1 Disability & Rehabilitation, 2012, 1–9, Early Online Copyright © 2012 Informa UK, Ltd. ISSN 0963-8288 print/ISSN 1464-5165 online DOI: 10.3109/09638288.2011.645115 Purpose: Multiple Sclerosis (MS) is a chronic degenerative condition where illness uncertainty is a key difficulty that people with MS and their significant others have to cope with. Clinicians acknowledge that people with MS need to be seen in the context of their families, however there is little knowledge on what to expect about how people cope as a couple, which this study set out to explore. Method: Interpretative Phenomenological Analysis (IPA) exploring, through semi- structured interviews, how seven couples, where one had MS, experienced coping with their situation. Results: Two overarching themes pertaining to coping as a couple emerged from the data: Coping Together: “Peaks and Troughs” and Coping Over the Long Haul, with each overarching theme relating to sub-themes. Two integrative themes emerged also, which were called Faith in Self and Faith in Each Other. Conclusions: These results will assist clinicians better comprehend how those with MS and their spouses cope in an interconnected way and this in turn affects their experience of rehabilitation. Results from this research indicated that clinicians need to be sensitive to the individual coping strategies of both members of a couple where one has MS, and address the changing needs of their relationship. Keywords: Chronic conditions, couples, coping, dyadic coping, multiple sclerosis, resilience Introduction Multiple Sclerosis (MS) is one of the leading causes of neu- rological disability in adults worldwide, with 3.6 cases per 100,000 person in women and 2.0 per 100,000 in men [1]. Having MS or being a signiicant other (SO) for someone with MS, signiicantly increases the likelihood of developing mental health disorders, particularly depression [2–4]. MS can lead to increased marital stress, with divorce twice more likely among couples where one partner has MS [5]. Health professionals oten focus on physical rehabilitation and can be unprepared for emotional issues [6] and the complexi- ties inherent in dyads. A dyad is when two people interact with and inluence each other [7]. It is important for health professionals to understand about how couples cope in order to devise successful rehabilitation programs [8–10]. Much research on coping has been concerned with the impact of stressors on the physical and mental health of individuals, and less on what actually happens between couples as they jointly cope with illness [11]. Psychological micro-analytic models of coping typically identify two major dimensions to how individuals cope: dealing with the problem which is causing stress (problem- focused coping) and regulating the emotional distress asso- ciated with the problem (emotion-focused coping [12,13]). Cross-sectional and longitudinal studies support the use of this model when it comes to understanding adjustment to MS for both those with MS and their SOs [14]. Rather than focusing on the coping of individuals, an alternative model of coping by Lewis, McBride & Pollak et al. [15] posits that a couple’s interdependence can inluence coping so that rather RESEARCH PAPER Coping with multiple sclerosis as a couple: ‘peaks and troughs’ - an interpretative phenomenological exploration Pauline Boland 1 , William M.M.Levack 1 , Sheena Hudson 1 & Elliot M. Bell 1,2 1 Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand and 2 Department of Psychological Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand Correspondence: Pauline Boland, Research Fellow, Rehabilitation Teaching and Research Unit, University of Otago, Wellington 6242, New Zealand. Tel: 0064 4 385 5541. E-mail: pauline.boland@otago.ac.nz It is important to consider how people with MS and • their signiicant others cope as a couple when plan- ning rehabilitation intervention Health professionals need to be mindful that the cop- • ing strategies of people with MS and their partners’ is reliant on concentrating on the present Health professionals could take a greater role in con- • sidering couples’ relationships and the role of opti- mism as part of rehabilitation Implications for Rehabilitation (Accepted November 2011) Disabil Rehabil Downloaded from informahealthcare.com by Wellington Medical Library on 03/28/12 For personal use only.