Journal of Behavioral Medicine

, Volume 35, Issue 2, pp 221–239

The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review

  • Ann-Marie Rosland
  • Michele Heisler
  • John D. Piette

DOI: 10.1007/s10865-011-9354-4

Cite this article as:
Rosland, AM., Heisler, M. & Piette, J.D. J Behav Med (2012) 35: 221. doi:10.1007/s10865-011-9354-4


In general, social support from family members affects chronic illness outcomes, but evidence on which specific family behaviors are most important to adult patient outcomes has not been summarized. We systematically reviewed studies examining the effect of specific family member behaviors and communication patterns on adult chronic illness self-management and clinical outcomes. Thirty studies meeting inclusion criteria were identified, representing 22 participant cohorts, and including adults with arthritis, chronic cardiovascular disease, diabetes, and/or end stage renal disease. Family emphasis on self-reliance and personal achievement, family cohesion, and attentive responses to symptoms were associated with better patient outcomes. Critical, overprotective, controlling, and distracting family responses to illness management were associated with negative patient outcomes. Study limitations included cross-sectional designs (11 cohorts); however results from longitudinal studies were similar. Findings suggest that future interventions aiming to improve chronic illness outcomes should emphasize increased family use of attentive coping techniques and family support for the patient’s autonomous motivation.


Family relations Social support Chronic disease Self-care Outcomes 

Supplementary material

10865_2011_9354_MOESM1_ESM.doc (150 kb)
Supplementary material 1 (DOC 150 kb)
10865_2011_9354_MOESM2_ESM.xlsx (28 kb)
Supplementary material 2 (XLSX 27 kb)
10865_2011_9354_MOESM3_ESM.xlsx (22 kb)
Supplementary material 3 (XLSX 21 kb)

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Ann-Marie Rosland
    • 1
    • 2
  • Michele Heisler
    • 1
    • 2
    • 3
    • 4
  • John D. Piette
    • 1
    • 2
  1. 1.Department of Veterans AffairsAnn Arbor VA Center for Clinical Management ResearchAnn ArborUSA
  2. 2.Department of Internal MedicineUniversity of Michigan Medical SchoolAnn ArborUSA
  3. 3.Robert Wood Johnson Clinical Scholars ProgramAnn ArborUSA
  4. 4.Department of Health Behavior and Health EducationUniversity of Michigan School of Public HealthAnn ArborUSA

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