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The relation of partners’ illness representations to the coping behaviors of patients with inflammatory rheumatic diseases through patients’ illness representation: A dyadic regulation process. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02937-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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2
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Why do Patients Engage in Pain Behaviors? A Qualitative Study Examining the Perspective of Patients and Partners. Clin J Pain 2020; 36:750-756. [PMID: 32769413 DOI: 10.1097/ajp.0000000000000868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Patients' pain behavior plays an important role in the interaction between patients and their partners, as acknowledged in operant models of pain. However, despite the considerable research attention to pain behaviors, the underlying motives of such behaviors are still unclear. The current study explores the motives to engage in pain behaviors and the possible discrepancies between individuals experiencing pain and partners' perceptions of those motives. METHODS A qualitative study was performed, comprising semistructured interviews with 27 patients with chronic low back pain and their partners. They were recruited through purposive sampling at 2 pain clinics located in Tehran, Iran. RESULTS Patients and partners mentioned a variety of motives for pain behaviors, including protecting oneself against more pain, regulating negative emotions, informing others about the pain severity, seeking validation or intimacy, gaining advantages from pain, and expressing anger. Patients and partners revealed the most similarities in motives such as protecting oneself against more pain and informing others about the pain severity. However, partners rarely acknowledged patients' motives for seeking validation and they were more likely to mention negative motives (eg, expressing anger). DISCUSSION In conclusion, partners are more likely to attribute negative motives to the patient's pain behaviors, which may lead to their hostility toward patients. The findings of this study provide new insights into motives of pain behaviors from the perspective of patients and partners, which can inform couple-based interventions in terms of effective pain communication.
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3
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Rossi MA, Maxwell JA, Rosen NO. Biased Partner Perceptions of Women's Pain Self-Efficacy in Postpartum Pain During Intercourse: A Dyadic Longitudinal Examination. THE JOURNAL OF PAIN 2020; 21:1047-1059. [PMID: 32006700 DOI: 10.1016/j.jpain.2020.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/19/2019] [Accepted: 01/06/2020] [Indexed: 11/25/2022]
Abstract
Postpartum pain during intercourse is a prevalent and distressing problem that has substantial consequences for affected couples. Partner perceptions-such as how partners perceive women's pain self-efficacy-contribute to an individual's pain experience. This study examined whether partners under- or over-estimate women's intercourse pain self-efficacy at 3-months postpartum and the implications of this bias for women's pain and couples' sexual functioning at 3- and 6-months postpartum. Women who reported pain during intercourse and their partners (N = 89 couples) completed online measures assessing pain self-efficacy (own or partner perceptions), pain intensity, and sexual functioning at 3- and 6-months postpartum. Analyses were based on the Truth and Bias Model of Judgement and Response Surface Analysis. Partners were accurate in their estimates of women's pain self-efficacy (ie, their estimates were positively correlated with women's), but they also underestimated it by perceiving women to be less efficacious than women themselves reported. When couples showed greater agreement for lower levels of pain self-efficacy at 3 months, women reported greater pain intensity and both partners reported poorer sexual functioning at 3- and 6-months postpartum. Findings may inform interventions that promote pain self-efficacy to improve partner support and couples' sexual functioning. PERSPECTIVE: When women report-and their partners perceive-low levels of women's self-efficacy for managing painful intercourse, women report greater postpartum pain during intercourse and couples indicate poorer sexual functioning. These findings suggest that interventions aimed at promoting couples' agreement at high pain self-efficacy may improve their adjustment to postpartum pain.
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Affiliation(s)
- Meghan A Rossi
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jessica A Maxwell
- Department of Psychology, University of Auckland, Auckland, New Zealand
| | - Natalie O Rosen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Obstetrics and Gynaecology, IWK Health Centre, Halifax, Nova Scotia, Canada.
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4
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Leon Mateos L. Psychosocial aspects of rheumatic and musculoskeletal diseases. REUMATOLOGIA CLINICA 2020; 16:1-2. [PMID: 30846261 DOI: 10.1016/j.reuma.2019.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 02/04/2019] [Indexed: 11/28/2022]
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5
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Brignon M, Vioulac C, Boujut E, Delannoy C, Beauvais C, Kivits J, Poivret D, Giraudet Le Quintrec JS, Untas A, Rat AC. Patients and relatives coping with inflammatory arthritis: Care teamwork. Health Expect 2019; 23:137-147. [PMID: 31774612 PMCID: PMC6978873 DOI: 10.1111/hex.12982] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 11/27/2022] Open
Abstract
Objective To explore how patients and relatives experience and talk together about their life with inflammatory arthritis. Design Qualitative research. Setting A convenience sample was used. Participants were recruited in seven rheumatology departments in France. Participants Patients with rheumatoid arthritis or spondyloarthritis, agreeing to participate in the study with a relative, age at least 18 years. Data collection and analysis Two psychologists conducted face‐to‐face interviews with 20 patient‐relative dyads (40 individuals). A thematic analysis followed a general inductive approach. Results Saturation was reached after interviews with 20 dyads. The analysis revealed four main themes: (a) disease ‘lived’ together: a new role for the relative (providing help in physical tasks, emotional support, acting as a driving force, having a role in medical care) and communication around the disease (not focusing on the disease); (b) impact of the disease on the relationship; (c) social impact of the disease on the dyad (social isolation); (d) difficulties and needs of the relative (need to better know the disease). Conclusion This study has highlighted the importance of recognizing the role of the relative in the management of inflammatory arthritis disease, especially when medical decisions are shared with professionals. A joint approach to treatment is a basis for coping with the disease. This approach supposes (a) discussions about relatives’ new roles to clarify them, (b) patients’ and relatives’ communication skills and (c) a good understanding of each other, which can be improved by providing information on the disease and coping strategies for both the patient and the relative.
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Affiliation(s)
| | - Christel Vioulac
- Laboratory of Psychopathology and Health Processes EA 4057, University of Paris Descartes - Sorbonne Paris Cité, Boulogne-Billancourt, France
| | - Emilie Boujut
- Laboratory of Psychopathology and Health Processes EA 4057, University of Paris Descartes - Sorbonne Paris Cité, Boulogne-Billancourt, France
| | | | - Catherine Beauvais
- Hôpitaux universitaires Est Parisien, AP-HP, Rheumatology Department, Saint-Antoine Hospital, Paris, France
| | - Joelle Kivits
- EA 4360 APEMAC, Université de Lorraine, Nancy, France
| | | | | | - Aurélie Untas
- Laboratory of Psychopathology and Health Processes EA 4057, University of Paris Descartes - Sorbonne Paris Cité, Boulogne-Billancourt, France
| | - Anne-Christine Rat
- EA 4360 APEMAC, Université de Lorraine, Nancy, France.,Rheumatology Department, University Hospital Nancy, Nancy, France
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6
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Mittinty MM, Kindt S, Mittinty MN, Bernardes S, Cano A, Verhofstadt L, Goubert L. A Dyadic Perspective on Coping and its Effects on Relationship Quality and Psychological Distress in Couples Living with Chronic Pain: A Longitudinal Study. PAIN MEDICINE 2019; 21:e102-e113. [DOI: 10.1093/pm/pnz267] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Abstract
Objective
Dyadic coping is a process of coping within couples that is intended not only to support the patient with chronic pain but also to maintain equilibrium in the relationship. This study aims to investigate the effect of patient-perceived and spouse-reported dyadic coping on both the patient and their partner’s relationship quality and anxiety, stress, and depression over time.
Methods
One hundred thirty-nine couples, with one partner experiencing chronic pain, participated in this study. Spanning three measurements over six months, couples reported on their anxiety, stress, depression, relationship quality, and dyadic coping.
Results
Patient-perceived supportive dyadic coping was positively associated with both partners’ relationship quality but was negatively associated with spouses’ stress over time. Patient-perceived negative dyadic coping was negatively associated with both partners’ relationship quality and positively associated with patients’ depression and spouses’ depression and stress over time. Spouse-reported supportive dyadic coping showed a positive association with their own relationship quality and a negative association with spouses’ depression at baseline and patients’ depression at three-month follow-up. Spouse-reported negative dyadic coping was negatively associated with their relationship quality at baseline and positively associated with their partner’s anxiety and stress at six-month and three-month follow-up, respectively. Similar inference was observed from the findings of growth curve model.
Conclusions
As compared with spouse report, patient perception of dyadic coping is a better predictor of both partners’ relationship quality and psychological outcomes over time. Both partners may benefit from early psychosocial intervention to improve their dyadic coping, relationship quality, and psychological outcomes.
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Affiliation(s)
- Manasi M Mittinty
- Pain Management Research Institute, The University of Sydney, Sydney, Australia
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sara Kindt
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Murthy N Mittinty
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Sonia Bernardes
- Department of Social and Organisational Psychology, Instituto Universitario de Lisboa, Lisbon, Portugal
| | - Annmarie Cano
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Lesley Verhofstadt
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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7
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Empathic Accuracy in Chronic Pain: Exploring Patient and Informal Caregiver Differences and Their Personality Correlates. ACTA ACUST UNITED AC 2019; 55:medicina55090539. [PMID: 31461997 PMCID: PMC6780485 DOI: 10.3390/medicina55090539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/13/2019] [Accepted: 08/21/2019] [Indexed: 11/24/2022]
Abstract
Background and objectives: Social factors have demonstrated to affect pain intensity and quality of life of pain patients, such as social support or the attitudes and responses of the main informal caregiver. Similarly, pain has negative consequences on the patient’s social environment. However, it is still rare to include social factors in pain research and treatment. This study compares patient and caregivers’ accuracy, as well as explores personality and health correlates of empathic accuracy in patients and caregivers. Materials and Methods: The study comprised 292 chronic pain patients from the Pain Clinic of the Vall d’Hebron Hospital in Spain (main age = 59.4 years; 66.8% females) and their main informal caregivers (main age = 53.5 years; 51.0% females; 68.5% couples). Results: Patients were relatively inaccurate at estimating the interference of pain on their counterparts (t = 2.16; p = 0.032), while informal caregivers estimated well the patient’s status (all differences p > 0.05). Empathic accuracy on patient and caregiver status did not differ across types of relationship (i.e., couple or other; all differences p > 0.05). Sex differences in estimation only occurred for disagreement in pain severity, with female caregivers showing higher overestimation (t = 2.18; p = 0.030). Patients’ health status and caregivers’ personality were significant correlates of empathic accuracy. Overall, estimation was poorer when patients presented higher physical functioning. Similarly, caregiver had more difficulties in estimating the patient’s pain interference as patient general and mental health increased (r = 0.16, p = 0.008, and r = 0.15, p = 0.009, respectively). Caregiver openness was linked to a more accurate estimation of a patient’s status (r = 0.20, p < 0.001), while caregiver agreeableness was related to a patient’s greater accuracy of their caregivers’ pain interference (r = 0.15, p = 0.009). Conclusions: Patients poorly estimate the impact of their illness compared to caregivers, regardless of their relationship. Some personality characteristics in the caregiver and health outcomes in the patient are associated with empathic inaccuracy, which should guide clinicians when selecting who requires more active training on empathy in pain settings.
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8
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Junghaenel DU, Schneider S, Broderick JE. Partners' Overestimation of Patients' Pain Severity: Relationships with Partners' Interpersonal Responses. PAIN MEDICINE 2019; 19:1772-1781. [PMID: 29036492 DOI: 10.1093/pm/pnx217] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives The present study examined whether concordance between patients' and their partners' reports of patient pain severity relates to partners' social support and behavioral responses in couples coping with chronic pain. Methods Fifty-two couples completed questionnaires about the patient's pain severity. Both dyad members also rated the partner's social support and negative, solicitous, and distracting responses toward the patient when in pain. Results Bivariate correlations showed moderate correspondence between patient and partner ratings of pain severity (r = 0.55) and negative (r = 0.46), solicitous (r = 0.47), and distracting responses (r = 0.53), but lower correspondence for social support (r = 0.28). Twenty-eight couples (54%) were concordant in their perceptions of patient pain; partners overestimated pain in 14 couples (27%), and partners underestimated pain in 10 couples (19%). Couple concordance in pain perceptions was not related to patients' reports; however, it significantly predicted partners' reports: Partners who overestimated pain reported giving more social support (β = 0.383, P = 0.016), fewer negative responses (β = -0.332, P = 0.029), and more solicitous responses (β = 0.438, P = 0.016) than partners who were in agreement or who underestimated pain. Discussion Partner overestimation of pain severity is associated with partner-reported but not with patient-reported support-related responses. This finding has important clinical implications for couple interventions in chronic pain.
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Affiliation(s)
- Doerte U Junghaenel
- USC Dornsife Center for Self-Report Science, Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Stefan Schneider
- USC Dornsife Center for Self-Report Science, Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Joan E Broderick
- USC Dornsife Center for Self-Report Science, Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
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Raybone K, Family H, Sengupta R, Jordan A. (Un)Spoken realities of living with axial spondyloarthritis: a qualitative study focused on couple experiences. BMJ Open 2019; 9:e025261. [PMID: 31272972 PMCID: PMC6615774 DOI: 10.1136/bmjopen-2018-025261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Axial spondyloarthritis is a long-term rheumatic condition. The symptoms, including pain, can impact on the daily life routines and psychological well-being of individuals that are diagnosed with axial spondyloarthritis (axSpA). Partners are often a main source of support for individuals who manage a long-term condition and they can also be affected by the illness experience, often themselves reporting elevated levels of emotional distress. Few qualitative studies have explored the impact of axSpA on partner relationships. This study addresses the social context of axSpA by investigating the experiences for both individuals with axSpA and their partners. DESIGN Semistructured individual telephone interviews analysed using thematic analysis at a dyadic partner level. SETTING Participants were recruited from the social media pages of a UK-based axSpA-specific charity. PARTICIPANTS Nine heterosexual partner dyads (23-65 years), who were currently cohabiting, comprising nine individuals diagnosed with axSpA (n=6 females) and nine partners (n=3 females). RESULTS Three themes 'Perceived relational closeness', 'Playing third wheel to axSpA' and 'Tensions surrounding a carer-type role' were identified. The findings illustrate how living with axSpA can influence closeness between partners and dominate daily decisions, particularly surrounding leisure activities. Partners commonly adopted a carer-type role, despite many individuals with axSpA expressing desire for a greater sense of autonomy. CONCLUSIONS This study provides an important insight into the lived experiences of both individuals with axSpA and their partners. Findings highlight the social context of managing a long-term condition and suggest the need for including partners within consultations, and the need for support provision for partners.
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Affiliation(s)
| | - Hannah Family
- Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - Raj Sengupta
- The Royal National Hospital for Rheumatic Diseases, Bath, UK
| | - Abbie Jordan
- Psychology, Centre for Pain Research, University of Bath, Bath, UK
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10
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Fibromyalgia and rheumatoid arthritis: Personality and psychopathology differences from the Minnesota Multiphasic Personality Inventory-2. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2018.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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11
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Tate AM, Martire LM, Zhaoyang R. Spousal understanding and marital satisfaction in pain patients and their spouses. PERSONAL RELATIONSHIPS 2019; 26:42-53. [PMID: 34335070 PMCID: PMC8323495 DOI: 10.1111/pere.12264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The current study tested the hypotheses that knee osteoarthritis (OA) patients and spouses who report more spousal understanding of patient's pain would report greater marital satisfaction. A total of 124 couples completed interviews at three time points across 18 months. Results from dyadic analyses showed that patients who felt more understood by their spouse report, and have spouses who report, higher marital satisfaction concurrently. In addition, patients who felt more understood by their spouse reported higher marital satisfaction over time. Spouses' reports of understanding also had a significant influence on the patients' and their own marital satisfaction concurrently. Results highlight the importance of spouses understanding knee OA patients' pain for both dyad members' marital satisfaction.
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Affiliation(s)
- Ashley M. Tate
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Lynn M. Martire
- Department of Human Development and Family Studies and the Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania
| | - Ruixue Zhaoyang
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania
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12
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Wilkins VM, Sirey JA, Bruce ML. Caregiver Reward and Burden: Differing Constructs in Family Members Providing Care for Medically Ill Homebound Older Adults. J Aging Health 2019; 32:361-370. [DOI: 10.1177/0898264319825760] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: This study examined the relationship between caregiver burden and reward and how each relates to factors, such as depression, within the caregiving dyad. Method: A total of 101 older adults and their primary family caregivers were recruited upon enrolling in home health care services. Patients were assessed for sociodemographic information, depression, disability, pain, and caregiver support at baseline and at 8 weeks. Caregivers were assessed at baseline for sociodemographic information, depression, caregiver burden, caregiver reward, and caregiving tasks they provide. Results: Burden and reward were significantly inversely correlated, but differentially associated with distinct patient and caregiver variables. Patients whose caregivers reported higher baseline levels of caregiver reward were more likely to have lower depression scores at follow-up. Discussion: Given that different aspects of patients and caregivers influence reward and burden, assessing caregivers for both burden and reward may better target caregiver interventions at the individual and family levels, particularly for older adult depression.
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13
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Leon L, Redondo M, Fernández-Nebro A, Gómez S, Loza E, Montoro M, Garcia-Vicuña R, Galindo M. Expert recommendations on the psychological needs of patients with rheumatoid arthritis. Rheumatol Int 2018; 38:2167-2182. [PMID: 29808295 DOI: 10.1007/s00296-018-4057-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 05/17/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To establish feasible and practical recommendations for the management of the psychological needs of patients with rheumatoid arthritis (RA) from the moment of diagnosis through the course of the disease. METHODS A nominal group meeting was held with an RA expert team including rheumatologists and psychologists, at which a guided discussion addressed the most important psychological and emotional needs in RA. Based on the comments collected, and a literature review, a matrix document of recommendations for telematics discussion was prepared, as well as a Delphi survey to test agreement with these recommendations. Agreement was defined if at least 80% of participants voted ≥ 7 (from 1, totally disagree to 10, totally agree). For each recommendation, the level of evidence and grading of recommendations was established following the Oxford criteria, and the degree of agreement through the Delphi. RESULTS Thirteen recommendations were established, addressing several key processes: (1) identification of psychological problems and needs in patients with RA, and a guideline for their management in daily practice; (2) communication with patients; (3) referral criteria to mental health professionals. CONCLUSIONS These recommendations are intended to help health care professionals openly address the psychological aspects of patients in daily practice to follow and treat them properly.
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Affiliation(s)
- Leticia Leon
- Rheumatology Unit, IDISSC, San Carlos Clinical Hospital, Madrid, Spain.,Faculty of Heath Sciences, Camilo José Cela University, Madrid, Spain
| | - Marta Redondo
- Faculty of Heath Sciences, Camilo José Cela University, Madrid, Spain
| | - Antonio Fernández-Nebro
- Rheumatology Clinical Management Unit, Biomedical Research Institute in Malaga (IBIMA), Regional University Hospital in Malaga, University of Malaga, Malaga, Spain
| | - Susana Gómez
- Pfizer Medical Department, Alcobendas, Madrid, Spain
| | | | - María Montoro
- Pfizer Medical Department, Alcobendas, Madrid, Spain
| | | | - María Galindo
- Rheumatology Service, 12 de Octubre University Hospital, Av. Cordoba, s/n, 28041, Madrid, Spain.
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14
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Perceptions in Rheumatoid Arthritis: Comparative Study Between Patients and Their Close Families. J Clin Rheumatol 2018; 23:262-266. [PMID: 28099218 DOI: 10.1097/rhu.0000000000000478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare perceptions of patients with rheumatoid arthritis (RA) to those of their families regarding pain and subjective experience of the disease. METHODS It was a monocentric study, including 120 RA patients (according to the American College of Rheumatology criteria). The questionnaires were developed during meetings of RA patients, rheumatologists, and methodologists while referring to the literature. The patient questionnaire comprised 22 items organized in 4 sections: pain, perceived experience of the disease, activity restrictions, and help received. Concordance among patients, family, and friends replies was evaluated using the kappa coefficient. RESULTS The mean age was 42 ± 12 years with female predominance 110 (91.7%). The family member was usually the spouse (46.3%). Joint pain was described by patients as spontaneous (98.3%), unpredictable (95.9%), and variable (95.1%). RA had negatively affected work-related activities (100%), recreational activities (98.4%), family life (87.6%), relationships with friends (77.7%), sexual activities (50.4%), plans for having children (47.1%), and intimate relationships (46.3%). Concordance between patients and family perceptions was mediocre for pain severity (kappa: 0.3) and main joint-pain characteristics, excellent for majority items of experience of the disease (kappa > 0.80). Family tended to underestimate pain severity and to overestimate negative effects of RA on patient's life. CONCLUSION We found a good agreement between patients' and family members' perceptions. It is essential that any family support be in accordance with patients' needs. Our qualitative analysis objectified, in addition to a major physical impact of the disease, a negative psychosocial effect.
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15
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Ruben MA, Blanch-Hartigan D, Shipherd JC. To Know Another’s Pain: A Meta-analysis of Caregivers’ and Healthcare Providers’ Pain Assessment Accuracy. Ann Behav Med 2018; 52:662-685. [DOI: 10.1093/abm/kax036] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Mollie A Ruben
- School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences University, Boston, MA
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, US Department of Veterans Affairs, Boston, MA
| | | | - Jillian C Shipherd
- National Center for PTSD, Women’s Health Sciences, VA Boston Healthcare System, Boston, MA
- Boston University School of Medicine, Boston, MA
- Lesbian, Gay, Bisexual, and Transgender (LGBT) Program, Veterans Health Administration, Washington, DC
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16
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Gossec L, Chauvin P, Saraux A, Hudry C, Cukierman G, de Chalus T, Dreuillet C, Saulot V, Tong S, Russo-Marie F, Joubert JM, Berenbaum F. Development and psychometric validation of a patient-reported outcome measure to assess fears in rheumatoid arthritis and axial spondyloarthritis: the Fear Assessment in Inflammatory Rheumatic diseases (FAIR) questionnaire. Ann Rheum Dis 2017; 77:258-263. [PMID: 29102955 PMCID: PMC5867422 DOI: 10.1136/annrheumdis-2017-212000] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/15/2017] [Accepted: 10/06/2017] [Indexed: 01/08/2023]
Abstract
Objectives To develop and validate an outcome measure for assessing fears in patients with rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA). Methods Fears were identified in a qualitative study, and reformulated as assertions with which participants could rate their agreement (on a 0–10 numeric rating scale). A cross-sectional validation study was performed including patients diagnosed with RA or axSpA. Redundant items (correlation >0.65) were excluded. Internal consistency (Cronbach’s α) and factorial structure (principal component analysis) were assessed. Patients were classified into fear levels (cluster analysis). Associations between patient variables and fear levels were evaluated using multiple logistic regression. Results 672 patients were included in the validation study (432 RA, 240 axSpA); most had moderate disease activity and were prescribed biologics. The final questionnaire included 10 questions with high internal consistency (α: 0.89) and a single dimension. Mean scores (±SD) were 51.2 (±25.4) in RA and 60.5 (±22.9) in axSpA. Groups of patients with high (17.2%), moderate (41.1%) and low (41.7%) fear scores were identified. High fear scores were associated with high Arthritis Helplessness Index scores (OR 6.85, 95% CI (3.95 to 11.87)); high Hospital Anxiety and Depression Scale anxiety (OR 5.80, 95% CI (1.19 to 4.22)) and depression (OR 2.37, 95% CI (1.29 to 4.37)) scores; low education level (OR 3.48, 95% CI (1.37 to 8.83)); and high perceived disease activity (OR 2.36, 95% CI (1.10 to 5.04)). Conclusions Overall, 17.2% of patients had high fear scores, although disease was often well controlled. High fear scores were associated with psychological distress. This questionnaire could be useful both in routine practice and clinical trials.
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Affiliation(s)
- Laure Gossec
- Sorbonne Universités, UPMC Univ Paris 06,Institut Pierre Louis d'Epidémiologie et de Santé Publique (UMRS 1136), GRC-UPMC 08 (EEMOIS), Paris, France.,Rheumatology Department, Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Pierre Chauvin
- Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (UMRS 1136), Paris, France
| | - Alain Saraux
- Department of Rheumatology, CHU de la Cavale-Blanche, Brest, France.,Université de Brest, LabEx IGO, UMR1227, Lymphocytes B et Autoimmunité, Brest, France
| | - Christophe Hudry
- Department of Rheumatology, Hôpital Cochin, AP-HP, Paris, France
| | | | | | | | | | | | | | | | - Francis Berenbaum
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Paris, France.,Department of Rheumatology, Hôpital Saint-Antoine, AP-HP, DHU i2B, Paris, France
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17
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Abstract
This article provides an overview of the literature describing the effects of geriatric patients' pain on family members' relationships, psychological well-being, and physical health. The theoretic mechanisms that underlie the association between patients' pain and family members' outcomes are outlined, and studies describing these mechanisms are summarized. Limitations to the current literature are discussed, and key recommendations for future research and practice are presented.
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Affiliation(s)
- Catherine Riffin
- Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA.
| | - Terri Fried
- Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA; Clinical Epidemiology Unit, Geriatrics and Extended Care, Department of Internal Medicine (Geriatrics), Veterans Affairs Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516, USA
| | - Karl Pillemer
- Department of Human Development, College of Human Ecology, Cornell University, MVR G77, Ithaca, NY 06902, USA
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Ruben MA, van Osch M, Blanch-Hartigan D. Healthcare providers' accuracy in assessing patients' pain: A systematic review. PATIENT EDUCATION AND COUNSELING 2015; 98:1197-206. [PMID: 26223850 DOI: 10.1016/j.pec.2015.07.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 07/02/2015] [Accepted: 07/09/2015] [Indexed: 09/29/2023]
Abstract
OBJECTIVE Healthcare providers satisfy an important role in providing appropriate care in the prevention and management of acute and chronic pain, highlighting the importance of providers' abilities to accurately assess patients' pain. We systematically reviewed the literature on healthcare providers' pain assessment accuracy. METHODS A systematic literature search was conducted in PubMed and PsycINFO to identify studies addressing providers' pain assessment accuracy, or studies that compared patients' self-report of pain with providers' assessment of pain. RESULTS 60 studies met the inclusion criteria. Healthcare providers had moderate to good pain assessment accuracy. Physicians and nurses showed similar pain assessment accuracy. Differences in pain assessment accuracy were found according to providers' clinical experience, the timing of the pain assessment, vulnerable patient populations and patients' pain intensity. CONCLUSION Education and training aimed at improving providers with poor pain assessment accuracy is discussed especially in relation to those with limited clinical experience (<4 years) or a great deal of clinical experience (>10 years) and those providing care for vulnerable patient populations. PRACTICE IMPLICATIONS More research on characteristics that influence providers' pain assessment accuracy and trainings to improve pain assessment accuracy in medical and continuing education may improve pain treatment for patients.
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Affiliation(s)
- Mollie A Ruben
- US Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research, Boston, MA, USA.
| | - Mara van Osch
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
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Mohammadi S, Dehghani M, Khatibi A, Sanderman R, Hagedoorn M. Caregivers' attentional bias to pain: does it affect caregiver accuracy in detecting patient pain behaviors? Pain 2015; 156:123-130. [PMID: 25599308 DOI: 10.1016/j.pain.0000000000000015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Attentional bias to pain among family caregivers of patients with pain may enhance the detection of pain behaviors in patients. However, both relatively high and low levels of attentional bias may increase disagreement between patients and caregivers in reporting pain behaviors. This study aims to provide further evidence for the presence of attentional bias to pain among family caregivers, to examine the association between caregivers' attentional bias to pain and detecting pain behaviors, and test whether caregivers' attentional bias to pain is curvilinearly related to patient and caregiver disagreement in reporting pain behaviors. The sample consisted of 96 caregivers, 94 patients with chronic pain, and 42 control participants. Caregivers and controls completed a dot-probe task assessing attention to painful and happy stimuli. Both patients and caregivers completed a checklist assessing patients' pain behavior. Although caregivers did not respond faster to pain congruent than pain incongruent trials, caregiver responses were slower in pain incongruent trials compared with happy incongruent trials. Caregivers showed more bias toward pain faces than happy faces, whereas control participants showed more bias toward happy faces than pain faces. Importantly, caregivers' attentional bias to pain was significantly positively associated with reporting pain behaviors in patients above and beyond pain severity. It is reassuring that attentional bias to pain was not related to disagreement between patients and caregivers in reporting pain behaviors. In other words, attentional bias does not seem to cause overestimation of pain signals.
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Affiliation(s)
- Somayyeh Mohammadi
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands Families with Special Needs Department, Family Research Institute, Shahid Beheshti University, Tehran, Iran Laboratory of Research on Neuropsychophysiology of Pain, CRIUGM, University of Montreal, Montreal, QC, Canada Department of Psychology, Health and Technology, University of Twente, Enschede, the Netherlands
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Within-person variability in relationship satisfaction moderates partners' pain estimation in vulvodynia couples. Pain 2015; 156:703-710. [DOI: 10.1097/j.pain.0000000000000101] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rogers HL, Brotherton HT, Olivera Plaza SL, Segura Durán MA, Peña Altamar ML. Depressive and anxiety symptoms and social support are independently associated with disease-specific quality of life in Colombian patients with rheumatoid arthritis. REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 55:406-13. [PMID: 25816759 DOI: 10.1016/j.rbr.2015.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 06/22/2014] [Accepted: 01/11/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To examine the relationship between disease-specific Quality of Life (QOL) and socio-demographic, medical, and psychosocial factors in Colombian patients with Rheumatoid Arthritis (RA). METHODS One hundred and three RA patients recruited from ambulatory centers in Neiva, Colombia were administered the Disease Activity Scale 28 (DAS-28), QOL-RA, Zung Self-Rating Depression Scale, State-Trait Anxiety Inventory (STAI), Interpersonal Support Evaluation List-12 (ISEL-12), and Symptom Checklist-90 Revised (SCL-90R). RESULTS Lower QOL-RA was associated with lower socio-economic status (SES; r=0.26, p<0.01), higher likelihood of using opioids (t=-2.51, p<0.05), higher likelihood of comorbid pulmonary disease (t=-2.22, p<0.05), and lower ISEL-12 sub-scales (r's=0.41-0.31, p's<0.001). Lower QOL-RA was associated with higher DAS-28 (r=-0.28, p<0.01), Visual Analog Scale (VAS; r=-0.35, p<0.001), Zung Depression (r=-0.72, p <0.001), STAI-State (r=-0.66, p<0.001), STAI-Trait (r=-0.70, p<0.001), SCL-90R Global Severity Index (r=-0.50, p<0.001), SCL-90R Positive Symptom Total (r=-0.57, p<0.001), and all SCL-90R sub-scales (r's=-0.54--0.21, p's<0.01). A multivariate linear regression model indicated that SES (B=2.77, p<0.05), Zung Depression (B=-0.53, p<0.001), STAI-State (B=-0.26, p<0.05), and ISEL-12 Belonging (B=1.15, p<0.01) were independently associated with QOL-RA, controlling for significant associations. CONCLUSIONS More depressive and anxiety symptoms were independently associated with lower disease-specific QOL, while higher perceptions of having people to do activities with (belonging social support) and higher SES were independently associated with higher disease-specific QOL. Psychosocial factors impact QOL in RA above and beyond disease activity. Additional research into the benefits of psychosocial assessment of RA patients and provision of comprehensive care to improve QOL is warranted.
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Affiliation(s)
- Heather L Rogers
- Departamento de Métodos e Psicologia Experimental, Universidade de Deusto, Bilbao, Espanha.
| | - Hardin T Brotherton
- Departamento de Métodos e Psicologia Experimental, Universidade de Deusto, Bilbao, Espanha
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Abstract
OBJECTIVES This study explored correlates of spousal ability to infer the thoughts and feelings of individuals with chronic pain (ICPs). METHODS Participant couples (N=57), who consisted of at least 1 couple member with chronic pain, engaged in a videotaped discussion about pain, after which they completed an empathic accuracy procedure where spouses of ICP were asked to infer thoughts/feelings of ICPs. RESULTS Overall levels of partner empathic accuracy were similar to other studies of couples. Several characteristics of the pain experience and the marital relationship correlated with empathic accuracy for thoughts and feelings. Specifically, partner catastrophizing about the ICP's pain was associated with less empathic accuracy for thoughts, whereas ICP pain severity was related to a greater empathic accuracy for feelings. Several significant interactions were also found, with marital satisfaction and partner's own pain experience acting as moderators. DISCUSSION These findings provide support for models of empathy that argue that characteristics of the pain condition and characteristics of the observer are important contributors to observers' understanding of pain. In addition, the findings support previous research that suggests there are different processes for understanding the emotional versus the cognitive experience of others.
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Couple perceptions of fibromyalgia symptoms: the role of communication. Pain 2013; 154:2417-2426. [PMID: 23872105 DOI: 10.1016/j.pain.2013.07.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 07/09/2013] [Accepted: 07/15/2013] [Indexed: 11/23/2022]
Abstract
The objectives of the current study were to describe fibromyalgia patient-spouse incongruence regarding patient pain, fatigue, and physical function; and to examine the associations of individual and interpersonal factors with patient-spouse incongruence. Two hundred four fibromyalgia patients and their coresiding partners rated the patient's symptoms and function. Multilevel modeling revealed that spouses, on average, rated patient fatigue significantly lower than patients. Couple incongruence was not significantly different from zero, on average, for pain severity, interference, or physical function. However, there was significant variability across couples in how they rated the severity of symptoms and function, and how much incongruence existed within couples. Controlling for individual factors, patient and spouse reports of communication problems were significantly associated with levels of couple incongruence regarding patient fatigue and physical function, albeit in opposing directions. Across couples, incongruence was high when patients rated communication problems as high; incongruence was low when spouses rated communication problems as high. An important within-couple interaction was found for pain interference, suggesting that couples who are similar on level of communication problems experience low incongruence; those with disparate ratings of communication problems experience high incongruence. Findings suggest the important roles of spouse response and the patient's perception of how well the couple is communicating. Couple-level interventions targeting communication or other interpersonal factors may help to decrease incongruence and lead to better patient outcomes.
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Purden M, Mustafa SS, Looper KJ, Zelkowitz P, Baron M. Caregiving appraisal and disease activity in early inflammatory arthritis. Scand J Caring Sci 2013; 27:156-64. [PMID: 22671439 DOI: 10.1111/j.1471-6712.2012.01018.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The caregiving process accompanying inflammatory arthritis can be stressful to both caregivers and care recipients. In this study, we examined how caregiving involvement and caregiving appraisal as perceived by both patients and their caregiving spouses relate to disease activity and mental health of patients in early inflammatory arthritis. METHODS Patients in the early phase (> 6 weeks, <18 months duration) of inflammatory arthritis were recruited from a larger early inflammatory arthritis registry, which recorded sociodemographic data and disease characteristics. Disease activity was measured with the Disease Activity Score in 28 joints (DAS28). Current depressive symptoms were measured using the Center for Epidemiologic Studies - Depression Mood Scale. Patient and spouse perceived caregiving involvement and caregiving appraisal were assessed using the Caregiving Involvement Questionnaire and Caregiving Appraisal Scale, respectively. RESULTS The study sample consisted of 73 patients living with spouse. Mean age was 54 years, 64.4% were women and mean illness duration was 7.48 months. Patients' positive caregiving appraisal was associated with less disease activity (DAS28) (p = 0.003) and less total depressive mood (p < 0.001). In multivariate analysis, patients' appraisal of the caregiving context was negatively associated with disease activity (DAS28) after controlling for caregiving involvement and depression (p = 0.035). CONCLUSION This study indicates that, in early inflammatory arthritis, patients' caregiving appraisal might be important to consider when assessing disease activity. Clinicians are encouraged to include both patients and their spouse caregivers in interventions.
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Affiliation(s)
- Margaret Purden
- Department of Nursing, McGill University, Montreal, QC, Canada
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25
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West C, Buettner P, Stewart L, Foster K, Usher K. Resilience in families with a member with chronic pain: a mixed methods study. J Clin Nurs 2012; 21:3532-45. [DOI: 10.1111/j.1365-2702.2012.04271.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Riffin C, Suitor JJ, Reid MC, Pillemer K. Chronic pain and parent-child relations in later life: An important, but understudied issue. ACTA ACUST UNITED AC 2012; 3:75-85. [PMID: 23280120 DOI: 10.1080/19424620.2012.707619] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Chronic pain is a debilitating and pervasive health problem, particularly among older adults. Researchers and clinicians acknowledge that pain conditions do not occur in isolation, but rather exact a toll on the individual sufferer and the family system at large. No research, however, has explicitly explored the impact of older parents' chronic pain symptoms on their adult children. In this article, we present relevant predictions from theoretical models that identify the interpersonal effects of chronic illness and pain on family relationships. Guided by theory and empirical research on these topics, we present a conceptual framework of hypothesized risk factors for adult children of parents with chronic pain. We conclude by offering an agenda for future research.
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Affiliation(s)
- Catherine Riffin
- Department of Human Development, Cornell University, Ithaca, New York, United States
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Kool MB, van Middendorp H, Lumley MA, Bijlsma JWJ, Geenen R. Social support and invalidation by others contribute uniquely to the understanding of physical and mental health of patients with rheumatic diseases. J Health Psychol 2012; 18:86-95. [DOI: 10.1177/1359105312436438] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This study examined whether social support and invalidation (lack of understanding and discounting by others) are differently associated with physical and mental health. Participants were 1455 patients with fibromyalgia, rheumatoid arthritis, ankylosing spondylitis, osteorarthritis, or another rheumatic disease. Participants completed online questionnaires. Social support correlated negatively with discounting responses of others (moderately) and lack of understanding (strongly). Both invalidation and social support were additively associated with patients’ mental health, but only discounting was significantly associated with patients’ physical health. This suggests that improving health of patients with rheumatic diseases requires the consideration of both social support and invalidation.
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Affiliation(s)
- Marianne B Kool
- Utrecht University, The Netherlands
- University Medical Center Utrecht, The Netherlands
| | | | | | | | - Rinie Geenen
- Utrecht University, The Netherlands
- University Medical Center Utrecht, The Netherlands
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Mohammadi S, Dehghani M, Sharpe L, Heidari M, Sedaghat M, Khatibi A. Do main caregivers selectively attend to pain-related stimuli in the same way that patients do? Pain 2012; 153:62-67. [DOI: 10.1016/j.pain.2011.08.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Revised: 08/03/2011] [Accepted: 08/19/2011] [Indexed: 11/15/2022]
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Merz EL, Malcarne VL, Ko CM, Sadler M, Kwack L, Varni JW, Sadler GR. Dyadic concordance among prostate cancer patients and their partners and health-related quality of life: does it matter? Psychol Health 2011; 26:651-66. [PMID: 20680885 DOI: 10.1080/08870441003721251] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Serious and chronic illnesses occur within a family context, affecting not only the patient but also the spouse/partner, children and extended family network. Spouses/partners are likely to experience the greatest personal impact, and may influence patient adjustment. Also, the intimate relationship may be affected by the illness experience. This study examined whether dyadic concordance on the characteristics of prostate cancer (PC) was related to health-related quality of life (HRQOL), psychological distress and marital adjustment in PC patients and their female partners. Couples (N=164) completed questionnaires on the appraisals of PC, and individual and dyadic adjustment. Patient and partner PC appraisal ratings were positively correlated. There was a general pattern of patients and partners in concordant dyads, versus those in dyads in which spouses maximised or minimised PC characteristics, reporting significantly better individual HRQOL outcomes, although there were several exceptions. Patient-partner appraisal (dis)agreement generally did not significantly predict dyadic adjustment. Overall, results suggest that dyadic disagreement is associated with worse HRQOL in couples facing PC.
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Affiliation(s)
- Erin L Merz
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120-4913, USA
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Chachamovich JR, Chachamovich E, Ezer H, Fleck MP, Knauth DR, Passos EP. Agreement on perceptions of quality of life in couples dealing with infertility. J Obstet Gynecol Neonatal Nurs 2011; 39:557-65. [PMID: 20920002 DOI: 10.1111/j.1552-6909.2010.01168.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To examine the extent to which men and women seeking treatment for infertility were able to accurately perceive their partners' ratings of their quality of life (QOL). DESIGN Cross-sectional prospective study. Quality of life was measured as a multidimensional construct. SETTING Assisted reproduction clinic of a university hospital. PARTICIPANTS One hundred and sixty-two couples participated. The men's and women's mean ages were 36.1 and 32.1 years, respectively. Most participants had no children, and no previous assisted reproduction attempts. METHODS Men and women completed the World Health Organization-Quality of Life-Brief (WHOQOL-Brief) and the Beck Depression Inventory independently. Paired t tests were used to explore men's perceptions of their wives' QOL ratings and wives' perceptions of their husbands' ratings. Multiple regression and repeated-measures ANCOVA were used to examine the role of depression. RESULTS Proxy assessments were consistently lower than self-reports on the domains of QOL. The influence of depression on agreement was minimal, and no gender effect was observed. CONCLUSION Findings indicated little agreement in perceptions of the partner's QOL, with each partner tending to underrate the other's view. Practitioners need to consider the differences between partners to enable partners to better understand and support each other.
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Lehman AJ, Pratt DD, DeLongis A, Collins JB, Shojania K, Koehler B, Offer R, Esdaile JM. Do spouses know how much fatigue, pain, and physical limitation their partners with rheumatoid arthritis experience? Implications for social support. Arthritis Care Res (Hoboken) 2010; 63:120-7. [DOI: 10.1002/acr.20330] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Kappesser J, de C. Williams AC. Pain estimation: Asking the right questions. Pain 2010; 148:184-187. [DOI: 10.1016/j.pain.2009.10.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Revised: 09/09/2009] [Accepted: 10/07/2009] [Indexed: 11/27/2022]
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Kienle R, Luszczynska A, Pfüller B, Knoll N. Appraisal Detection Bias and Well-Being in Close Relationships: Couples Experiencing Assisted Reproduction Treatment. Appl Psychol Health Well Being 2009. [DOI: 10.1111/j.1758-0854.2009.01011.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Junghaenel DU, Broderick JE. Validation of the MPI patient profiles by partners and healthcare providers. Pain 2009; 144:130-8. [PMID: 19410367 DOI: 10.1016/j.pain.2009.03.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Revised: 01/11/2009] [Accepted: 03/26/2009] [Indexed: 11/16/2022]
Abstract
The Multidimensional Pain Inventory (MPI) is one of the most widely used instruments to assess patients' coping with chronic pain. It provides a psychosocial classification system that categorizes patients into three coping styles: Adaptive, Dysfunctional, and Interpersonally Distressed. To date, comprehensive information about the validity of the MPI taxonomy obtained from informants other than the patient has been unavailable. This has limited conclusions about the extent to which the MPI captures patients' adaptation to chronic pain beyond self-report. The present study is the first to examine whether the distinct multidimensional profiles underlying the patient clusters can be confirmed by proxy report. Ninety-nine chronic pain patients, their partners, and their healthcare providers participated in the study. Patients completed the MPI twice to determine stability of classification. Partners and providers rated the patient on MPI proxy versions developed for this study. Results revealed that partner- and provider-reported MPI ratings corresponded with the self-report patient profiles. The profiles of patients showing classification stability rather than switching of cluster assignment between the two MPI assessments had the highest correspondence with proxy ratings. These results extend prior validity research on the MPI and demonstrate that differential psychological adaptational styles to chronic pain can be reliably recognized by partners and healthcare providers.
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Affiliation(s)
- Doerte U Junghaenel
- Department of Psychiatry & Behavioral Science, Putnam Hall, Stony Brook University, Stony Brook, NY 11794-8790, USA.
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Laidmäe VI, Leppik L, Tulva T, Hääl ML. Disease-related social and family life: people coping with rheumatoid arthritis in Estonia. CRITICAL PUBLIC HEALTH 2009. [DOI: 10.1080/09581590802375871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Individual and relational correlates of pain-related empathic accuracy in spouses of chronic pain patients. Clin J Pain 2009; 24:669-77. [PMID: 18806531 DOI: 10.1097/ajp.0b013e318173c28f] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aims to investigate correlates of pain-related empathic accuracy in spouses of chronic pain patients. Specifically, analyses addressed: (1) the correlates of pain-related empathic accuracy, (2) the relation between pain-related empathic accuracy, and patient and spouse adaptational outcomes, and (3) the relation between pain-related empathic accuracy and relational outcomes. METHODS Fifty-eight chronic pain patients (28 women and 30 men) were filmed while participating in a simulated occupational lifting task. Patients were asked to report their level of pain while lifting canisters partially filled with sand. Spouses were later asked to view the video record of their partner's performance and to estimate their partner's level of pain. Empathic accuracy was defined in terms of the overall discrepancy between patients' pain ratings and spouses' pain estimates, and by the degree of covariation between patients' pain ratings and spouses' pain estimates across trials. RESULTS Analysis revealed that patients' pain severity, catastrophizing, fear of pain, and level of disability were significant correlates of empathic accuracy. Higher levels of pain-related empathic accuracy were associated to negative adaptational outcomes for chronic pain patients. With regard to the spouse, empathic accuracy was associated with the spouses' perceiving that they express less punitive responses when the patient is in pain. Empathic accuracy was not significantly related to relational outcomes. DISCUSSION The results of this study suggest that empathic accuracy is associated with negative outcomes for the patient, and might not be an important correlate of marital satisfaction in couples in which one of the partners is suffering from chronic pain.
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Kappesser J, de C. Williams AC. Pain judgements of patients’ relatives: examining the use of social contract theory as theoretical framework. J Behav Med 2008; 31:309-17. [DOI: 10.1007/s10865-008-9157-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2007] [Accepted: 04/29/2008] [Indexed: 10/22/2022]
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Pouchot J, Le Parc JM, Queffelec L, Sichère P, Flinois A. Perceptions in 7700 patients with rheumatoid arthritis compared to their families and physicians. Joint Bone Spine 2007; 74:622-6. [PMID: 17693115 DOI: 10.1016/j.jbspin.2006.11.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2006] [Accepted: 11/24/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare perceptions of patients with rheumatoid arthritis (RA) to those of their families and usual physicians regarding pain and subjective experience of the disease. METHODS Questionnaires were mailed to patients listed in the files of a non-profit patient organization (Association Française des Polyarthritiques). Each patient, one family member (or close friend), and the usual physician were each asked to complete a questionnaire. Concordance among replies made by patients, family/friends, and physicians was evaluated using the kappa coefficient. RESULTS Questionnaires were sent to 20,468 patients, among whom 7702 (38%) mailed back adequate data. The family member was usually the spouse (70%) and the usual physician a rheumatologist (68%). Joint pain was described by patients as variable (80%) and unpredictable (68%). Patients reported a need to push themselves (86%), frustration (86%), anxiety about possible disease progression (89%), and being prevented from making plans for the future (6%). A negative impact was reported on recreational activities (84%), work (56%), and family life and sexuality (51%). Concordance was excellent for pain severity (kappa>0.90) and good for the main joint-pain characteristics and experience of the disease (kappa>0.70), although family members tended to overestimate, and physicians to underestimate, the intensity of the pain. CONCLUSION We found good overall agreement between perceptions of patients, their families, and their physicians, despite differences between these last two groups. Our qualitative analysis showed not only a major physical impact of the disease, but also marked negative psychosocial effects.
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Affiliation(s)
- Jacques Pouchot
- Internal Medicine Department, European Georges Pompidou Teaching Hospital, 20 rue Leblanc, Paris 75015, France.
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Meyler D, Stimpson JP, Peek MK. Health concordance within couples: A systematic review. Soc Sci Med 2007; 64:2297-310. [PMID: 17374552 DOI: 10.1016/j.socscimed.2007.02.007] [Citation(s) in RCA: 355] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2006] [Indexed: 10/23/2022]
Abstract
Research has consistently linked marriage and positive health outcomes. In addition, many researchers have found that couples often have similar or concordant health statuses. However, concordance research has been conducted in many fields for decades without a concise review of the literature, nor has one theory of health concordance been established. A systematic review was performed implementing rigorous identification strategies, and 103 health concordance research articles were identified and reviewed to understand what research has been conducted in mental health, physical health, and health behavior concordance among couples. The research overwhelmingly suggests evidence for concordant mental and physical health, as well as health behaviors among couples. Each area of health concordance research offers room for greater research and deeper understanding for the causes of health concordance.
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Kaptein AA, Scharloo M, Helder DI, Snoei L, van Kempen GMJ, Weinman J, van Houwelingen JC, Roos RAC. Quality of life in couples living with Huntington's disease: the role of patients' and partners' illness perceptions. Qual Life Res 2007; 16:793-801. [PMID: 17375373 PMCID: PMC1915604 DOI: 10.1007/s11136-007-9194-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2006] [Accepted: 02/13/2007] [Indexed: 11/11/2022]
Abstract
Research suggests that chronically ill patients and their partners perceive illness differently, and that these differences have a negative impact on patients’ quality of life (QoL). This study assessed whether illness perceptions of patients with Huntington’s disease (HD) differ from those of their partners, and examined whether spousal illness perceptions are important for the QoL of the couples (n = 51 couples). Partners reported that their HD-patient spouses suffered more symptoms and experienced less control than the patients themselves reported. Illness perceptions of patients and partners correlated significantly with patient QoL. Partners’ beliefs in a long duration of the patients’ illness and less belief in cure, were associated with patient vitality scores. Suggestions for future research emphasize the importance of qualitative research approaches in combination with cognitive-behavioural approaches.
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Affiliation(s)
- A A Kaptein
- Leiden University Medical Centre (LUMC), Psychology Unit, 2300 RB, Leiden, The Netherlands.
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41
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Martire LM, Keefe FJ, Schulz R, Ready R, Beach SR, Rudy TE, Starz TW. Older spouses' perceptions of partners' chronic arthritis pain: implications for spousal responses, support provision, and caregiving experiences. Psychol Aging 2006; 21:222-230. [PMID: 16768570 DOI: 10.1037/0882-7974.21.2.222] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study of older patients with osteoarthritis and their spouses examined concordance between patients' and spouses' reports of patients' pain severity and the association of concordance with support and caregiving outcomes. Patients and spouses independently viewed videotapes of the patient performing simulated household tasks and provided ratings of patients' pain. Spousal overestimation of patients' pain was the most common type of nonconcordance. Spouses who were accurate in their perceptions of their partner's level of pain during a log-carrying task responded less negatively and provided emotional support that was more satisfying to patients. In addition, spouses who were accurate in their perceptions of their partner's pain during the log-carrying task reported less stress from providing support and assistance. Future research that uses such observational methods may be highly useful for understanding the effects of chronic illness on older couples.
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Affiliation(s)
- Lynn M Martire
- University Center for Social and Urban Research, University of Pittsburgh
| | | | - Richard Schulz
- University Center for Social and Urban Research, University of Pittsburgh
| | - Rebecca Ready
- University Center for Social and Urban Research, University of Pittsburgh
| | - Scott R Beach
- University Center for Social and Urban Research, University of Pittsburgh
| | - Thomas E Rudy
- Department of Anesthesiology, University of Pittsburgh
| | - Terence W Starz
- Division of Rheumatology, School of Medicine, University of Pittsburgh
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42
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Lewis MA, Kalinowski CT, Sterba KR, Barrett TM, DeVellis RF. Interpersonal processes and vasculitis management. ACTA ACUST UNITED AC 2006; 55:670-5. [PMID: 16874771 DOI: 10.1002/art.22092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Megan A Lewis
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC 27599-7440, USA.
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43
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Herzer M, Zakowski SG, Flanigan R, Johnson P. The Relationship Between Threat Appraisal and Social Constraints in Cancer Survivors and Their Spouses. J Behav Med 2006; 29:549-60. [PMID: 16951990 DOI: 10.1007/s10865-006-9075-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2006] [Accepted: 08/01/2006] [Indexed: 10/24/2022]
Abstract
: Social constraints stem from unsupportive social environments and are associated with reluctance to discuss stressor-related thoughts and feelings. Support deterioration and erosion models provide a framework for explaining how a cancer patient's threat appraisal contributes to a spouse's inadvertent constraint on the patient's emotional expression. Also, based on social comparison theory and the convoy model, a discrepancy in threat appraisal between patient and spouse may create social constraints. Contrary to social cognitive processing theories, we hypothesized that threat appraisals may be an antecedent of social constraints, rather than a consequence. Cancer patients (n=75) and their spouses (n=75) completed questionnaires assessing cancer-related threat appraisals and perceived spousal social constraints at two time points. Cross-lagged panel design results suggested that patient appraisal precedes and predicts patients' perception of social constraints. However, patient and spouse appraisals did not significantly interact in predicting spousal constraints. Limitations and implications are discussed.
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Affiliation(s)
- Michele Herzer
- Department of Psychology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.
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44
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Leonard MT, Cano A, Johansen AB. Chronic pain in a couples context: a review and integration of theoretical models and empirical evidence. THE JOURNAL OF PAIN 2006; 7:377-90. [PMID: 16750794 PMCID: PMC1890016 DOI: 10.1016/j.jpain.2006.01.442] [Citation(s) in RCA: 165] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 05/10/2005] [Revised: 11/16/2005] [Accepted: 01/03/2006] [Indexed: 12/11/2022]
Abstract
UNLABELLED Researchers have become increasingly interested in the social context of chronic pain conditions. The purpose of this article is to provide an integrated review of the evidence linking marital functioning with chronic pain outcomes including pain severity, physical disability, pain behaviors, and psychological distress. We first present an overview of existing models that identify an association between marital functioning and pain variables. We then review the empirical evidence for a relationship between pain variables and several marital functioning variables including marital satisfaction, spousal support, spouse responses to pain, and marital interaction. On the basis of the evidence, we present a working model of marital and pain variables, identify gaps in the literature, and offer recommendations for research and clinical work. PERSPECTIVE The authors provide a comprehensive review of the relationships between marital functioning and chronic pain variables to advance future research and help treatment providers understand marital processes in chronic pain.
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Affiliation(s)
- Michelle T Leonard
- Department of Psychology, Wayne State University, Detroit, Michigan 48202, USA
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45
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Stephens MAP, Martire LM, Cremeans-Smith JK, Druley JA, Wojno WC. Older women with osteoarthritis and their caregiving husbands: Effects of pain and pain expression on husbands' well-being and support. Rehabil Psychol 2006. [DOI: 10.1037/0090-5550.51.1.3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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46
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Geisser ME, Cano A, Leonard MT. Factors associated with marital satisfaction and mood among spouses of persons with chronic back pain. THE JOURNAL OF PAIN 2005; 6:518-25. [PMID: 16084466 DOI: 10.1016/j.jpain.2005.03.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2005] [Revised: 02/28/2005] [Accepted: 03/04/2005] [Indexed: 10/25/2022]
Abstract
UNLABELLED Few studies have examined the impact of chronic pain on the spouse. In this study the impact of pain and disability as rated by both the patient and the spouse on spouse marital satisfaction and affective distress was examined in 110 couples. Zero-order correlations indicated that absolute ratings of perceived disability by the spouse, rather than discrepancies between spouse and patient ratings, were most highly associated with spouse marital dissatisfaction and affective distress. Predictors of spouse marital satisfaction and distress were examined by using simultaneous multiple regression. Spouse ratings of greater physical disability were significantly related to greater spouse affective distress. Spouse ratings of higher psychosocial disability, lower spouse marital satisfaction, and being a patient of male gender were marginally related to higher spouse affective distress. Spouse marital dissatisfaction was significantly associated with patient ratings of greater psychosocial disability and lower pain. Spouse-rated psychosocial disability and affective distress were also marginally related to spouse marital satisfaction. These findings highlight the importance of patient disability, particularly limitations in function as perceived by the spouse, on spouse adjustment. PERSPECTIVE The impact of chronic pain on the spouse of the person with pain has received little empirical attention. The present study examines the relationship between patient and pain-related factors and psychosocial adjustment in the spouse.
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Affiliation(s)
- Michael E Geisser
- Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI 48108, USA.
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Cano A, Leonard MT, Franz A. The significant other version of the Pain Catastrophizing Scale (PCS-S): preliminary validation. Pain 2005; 119:26-37. [PMID: 16298062 PMCID: PMC2679670 DOI: 10.1016/j.pain.2005.09.009] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2005] [Revised: 06/29/2005] [Accepted: 09/02/2005] [Indexed: 10/25/2022]
Abstract
Researchers have hypothesized that pain catastrophizing has a social function. Although work has focused on the catastrophizing of individuals with chronic pain (ICPs), little is known about the pain catastrophizing of their significant others. The purpose of this study was to test the validity of a revised version of the original PCS [Sullivan MJL, Bishop S, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess 1995; 7: 432-524.] in which individuals were instructed to report on their own catastrophizing about their significant other's pain. In Study 1, a confirmatory factor analysis was conducted to determine the factor structure of the PCS-Significant Other (PCS-S) in a diverse sample of university undergraduates (n=264). An oblique second-order 3-factor model with two cross-loadings provided the best fit and this model was invariant across gender and racial groups. This factor structure was cross-validated in Study 2 with a second sample of university undergraduates (n=213). Results indicated that the 3-factor structure with two cross-loadings was a viable model of significant others' pain catastrophizing across gender and racial groups. In Study 3, this factor structure was replicated and the content validity of the PCS-S was examined in a sample of adult ICPs and their spouses (n=111). Spouse catastrophizing was related to ICP pain severity and interference as well as both spouses' depressive symptoms. In addition, ICPs were at a greater risk for psychological distress when both spouses had higher levels of catastrophizing. The PCS-S has the potential to be a useful and valid measure of pain catastrophizing in the significant others of ICPs.
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Affiliation(s)
- Annmarie Cano
- Corresponding author. Tel.: C1 313 577 1492; fax: C1 313 577 7636. E-mail address: (A. Cano)
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Cano A, Johansen AB, Franz A. Multilevel analysis of couple congruence on pain, interference, and disability. Pain 2005; 118:369-379. [PMID: 16289795 PMCID: PMC2667887 DOI: 10.1016/j.pain.2005.09.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2005] [Revised: 08/10/2005] [Accepted: 09/02/2005] [Indexed: 11/29/2022]
Abstract
Couple congruence on ratings of pain severity and disability were examined using hierarchical linear modeling. Older community Individuals with Chronic Pain (ICPs) and their spouses completed the Multidimensional Pain Inventory (pain severity, interference, negative spouse responses to pain), Sickness Impact Profile (physical disability, psychosocial disability), and the Mood and Anxiety Symptom Questionnaire (psychological distress). Both spouses reported on ICPs' pain and disability as well as their own psychological distress. Spousal incongruence was observed on interference and physical disability such that ICPs reported greater disability than their spouses reported for them. No significant incongruence was observed in pain severity or psychosocial disability. Predictors of couples' mean ratings of pain and disability were identified. Specifically, couples in which the ICP was female reported higher couples' ratings of pain severity and interference. ICP distress was related to higher couples' ratings of all pain and disability variables whereas spouse distress was related to higher psychosocial disability ratings. ICPs' perceptions of negative spouse responses were also positively associated with couples' ratings of physical and psychosocial disability. In terms of congruence, ICP distress was associated with incongruence on interference, physical disability, and psychosocial disability whereas spouse distress predicted incongruence on pain severity, and interference. This study suggests that understanding couples' pain outcome ratings involves an awareness of factors that might influence their perceptions and behaviors.
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Affiliation(s)
- Annmarie Cano
- Corresponding author. Tel.: +1 313 577 1492; fax: +1 313 577 7636. E-mail address: (A. Cano). URL:http://sun.science.wayne.edu/∼acano/
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50
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Cano A, Johansen AB, Geisser M. Spousal congruence on disability, pain, and spouse responses to pain. Pain 2004; 109:258-265. [PMID: 15157686 PMCID: PMC2679672 DOI: 10.1016/j.pain.2004.01.036] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2003] [Revised: 12/29/2003] [Accepted: 01/05/2004] [Indexed: 11/30/2022]
Abstract
We examined congruence between chronic pain patients and their spouses on their reports of patient pain severity, patient disability, and spouse responses to pain. Patients reported that they were more physically and psychosocially disabled than their spouses reported them to be. However, spouses reported that the patients' pain was more severe than patients reported. Depressive disorders in the patient and gender interacted with patient-spouse ratings. For physical and psychosocial disability, depressed patient couples reported significantly larger differences in disability ratings than non-depressed patient couples. In addition, female patients' disability was rated as more severe by the female patients than by their husbands. Male patient couples did not report differences on physical disability. Findings relating to other forms of disability and to spouse responses are also described. The results are discussed in the context of an interpersonal perspective of chronic pain and have implications for the assessment of pain and disability.
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Affiliation(s)
- Annmarie Cano
- Department of Psychology, Wayne State University, 71 W. Warren Avenue, Detroit, MI 48202, USA
| | - Ayna B. Johansen
- Department of Psychology, Wayne State University, 71 W. Warren Avenue, Detroit, MI 48202, USA
| | - Michael Geisser
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
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