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J Behav Med. 2012 Apr;35(2):221-39. doi: 10.1007/s10865-011-9354-4. Epub 2011 Jun 21.

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

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Department of Veterans Affairs, Ann Arbor VA Center for Clinical Management Research, 2215 Fuller Road, Mailstop 152, Ann Arbor, MI 48105, USA.


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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