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

Abstract

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.

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Acknowledgments

This research was supported by the Department of Veterans Affairs, the Robert Wood Johnson Clinical Scholars Program, the Michigan Diabetes Research and Training Center (NIH #UL1RR024986) and the Michigan Institute for Clinical and Health Research (NIH #UL1RR024986). John Piette is a VA Senior Career Scientist. Reference database searches were done by Gurpreet K. Rana, MLIS, University of Michigan Taubman Medical Library. Ms. Rana received compensation for this work from the University of Michigan Robert Wood Johnson Clinical Scholars Program. We would like to thank Sarah Conner, Jessica Forestier, and Meghan Schmansky for assistance with compiling data and editing.

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Rosland, AM., Heisler, M. & Piette, J.D. The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review. J Behav Med 35, 221–239 (2012). https://doi.org/10.1007/s10865-011-9354-4

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Keywords

  • Family relations
  • Social support
  • Chronic disease
  • Self-care
  • Outcomes