Communication About Lifestyle Change Between Cardiac Patients and Their Partners

Abstract

Although adherence to a heart-healthy lifestyle can improve recovery from a heart attack or bypass surgery, compliance with recommended behavior modifications is generally low. A spouse or partner can influence patient lifestyle change but much remains to be learned about what types of interactions facilitate adherence versus produce overprotection or resistance. We interviewed 25 persons who experienced a cardiac event in the past year and 16 partners. Our goals were to describe how couples talk about adherence and to identify features of communication that were variable, meaningful, and potentially consequential. Couples varied in how often they talked about adherence and those who talked a little, a lot, or occasionally differed not just in quantity of talk but also in the meaning of talk and strategies for regulating its frequency. Adherence talk occurred in various speech events, including praise, problem-solving discussion, acknowledgment, meta-communication, argument, and compliance-gaining. Different types of episodes entailed different roles and relational qualities. When partners engaged in compliance-gaining, the style in which they attempted social control (e.g., direct or indirect, humorous or serious, ritualistic or not, verbal or nonverbal) shaped its meaning. Our findings are consistent with Goldsmith’s (2004) theory of social support and have implications for how we conceptualize and measure couple communication about adherence. Our descriptions of behavior may help couples understand why they experience interactions as supportive or not. Describing behaviors can also give validation to couples experiencing communication challenges as well as offer a range of possible alternatives for interacting.