Couples Coping With Chronic Illness: What's Gender Got to Do With It?

Over the past decade, the lion's share of research on coping has focused on individual coping efforts and adaptation outcomes. However, major life stressors are not experienced in a social vacuum. When one family member is experiencing ongoing, complex stressors or life strains, other family members are affected by both the stressor itself, its psychological impact on the affected individual, and its effect on the family's functioning. At this juncture in stress and coping research, it is important to move past a dominant focus on individual-level processes into a social ecological or family systems framework. Marriage is a primary relationship often considered distinct from other family relationships because it is long-term, affords a central role identity, and provides a fundamental resource of social support and coping assistance (Revenson, 1994). Much research has demonstrated the beneficial effects of social support from family on patients' coping, across a number of chronic conditions (e.g., Cutrona, 1996; Lyons, Sullivan, Ritvo, & Coyne, 1996; Revenson, 2003). Far less research has focused on the effect of illness on the healthy spouse, children, the marriage, or the family (Pedersen & Revenson, in press). Husbands and wives experience unique stresses as a result of living with a chronically ill person (see chap. 6, this volume; Hagedoorn, Kuijer, Buunk, DeJong, Wobbes, & Sanderman, 2000; Revenson & Gibofsky, 1995; Revenson & Majerovitz, 1990, 1991). Some stresses emanate directly from caregiving in which spouses are inextricably involved in decision making about treatment and day-to-day care if the patient is disabled. Other stresses emerge from the need to restructure family roles and responsibilities as the disease progresses