Table 4.

Objective Clinical Endpoint Studies

Study	Sample characteristics			Marital quality		Dependent measures and effect sizes
	N; Description	M age	% women	Measure	Validity rating	Outcome	r min	SE r	Covariates	rmax	Gender d
Cross-sectional
Fink et al. (1968)	36; P/C Severely disabled women	nr	100	SS composite a	3.5	Physician rating of physical mobility	.05	.17	0	-	-
Kimmel et al. (2000)	174; P/C End-stage renal disease patients (90.8% African-American)	54*	23	DAS Satisfaction, Negativity	4	Rating of disease severity	.06	.08	0		−0.06
Marcenes & Sheiham (1992)	164; C Fathers of schoolchildren Brazil	41.2	0	SS: Marital quality	2.75	Count of decayed, missing, and filled tooth surfaces	.41	.07	0	-	-
Marcenes & Sheiham (1996) b	164; C Mothers of schoolchildren Brazil	38.4	100	SS: Marital quality	2.75	Dental caries and periodontal disease status based on clinical examination	.25	.05	0	-	−0.09
Longitudinal studies (length of follow-up intervals in parentheses under Outcome)
Ashmore, Emery, Hauck, & MacIntyre (2005)	31; P/C Patients with diagnosis of COPD in pulmonary rehabilitation	67.8	35.5	DAS (111.7)	4	Δ 12 min walk test times (5 wk)	.00	.19	0	-	-
Coyne, Rohrbaugh, Shoham et al. (2001)	189; P/C Congestive heart failure patients	53	26	SS compositec	2	Mortality (4 years)	.28	.07	0	.28	0.42
Eaker, Sullivan, Kelley-Hayes, D’Agostino Sr., & Benjamin (2007)	2,994; C Subsample of Framingham Offspring Study	49	50	SS: Spouse shows love.	2.75	Incidence of CHD (MI, coronary insufficiency and mortality), mortality (10 y)	.00	.02	7	-	−0.0006
Haynes, Feinleib, & Kannel (1980)	1,764; R, C Subsample of Framingham Heart Study	57.5	57	SS: Conflict, satisfaction	2.5	CHD: Myocardial infarction; coronary insufficiency syndrome; angina pectoris; coronary heart disease, death. (8 y)	.00	.02	0	-	-
Helgeson (1991)	73; P/C Post myocardial infarction dx	53.5*	22	SS: Disclosure	2.25	Rehospitalization for cardiac event (1 y)	.60	.08	5	-	-
Hibbard & Pope (1993)	2,157; C 5% sample of regional health maintenance organization members in Pacific Northwest	41.5*	54	SS: Satisfaction	3	Diagnosis of stroke, ischemic HD, cancer malignancy, and mortality (15 y)	.00	.02	5	-	−0.001
Kiecolt-Glaser et al. (2005)	84; C, H Married couples	37	50	Hostile behaviors (RMICS)	3	90% wound healing after blister wound (12 days)	.23	.11	2	-	-
Kimmel et al. (2000) d	174; P/C End-stage renal disease patients (90.8% African-American)	54*	23	DAS Satisfaction, Negativity	4	Mortality (median 36.8 mo)	.20	.07	5	-	0.29
King & Reis (2012)	181; P/C Coronary artery bypass surgery recipients	60.6*	76.9*	SS: Satisfaction item from MAT 1 y post- surgery	3	Mortality (15 y)	.30	.07	0	.31	0.32
Kulik & Mahler (2006)	296; P/C CABG patients	64.2	24	DAS (nr)	4	Length of stay after first-time CABG operation (5 – 7 days)	.09	.06	0	-	0.21
Medalie et al. (1992)	8,458; R, C Male civil service employees Israel	51.8	0	SS: Support (wife showing love)	1.25	Duodenal ulcer incidence (5 y)	.13	.01	6	.14	-
Orth-Gomér et al. (2000)	187; P/C Patients previously hospitalized with acute MI; Stockholm Female Coronary Risk study Sweden	55.8	100	SS: Marital stress	3.25	Recurrent coronary events, including mortality (median 4.8 y)	.19	.07	1	.19	-
Vitaliano et al. (1993)	77; P/C Alzheimer’s patients	71.2	34	Expressed emotion during caregiver interview	2	Mini-mental status score (15-18 mo)	.00	.12	0	-	-
Yang & Schuler (2009)	100; P/C Newly diagnosed, surgically treated breast cancer patients	48.6	100	DAS Satisfaction	4	Karnofsky Performance Status scale (5 y)	.08	.10	5	-	-

^*Note. Studies are organized by study design (cross-sectional or longitudinal) and are listed in alphabetical order by author. Sample size refers to total number of individuals (as opposed to couples). All study samples collected in the United States unless otherwise noted in the study description. Signs for all effect sizes were oriented to indicate that higher scores on marital quality are related to better health. Covariates only refer to number of variables, not terms in a regression (i.e., interactions). Gender differences were computed as women – men; thus, negative numbers indicate larger effects for women compared to men. For sample descriptions: C = community, dx = diagnosis, H = healthy, NR = nationally representative, P/C = patient/clinic sample + primary diagnosis of interest (if specified), R = random sampling. For marital quality measures: SS = Study-specific measure; sample means for the DAS and MAT are reported in parentheses. Unless otherwise noted, Δ = change from baseline measures, nr = not reported, = inferred from other descriptive statistics in paper. CABG = Coronary artery bypass graft; CHD = coronary heart disease; COPD = Chronic obstructive pulmonary disease; MI = myocardial infarction; RMICS = Rapid Marital Interaction Coding System.

^aCompanionship, social status, power, understanding, affection, marital esteem, and sex in marriage.

^bSame sample as Marcenes and Sheiham (1992), only including data from mothers, but the paper provided separate estimates for mothers and fathers allowing for gender comparisons.

^cSelf-reported marital satisfaction, marital routines, positive illness discussions, and observed positive behavior.

^dSame sample as Kimmel (2000), in cross-sectional subjective endpoints. Included in meta-analysis of cross-sectional studies, and moderator analyses.