched with 40 maritally maladjusted women according to age, education, and employment status. Social support questionnaire, perceived invalidation of emotion scale, basic psychological need satisfaction frustration scale, cognitive emotion regulation questionnaire, and center for epidemiologic studies depression scale were administered. One-way ANCOVA revealed that maritally maladjusted women had lower level of social support [mean difference; -5.65(-9.97, -1.33), p < 0.05, partial η2 = 0.08] and more emotional invalidation [mean difference; 15.36(13.08, 17.65), p < 0.001, partial η2 = 0.71] compared to maritally adjusted women after controlling for the effect of depressive symptomatology. Maritally maladjusted women had more need frustration [mean difference; 10.75(7.59, 13.92), p < 0.001, partial η2 = 0.38] compared to maritally adjusted women. However, maritally adjusted women had more need satisfaction [mean difference; 13.36(9.67, 17.05), p < 0.001, partial η2 = 0.41] compared to maritally maladjusted women. Maritally adjusted women used more adaptive CER strategies (acceptance, refocus on planning and putting into perspective) [mean difference; 4.66(2.36, 6.95), p < 0.001, partial η2 = 0.18] compared to maritally maladjusted women whereas, maritally maladjusted women used more maladaptive strategies (self-blame, catastrophizing and blaming others) [mean difference; 4.66(2.77, 6.54), p < 0.001, partial η2 = 0.25] compared to maritally adjusted women. Maladjusted women had less social support and more emotional invalidation of emotions and psychological needs frustration. They used more maladaptive strategies to manage their negative emotions in comparison to maritally adjusted women. Identification of these cognitive emotion regulation strategies will help clinicians and counselors to devise psychological intervention targeting the use of adaptive strategies to minimize the negative mental health consequences.

Examination of the effect of the perceived stress in the coronavirus-19 pandemic on marital adjustment, sexual life and intimate partner violence.

AIMS: The aim of the study was to explore the effects of perceived stress during the pandemic on marital adjustment, sexual life and intimate partner violence. DESIGN: A cross-sectional design was employed in this study. METHODS: The data were collected with an online survey between October and December 2020 from 901 participants in Turkey. Participants completed the Descriptive Information Form, the Marital Adjustment Scale and the Perceived Stress Scale. Multivariate analysis of variance and moderation analysis were used in the analysis of the data. RESULTS: The pre-pandemic marital adjustment scores of the participants significantly decreased during the pandemic. The marital adjustment and sexual life of those with high perceived stress levels were found to be negatively affected, and they were exposed to violence during the pandemic. In the moderation analysis, a non-standardized coefficient of the marital adjustment variable in the model turned out to be significant, and the perceived stress decreased as marital adjustment increased. The marital adjustment was low, and the stress level was high in individuals exposed to violence. Besides, perceived stress was found to be effective in being exposed to intimate partner violence. CONCLUSION: The stress perceived by individuals during the COVID-19 pandemic negatively affected their marital adjustment and sexual life. Besides, perceived stress was found to be effective in being exposed to intimate partner violence, and marital adjustment decreased during the pandemic compared to the pre-pandemic period. IMPACT: During the pandemic period, health care providers should routinely screen the psychosocial health of individuals. Continuous, accessible, free psychosocial support services should be available in order to increase the psychosocial health and marital adjustment of people with high-stress levels and prevent exposure to violence. PATIENT OR PUBLIC CONTRIBUTION: The conduct of this study is based on an online survey with participants living in the same house with their spouses during the pandemic.

The relationship of marital adjustment and posttraumatic growth in female breast cancer patients and their husbands.

Posttraumatic growth (PTG) is very important for breast cancer couples to cope with cancer. Individual marital adjustment can affect PTG, however, it is still unknown that the effect of marital adjustment on one's own and their spouses' PTG in breast cancer couples. To investigate the status of PTG and marital adjustment and explore the relation between PTG and marital adjustment in breast cancer patient-husband dyads. General data, marital adjustment and PTG scores of breast cancer patients (N = 206) and their husbands (N = 206) were collected through a general information questionnaire, the Post-traumatic Growth Inventory (PTGI) and Marital Adjustment Test (MAT). T-tests and structural equation models were applied to explore the relations between marital adjustment and PTG among breast cancer patients and their husbands. The PTG among breast cancer patients was significantly higher than among their husbands (P < 0.05); the score of patients' marital adjustment was 96.18 ± 22.08, and that of their husbands was 96.22 ± 22.27. The participants' marital adjustment had a positive predictive effect on their own PTG (P < 0.05), and patients' marital adjustment also had a positive predictive effect on their husbands' PTG (P < 0.05). Breast cancer patients experienced more PTG than their husbands; patients' PTG was promoted by their own marital adjustment, while husbands' PTG was promoted by both their own and the patient's marital adjustment. In order to improve breast cancer patients' and their husbands' PTG, it is essential to promote their marital adjustment.

Communication skills training with the transactional analysis approach developed menopausal women's marital adjustment - a quasi-experimental study.

Introduction: Communication skills help people have a better life. Due to the changes caused by menopause and their effects on interpersonal communication, it is essential to reinforce communication skills during this period. This study aimed to investigate the effect of communication skills training (CST) using the transactional analysis (TA) approach on menopausal women's marital adjustment. Material and methods: This quasi-experimental study with a parallel design was performed by the availability sampling method with participation of 46 married menopausal women. Participants were randomly assigned to two groups. The intervention group participated in eight CST sessions with a TA approach. The control group did not receive any psychosocial or educational services. Participants completed the demographic information, Queen Dam communication skills, and Spinner's marital adjustment questionnaire before, at the end of, and one month after the training period. Data were analyzed by descriptive and analytical tests with SPSS22 software. Results: There was no significant difference in demographics between the groups (p < 0.05). The mean marital adjustment scores were 53.48 ±12.24, 117.70 ±11.15, and 116.52 ±10.73 before, at the end of, and one month after the intervention, respectively. The marital adjustment scores before the intervention did not differ between the two groups but significantly increased after training and in the follow-up period (p < 0.001). Conclusions: Communication skills training with a TA approach in postmenopausal women improves marital adjustment. Therefore, it is suggested that midwives use this method in comprehensive health centers as an effective method for improving the lives of postmenopausal women.

Intimate Relationships and Coronary Heart Disease: Implications for Risk, Prevention, and Patient Management.

PURPOSE OF REVIEW: Research and clinical services addressing psychosocial aspects of coronary heart disease (CHD) typically emphasize individuals, focusing less on the context of intimate relationships such as marriage and similar partnerships. This review describes current evidence regarding the role of intimate relationships in the development, course, and management of CHD. RECENT FINDINGS: Having an intimate partner is associated with reduced risk of incident CHD and a better prognosis among patients, but strain (e.g., conflict) and disruption (i.e., separation, divorce) in these relationships are associated with increased risk and poor outcomes. These associations likely reflect mechanisms involving health behavior and the physiological effects of emotion and stress. Importantly, many other well-established psychosocial risk and protective factors (e.g., low SES, job stress, depression, and optimism) are strongly related to the quality of intimate relationships, and these associations likely contribute to the effects of those other psychosocial factors. For better or worse, intimate partners can also affect the outcome of efforts to alter health behaviors (physical activity, diet, smoking, and medication adherence) central in the prevention and management CHD. Intimate partners also influence-and are influenced by-stressful aspects of acute coronary crises and longer-term patient adjustment and management. Evidence on each of these roles of intimate relationships in CHD is considerable, but direct demonstrations of the value of couple assessments and interventions are limited, although preliminary research is promising. Research needed to close this gap must also address issues of diversity, disparities, and inequity that have strong parallels in CHD and intimate relationships.

A dyadic approach to depression, resilience and quality of life on marital adjustment among infertile couples in Karachi, Pakistan: A cross-sectional study.

BACKGROUND: Infertility is a major reproductive health problem in Pakistan. It has the potential to cause serious negative impact on a couple's marital life and psychological health. AIM: This study aimed to assess the factors associated with maladjustment among infertile couples. METHOD: An analytical cross-sectional design was employed. Validated scales were used to assess marital adjustment, depression, resilience and quality of life among infertile couples. Purposive sampling was employed to enrol 334 infertile couples from a private infertility medical centre, of Karachi, Pakistan. RESULTS: Among couples, marital adjustment scores were comparable, but resilience and quality of life were significantly low among wives whereas depression was significantly high among wives compared with husbands. Wives' marital adjustment was positively correlated with husband's resilience and quality of life and negatively related with his depression. After employing adjusted actor-partner interdependence modelling, wives' own depression and resilience had significant effect on their marital adjustment and their partner's resilience, depression and quality of life did not have any impact on their outcome. On the contrary, wives' resilience had a significant effect in increasing the marital adjustment of their husband. CONCLUSION: This study highlights the need to promote psychological support (resilience building skills) or couples' therapy to all those couples undergoing infertility treatment.

Developing a model on the factors affecting family resilience in the COVID-19 pandemic: Risk and protective factors.

During the COVID-19, the relationships among family members and the stress that accompanied have increasingly affected families. The first aim of this study is to test the effects of marital adjustment, perceived stress and parental self-efficacy of married couples on family resilience during the COVID-19 pandemic. The second aim of this study is to investigate whether or not family resilience, perceived stress, parental self-efficacy and marital adjustment differentiate depending on demographic and other variables in the COVID-19 pandemic. Participants consisted of 241 married individuals with at least one child between 4 and 18 years old, and data were collected online. It was found that when perceived stress increased, parental self-efficacy and marital adjustment decreased; besides, this perceived stress indirectly influenced family resilience through parental self-efficacy and marital adjustment. Similarly, it was found that pregnant participants experienced higher level of perception of stress during the COVID-19 period. It was found that the family resilience of participants who got support within the family was higher than participants who got support from outside the family. However, no differences were found between males and females. In stressful processes like the COVID-19 pandemic, each sub-system of the family (individual, couple and parent) has a significant role in the resilience level of the family as a whole. Future studies focus on experimental and can focus on programs prepared for family resilience. Intervention programs can be prepared related to stress perception, parental skills and marital adjustment of married couples and their influence on family resilience can be searched.

Distinct dyadic coping profiles in Chinese couples with breast cancer.

PURPOSE: Conceptualizing cancer as a dyadic stress provides new insight into how stress impacts couples with breast cancer. The present study aimed to identify subgroups with distinct dyadic coping profiles in a sample of Chinese couples with breast cancer and to determine how these subgroups differed in terms of demographic and clinical characteristics in addition to marital adjustment outcomes. METHODS: Using convenience sampling, a cross-sectional survey was conducted. Couples with breast cancer completed the general information questionnaire, the Dyadic Coping Inventory, and the Locke-Wollance Marital Adjustment Test. The modeling was performed using a latent profile analysis to identify the dyadic coping subgroups. Parametric and nonparametric tests were applied to examine between-group differences across the identified classes. RESULTS: The analytical results supported a three-class solution of dyadic coping groups: high (27.4%), medium (32.2%), and low (40.4%). Between-group differences were found in educational background, number of children, postoperative time, and type of surgery. CONCLUSION: Most couples reported low levels of dyadic coping. The couples with an educational level of primary school or below, with one child or who were childless, and who had undergone breast preservation surgery within the past year were more likely to belong to the low dyadic coping group. When supporting couples with breast cancer, it is essential to assess several demographic and clinical risk factors in addition to the marital adjustment level to identify high-risk subgroups that warrant intervention.

A pathway to negative acculturation: marital maladjustment mediates the relationship between the length of residency and depressive symptoms in immigrant women in Taiwan.

BACKGROUND: Immigrant women in Taiwan experience a variety of acculturative and marital problems that result in a mental-health problems. We examined the mediational effect of marital adjustment on the relationship between acculturation and depressive symptoms in immigrant women in Taiwan. METHODS: All participants (N = 127) were interviewed to collect data regarding their basic sociodemographics, depressive symptoms, acculturation (using language proficiency and years in Taiwan as indicators), and marital adjustment. We used a Sobel test to examine how marital adjustment mediates the relationship between acculturation and depressive symptoms. RESULTS: Our results indicated that an increased length of residency exacerbated depressive symptoms (ß = 0.62, p = 0.03) and that this relationship contributed, in part, to the mediational effect of marital adjustment. That is, marital adjustment deteriorated with the length of residency (ß = - 0.26, p = 0.0013), resulting in the development of depressive symptoms (ß = - 0.95, p = 0.0013). CONCLUSION: Although the duration of residency may be useful as a proxy for acculturation in the assessment of some health outcomes, our findings imply that it is better to conceptualize it as a cumulative stress when considering the mental health of immigrant women. Marital maladjustment acts as a mediator in this relationship. As such, it is important to provide immigrant families with programs and resources to assist them in adapting to their marriages and to improve the mental health of immigrant women.

Patient and sibling adjustment to pediatric cancer: the roles of parental relationship adjustment and depressive symptoms.

PURPOSE: Pediatric cancer may impact parents' partner relationship and increase patient, parent, and sibling distress. This study examined parents' reports of their relationship adjustment and depressive symptoms and their association with their ratings of patients' and siblings' emotional/behavioral problems in families of recently diagnosed pediatric cancer patients. DESIGN: Cross-sectional questionnaire study. SAMPLE: A total of 31 parents (87% female; 71% Latino) of pediatric cancer patients. METHODS: Parents reported on their relationship adjustment, depressive symptoms, and the patients' and siblings' emotional/behavioral problems. FINDINGS: Poorer relationship adjustment was correlated with more parent depressive symptoms and patient emotional/behavioral problems. Parent depressive symptoms were positively correlated with emotional/behavioral problems in patients and siblings. After accounting for child age and parent depressive symptoms, relationship adjustment remained significantly associated with patient, but not sibling, problems. CONCLUSIONS: When parents have poorer relationship adjustment following diagnosis, children with cancer may be at increased risk for emotional/behavioral problems. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS OR POLICY: Interventions targeting the partner relationship may be relevant to supporting family adjustment following diagnosis.

[Correlation of stigma with marital adjustment in female patients undergoing artificial insemination with donor sperm].

Objective: To investigate the stigma and marital adjustment of the female patients undergoing artificial insemination with donor sperm (AID) and analyze their correlation. METHODS: Using the convenience sampling method, we selected 208 infertile female patients undergoing AID from March to December 2020. We conducted a cross-sectional survey among the patients with General Information Questionnaire, Infertility Stigma Scale (ISS), and Dyadic Adjustment Scale (DAS). RESULTS: The total ISS score and DAS score of the patients were 54.19 ± 14.52 and 116.23 ± 15.30, respectively. Pearson analysis showed that the total and individual item ISS scores were negatively correlated with the DAS score (P < 0.01). Multivariate linear regression analysis manifested that stigma was an important factor influencing marriage adjustment (P < 0.01) and explained 34.1% of the total variations. CONCLUSIONS: Stigma is an important factor affecting marital adjustment in female patients undergoing AID and negatively correlated with marital adjustment: The lower the stigma, the better the marital adjustment. Adequate attention should be paid to the stigma of the infertile women undergoing AID and targeted measures should be developed for its intervention.

Evaluation of the marital adjustment and sexual functions in individuals with visual disability.

BACKGROUND: Sexuality is an important component of marriage. Individuals with visual disability tend to experience more sexual problems, which could deteriorate their marriage relationships and cause difficulties in establishing and maintaining sexual relationships. AIMS: This study aims to evaluate marital adjustment and sexual functions in individuals with visual disability. SUBJECTS AND METHODS: The sample of this descriptive study consisted of 95 individuals with visual disability who were members of a relevant private association in Turkey and met the inclusion criteria. The sample size was calculated using the sample with a known population approach. Data were collected using the Sociodemographic Form, the Marital Adjustment Scale (MAS), and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). The data were analyzed using the Mann-Whitney U test, Kruskal-Wallis test, Dunn's test, and the Spearman's Rho Correlation Analysis. RESULTS: The mean scores for the MAS and the GRISS were 48.0 (23-60) and 51.5 (17-72), respectively. There was a statistically significant difference between the mean scores of individuals with visual disability and their spouses in the MAS by their age (P < 0.05). The subscales of the GRISS (except for frequency and communication) indicated that men with visual disability had problems regarding impotence, premature ejaculation, sensuality, avoidance, and satisfaction subscales. There was a statistically significant and negative relationship between the marital adjustment total scores of the males with visual disability and their scores in the avoidance, satisfaction, frequency, and communication subscales (P < 0.05; P < 0.01). CONCLUSION: The participants were found to have good marital adjustment. However, males with visual disability had a low level of sexual problems.

Dyadic coping, marital adjustment and quality of life in couples during pregnancy: an actor-partner approach.

Objective: This study aimed to examine the impact of dyadic coping on the quality of life of couples during pregnancy and to explore the potential mediating role of marital adjustment on this association.Background: According to the systemic transactional model, pregnancy can be characterised as a situation of dyadic stress because it affects both members of the couple. However, the impact of dyadic coping on couples' quality of life during pregnancy is unexplored. Also, the potential mediating role of marital adjustment on this association remains understudied.Methods: Participants were 320 pregnant women and their partners (N = 640) who completed the Dyadic Coping Inventory, the Dyadic Adjustment Scale and the World Health Organisation Quality of Life instrument. Data were analysed using the actor-partner interdependence mediation model.Results: Results showed that there was an intrapersonal indirect effect of dyadic coping on quality of life through marital adjustment. Moreover, an interpersonal indirect effect was found with fathers' dyadic coping being associated with mothers' quality of life through mothers' marital adjustment.Conclusions: These findings highlight the importance of assessing dyadic coping strategies of couples during pregnancy and targeting them in the psychological support offered to couples as a way of improving their marital adjustment, and consequently, their quality of life.

The Role of Dyadic Coping on the Marital and Emotional Adjustment of Couples With Infertility.

Infertility is a challenging experience, affecting individual and couples' adjustment. However, the way the members of the couple support each other may affect the experience of infertility and their adjustment. This study aimed to investigate the role of dyadic coping by oneself and by the partner in the association between the impact of infertility and dyadic and emotional adjustment (anxiety and depression) to infertility. In this cross-sectional study, a total of 134 participants (67 couples with infertility) completed self-report questionnaires assessing infertility-related stress, dyadic coping, dyadic adjustment, and depression and anxiety symptoms. A path analysis examined the direct and indirect effects between the impact of infertility in one's life and dyadic and emotional adjustment. There is an indirect effect of the impact of infertility in one's life on dyadic adjustment through men's perceived dyadic coping efforts employed by the self (dyadic coping by oneself) and women's perceived dyadic coping efforts of the partner (dyadic coping by the partner). Regarding the emotional adjustment of infertile couples, infertility stress impact had an indirect effect only on depressive symptoms through men's dyadic coping by oneself. The results highlight the importance of men's dyadic coping strategies for the marital adjustment of couples as well as for men's emotional adjustment. Findings emphasize the importance of involving men in the fertility treatment process, reinforcing the dyadic nature of infertility processes.

La infertilidad es una experiencia difícil que afecta la adaptación de los individuos y de las parejas. Sin embargo, la manera en la que los miembros de la pareja se apoyan entre sí puede afectar la experiencia de infertilidad y su adaptación. Este estudio tuvo como finalidad investigar el papel que desempeña el afrontamiento diádico por parte de uno mismo y de la pareja en la asociación entre el efecto de la infertilidad y la adaptación diádica y emocional (ansiedad y depresión) a la infertilidad. En este estudio transversal, un total de 134 participantes (67 parejas con infertilidad) contestaron cuestionarios de autoinforme que evaluaron el estrés relacionado con la infertilidad, el afrontamiento diádico, la adaptación diádica y los síntomas de depresión y ansiedad. Un análisis de ruta analizó los efectos directos e indirectos entre la influencia de la infertilidad en la vida de uno y su adaptación diádica y emocional. Hay un efecto indirecto de la influencia de la infertilidad en la vida de uno sobre la adaptación diádica a través de los esfuerzos de afrontamiento diádico percibidos por los hombres empleados por el yo (afrontamineto diádico por uno mismo) y los esfuerzos de afrontamiento diádico percibidos por las mujeres empleados por la pareja (afrontamiento diádico por la pareja). Con respecto a la adaptación emocional de las parejas infértiles, la influencia del estrés por la infertilidad tuvo un efecto indirecto solo en los síntomas depresivos a través del afrontamiento diádico de los hombres por uno mismo. Los resultados destacan la importancia de las estrategias de enfrentamiento diádico de los hombres para la adaptación conyugal de las parejas así como para la adaptación emocional de los hombres. Además, los resultados enfatizan la importancia de hacer participar a los hombres en el proceso de tratamiento de la fertilidad, lo cual refuerza la índole diádica de los procesos de infertilidad.

Dyadic coping and marital adjustment during pregnancy: A cross-sectional study of Italian couples expecting their first child.

Although the transition to parenthood is currently defined as a normative event, it can be potentially stressful for the couple relationship as it may contribute to psychological distress and reduced marital satisfaction. Using the systemic-transactional conceptualisation of stress and coping as a theoretical framework, we claimed that the ability of the parents-to-be to adjust to their new roles and identity is influenced by dyadic coping strategies. This study examined the effects of dyadic coping on marital adjustment in a sample of 78 primiparous couples. Women and partners completed the Dyadic Adjustment Scale and the Dyadic Coping Questionnaire during late pregnancy. Data were analysed using the Actor-Partner Interdependence Model. Results revealed that both women and partners' scores on positive dyadic coping behaviours contributed to higher marital adjustment, suggesting that risks for marital dissatisfaction may exist for couples not able to implement adaptive dyadic coping strategies, or for those unsatisfied with the implemented coping behaviours.

Stress and marital adjustment in families of children with cancer.

OBJECTIVE: Pediatric cancer is highly stressful for parents. The current prospective study examines the impact of several stressors (financial strain, life threat, treatment intensity, treatment-related events, and negative life events) on the trajectory of marital adjustment across the first year following diagnosis. We examined whether average level of stressors across the year was related to (1) levels of marital adjustment at the end of the first year of treatment and () the rate of change in marital adjustment. METHOD: One hundred and thirty families of children newly diagnosed with cancer (M age = 6.33 years, SD = 3.61) participated. Primary caregivers provided 12 monthly reports on marital adjustment and stressors. RESULTS: Multilevel models indicated that although marital adjustment was stable across the first year on average, random effect estimates suggested that this was the result of differing trajectories between families (eg, some increasing and others decreasing). Five individual stress constructs and a cumulative stress composite were then used to predict this variability. Higher average economic strain was related to consistently poorer marital adjustment across time. Higher average frequency of treatment-related events and negative life events were associated with decreasing adjustment over time and lower adjustment at the end of the first year of treatment. Perception of life threat and treatment intensity were not associated with final levels or trajectory of adjustment. Finally, higher cumulative stress was associated with consistently poorer marital adjustment across time. CONCLUSION: Implications for identification of at-risk families are discussed, and importance of delivering tailored interventions for this population.

Perceived burdensomeness, thwarted belongingness and suicidal ideation in patients with fibromyalgia and healthy subjects: a cross-sectional study.

Perceived burdensomeness and thwarted belongingness are key factors in the development of suicidal behaviors that have been frequently observed among patients with fibromyalgia. The aim of the present study was to compare these two factors in patients with fibromyalgia with and without suicidal ideation and healthy subjects. Secondary objectives were to evaluate the relationship between these two factors and the secondary variables included in the study, such as depression, sleep quality or the degree of marital adjustment. Perceived burdensomeness and thwarted belongingness were assessed with the Interpersonal Needs Questionnaire, depression and suicidal ideation with the Patients Health Questionnaire-9, suicidal risk with the Plutchik Suicide Risk scale, sleep with the Insomnia Severity Index, and marital adjustment with the Locke-Wallace Marital Adjustment scale. Questionnaire scores were compared with the Kruskal-Wallis test. 49 healthy subjects, 38 patients with fibromyalgia without suicidal ideation and 15 patients with fibromyalgia and suicidal ideations were included. Perceived burdensomeness scores were significantly higher in patients with suicidal ideation than in patients without suicidal ideation and controls; thwarted belongingness scores were significantly higher in patients with suicidal ideation than in controls. Marital adjustment was also significantly poor in patients with suicidal ideation than in patients without suicidal ideation and controls. Among patients with fibromyalgia, perceived burdensomeness seems to be strongly related with suicidal ideation, whereas thwarted belongingness seems to play a less relevant role at this respect. Poor marital adjustment could be related with depression.

Relations Between Depression Level and Conflict Resolution Styles, Marital Adjustments of Patients With Major Depression and Their Spouses.

The objective of this study was to determine to relations between the depression level and the conflict resolution styles, marital adjustments of the depressed patients and to analyze the conflict resolution styles, marital adjustments of both the patients and their spouses as the possible predictors of depression levels. The research comprised 113 patients with major depression and their spouses. While there was a negative correlation between depression scores and positive and subordination conflict resolution styles subscales of the patients, there was a positive correlation between the depression scores and negative conflict resolution style subscale. Negative correlation was observed between the depression and marital adjustment scores of patients (p<0.05). The conflict resolution styles and marital adjustment of depressed patients and their spouses are predictors of depression in patients.