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Abstract
Chronic illnesses (CIs) are the leading causes of morbidity and mortality in the United States. Currently, sixty percent of adults living in the United States have one CI, and forty percent are living with two or more CIs. CI self-management is a critical component of ongoing care and often involves the person living with CI’s (PLCI) close others, especially their romantic partner. I propose the PLCI, their physician, and their romantic partner form a triadic transactive system that sets, pursues, and monitors the outcomes of CI self-management goals. The COVID-19 pandemic and mitigation measures have disrupted routine care for CIs from health professionals. Thus, I posited the transactive links between the PLCI and their physician would become fewer and weaker and these CI self-management responsibilities would shift to the PLCI-partner relationship. I hypothesized the disruption to routine care and the triadic transactive system would predict worse CI self-management and that this relation would be mediated by weakened goal coordination between the PLCI and their partner. I also proposed the PLCI and their partner’s relationship factors, specifically social support, goal responsiveness, and health communication efficacy, would buffer these negative effects to predict better CI self-management. Adults living with CI who had a cohabiting romantic partner completed an online survey about their experienced disruption to their routine care for CI from the COVID-19 pandemic, their perceptions of received social support from their partner, their partner’s goal responsiveness, the couple’s health communication efficacy, the couple’s goal coordination, and the quality of their CI self-management. Social support, goal responsiveness, and health communication efficacy were associated with strengthened goal coordination and predicted better CI self-management. Contrary to my hypothesis, a higher degree of disruption to the transactive system predicted better CI self-management. This relation was mediated by strengthened goal coordination with one’s romantic partner. The indirect effect of disruption to the transactive system predicting CI self-management through goal coordination was not contingent on relationship factors. Results are discussed in the context of Transactive Goal Dynamics theory and dyadic coping with chronic illness, and future directions for this line of research are suggested.