Dyadic Interdependence in Non-spousal Caregiving Dyads’ Wellbeing: A Systematic Review

Caregiving dyads (i.e., an informal caregiver and a care recipient) work as an interdependent emotional system, whereby it is assumed that what happens to one member of the dyad essentially happens to the other. For example, both members of the dyad are involved in care giving and care receiving experiences and therefore major life events, such as a serious illness affect the dyad and not only the individual. Consequently, informal caregiving may be considered an example of dyadic interdependence, which is “the process by which interacting people influence one another’s experience.” This systematic review aimed to synthesize studies of dyadic interdependence, specifically in non-spousal caregiving dyads (e.g., adult children—parents, siblings, other relatives, or friends). Electronic databases (PsycINFO, Pubmed, and CINAHL) were systematically searched for dyadic studies reporting on interdependence in the emotional and relational wellbeing of non-spousal caregiving dyads. A total of 239 full-text studies were reviewed, of which 14 quantitative and qualitative studies met the inclusion criteria with a majority of dyads consisting of adult daughters caring for their older mothers. A narrative synthesis suggested mutual influences between non-spousal caregiving dyad members based on: (1) associations between intrapersonal (e.g., psychological functioning) and interpersonal (e.g., relationship processes) variables and emotional and relational wellbeing of the dyad; (2) associations between care context variables (e.g., socio-demographics and care tasks) and emotional and relational wellbeing of the dyad; and (3) patterns of covariation between caregivers’ and care recipients’ wellbeing. Evidence supporting dyadic interdependence among non-spousal caregiving dyads shed light on the ways dyad members influence each other’s wellbeing while providing and receiving care (e.g., via the exchange of support). Future studies investigating mutual influences in dyads, should differentiate subsamples of caregivers based on relationship type, and adopt dyadic and longitudinal designs. Systematic Review Registration [https://www.crd.york.ac.uk/prospero/#recordDetails], identifier [CRD42021213147].


Aim
The purpose of the systematic review is to review studies that examined the interdependence between non-spousal caregiving dyad members (e.g., adult children -parents, siblings etc.). Interdependence was defined using Cook and Kenny's definition: "There is interdependence in a relationship when one person's emotion, cognition, or behaviour affects the emotion, cognition, or behaviour of a partner". (Cook & Kenny, 2005). Investigating interdependence of psychological and interpersonal processes in patient-caregiver dyad allows researchers to examine the influence of each individual's psychological functioning on the well-being of their companion, leading to the identification of connections between caregiver, care recipient and the illness context. Romantic couple's literature has found that relationships are inherently interdependent in nature -the outcomes that one partner experiences become deeply intertwined with another partner's outcomes over time and across context (Clark & Mills, 2011;Kelley & Thibaut, 1987;Rusbult & Van Lange, 2003). Mainly spousal patients and caregivers exhibit dyadic interdependence, which suggests that a patient's well-being directly impacts caregiver's well-being and vice versa (Segrin, Badger, & Harrington, 2012). In caregiving literature, increasing interest is given also to different type of caregiving dyads, such as adult-children parents and other family member. Therefore, the first objective is to focus on interdependence between non spousal patient-caregiver dyads and, secondly, to describe the intra/inter-personal factors (e.g., dyadic coping, interactions, mutuality, relationship/family functioning) between these caregivers and care recipients , in order to highlight which components have the greatest potential for effecting changes on caregivers' psychological wellbeing (e.g., burden, stress or distress, anxiety, depression, mood, positive outcomes, relationship satisfaction) in these specific non-spousal relationships.

PICO Format
(Outline the PICOs for your question -i.e., Patient, Intervention, Comparison, Outcome, and Study Design -as applicable) P Informal Caregivers and their care recipients.

I Phenomenon of interest: interdependence and reciprocal interactions between dyad members
(non spouses). Focus on intrapersonal, interpersonal and care context variables.

C N/A
O Caregiver outcomes (e.g., burden, stress or distress, anxiety, depression, mood, positive outcomes, relationship satisfaction) and correlations among dyad members' outcomes.
S Qualitative (semi-structured interviews), Quantitative (longitudinal and cross-sectional design) and mixed method studies.

Inclusion Criteria
(List criteria such as age groups, study designs, etc., to be included) • Adult (18 years or older) informal caregivers of adult care recipients (if the age of the CR is not specified, include) with chronic illness, disability or physical disability (e.g., cancer, heart disease, stroke, diabetes, dementia, COPD…). If not specified the type of illness, include. • Care recipients are community dwelling and not receiving palliative care.
• Any type of relationship between CG-CR: adult children -parents, siblings. Do NOT INCLUDE spouses or romantic relationships. • Among intra/inter-personal processes include: interactions and communication within caregiver and care recipient, dyadic coping, collaboration, social support provided or received, quality and type of relationship, relationship/family functioning, responsiveness, relational experiences. • Studies with qualitative (semi-structured interviews), quantitative (longitudinal and cross-sectional) and mixed methods. • Research report.
• Publication in English.
• Papers from all the years.

Exclusion Criteria
(List criteria such as study designs, date limits, etc., to be excluded) • Studies with children (< 18 age).

• Spouses or romantic relationship between CG and CR.
• Intervention studies.
• Exclude studies with professional caregivers, medical staff, nurses (if the caregiver is not present). • Grey literature: conference abstract, presentations, proceedings; regulatory data; unpublished trial data, government publications; reports (such as white papers, working papers, internal documentation); dissertations/thesis. • Reviews and protocols.

If YES, which one(s) (e.g., Cochrane RCT filter, PubMed Clinical Queries filter)? Provide the source if this is a published filter. [mandatory if YES to previous question -textbox]
Other notes or comments you feel would be useful for the peer reviewer?
Based on the research question, the search string was finalized with the help of the Librarian of the Department of Health Psychology.
Please copy and paste your search strategy here, exactly as run, including the number of hits per line.