Couples' experiences of coping with Multiple Sclerosis: a qualitative systematic review and metasynthesis

PurposeThis systematic review sought to synthesise the qualitative literature exploring couples' experiences of dyadic coping, when one partner has Multiple Sclerosis (MS).MethodsThe review protocol was pre-registered with PROSPERO. Five databases (PubMed, EMBASE, CINAHL, PsycINFO and Scopus) were searched for relevant papers from inception to January 2024. Seven hundred and ninety three papers were screened against pre-defined inclusion criteria. Data from 11 studies (n = 204) were quality assessed using the Critical Appraisal Skills Programme qualitative checklist and included in the metasynthesisResultsThe synthesis resulted in four themes related to couples' experiences of coping with MS: dance of accommodation, a sense of unity, outside of us and evolving as a unit. Communication attunement was perceived as key for couples to maintain cohesion in the relationship. Developing a shared narrative around MS helped couples to align their perspectives and co-ordinate their coping. The findings suggest that many couples coped by consciously maintaining a focus in the present. The wider system of social supports also appeared to frame the couples unique dyadic coping process in specific ways.ConclusionsThe findings from this synthesis provide support for the conceptualisation of MS as a shared experience to support couples' rehabilitation efforts. For couples coping with Multiple Sclerosis (MS), communication attunement is a key variable for maintaining cohesion and closeness in the relationship to manage disease impact. Framing MS as a shared challenge helps couples to co-ordinate their coping response, engage in collaborative disease management and rehabilitation, and jointly undertake lifestyle adaptations.Each couple's unique response to coping with MS should be considered within a broader ecological framework, including social and professional supports that may support rehabilitation efforts.