Cycle of Adjustment to Multiple Sclerosis: Impact of Dyadic Coping on Caregiver Relationships

Background/Purpose: Thirty percent of individuals with multiple sclerosis (MS) receive additional care and assistance from their spouses, and half of caregivers report experiencing caregiver burden. One contributor to caregiver burden is poor coping and adjustment to the informal caregiving role. Informal caregivers of those with MS report an association between negative coping skills and stress in the caregiver role. Poor coping has been associated with worse communication with one’s partner, negative perceptions of self and the partner, and over half of couples considering ending the relationship. However, few researchers have examined the interaction of caregiver burden and coping considering the influence on one’s relationship. The purpose of this study was to determine how dyadic coping, individual coping, and caregiver burden in the intimate partner of an individual with MS related to relationship satisfaction. Additionally, we aimed to determine if dyadic coping and individual coping buffered the relationship between caregiver burden and relationship satisfaction.

Methods: The present study was a cross-sectional design that included partners of an individual diagnosed with multiple sclerosis for over 6 months who were married or co-habiting with the partner for over one year. Participants were recruited using convenience sampling through contacting MS organizations, support groups, and Facebook groups. Participants were directed to a Qualtrics survey. Variables were measured using the Couple Satisfaction Index, Dyadic Coping Inventory, Zarit Burden Interview, Brief COPE, and Behavior Problem Checklist. A regression model was used with caregiver burden, individual coping, and dyadic coping as independent variables along with interaction effects of caregiver burden and individual or dyadic coping. Relationship satisfaction was a dependent variable. Demographic controls included gender, age, race, income, marital status, years in relationship, number of children, and time since diagnosis.

Results: The sample contained 51 cases. Control variables (participants’ sex, having children, and activities of daily living score of the partner) were found to be statistically associated with relationship satisfaction. Following linear regression analysis, dyadic coping was significantly associated with relationship satisfaction. Additionally, dyadic coping acted as a buffer between caregiver burden and relationship satisfaction. Individual coping and caregiver burden were not significantly associated with relationship satisfaction. Individual coping did not buffer the relationship between caregiving burden relationship satisfaction.

Conclusions: Data demonstrated that there was a linear relationship between dyadic coping and relationship satisfaction, while a linear relationship did not exist with caregiver burden or individual coping and relationship satisfaction. These insignificant results could be related to the small sample size as well as scores for caregiver burden trending higher than the population mean and scores for relationship satisfaction trending lower than the population mean. While the study sample was small and a more robust sample would be beneficial for more generalizable results, this study carries implications for therapeutic treatment of spousal caregivers. As former studies show, caregiving partners experience identity crises and relationship dissatisfaction following diagnosis of a partner with MS. The data suggest that systemic treatment including dyadic coping could repair the relationship more effectively than individual coping skills.