Do spouses know how much fatigue, pain, and physical limitation their partners with rheumatoid arthritis experience? Implications for social support

Abstract

Objective. To determine whether perceptions of clinical manifestations (fatigue, pain, and physical limitation) of rheumatoid arthritis (RA) differ between spouses and their partners with RA, and to determine whether the differences are associated with the perception of beneficial and problematic spousal social support. Methods. English-speaking adults with RA of >6 months' duration and their spouses (n ‫؍‬ 222 couples) completed standardized questionnaires for fatigue, pain, physical limitation, beneficial spousal support, and problematic spousal support. Spouses completed questionnaires based on their perception of their partner with RA. Agreement scores for fatigue, pain, and physical limitation were calculated by subtracting spouse scores from the scores of the partner with RA. Agreement levels were defined a priori: agreement (within ؎ one-half of a minimum clinically important difference [MCID] unit), overestimator (< one-half an MCID), and underestimator (> one-half an MCID). Separate hierarchical linear regression models were used to measure the association between beneficial support and problematic support after adjusting for RA duration, physical health, sex, educational level, relationship duration, and satisfaction. Results. Response rate for couples was 82%. Relative to participants with RA, spouses overestimated fatigue (26%), pain (29%), and physical limitation (39%), and underestimated fatigue (11%), pain (17%), and physical limitation (34%). After statistically controlling for demographic, disease, and psychosocial variables, participants with RA whose spouses underestimated fatigue received more problematic support (R 2 ‫؍‬ 3.7%, P ‫؍‬ 0.002), as did those whose spouses underestimated or overestimated physical limitation (R 2 ‫؍‬ 3.4%, P ‫؍‬ 0.017). Conclusion. Persons with RA perceived more problematic spousal support when their spouse underestimated fatigue, or underestimated or overestimated physical limitation levels.

Partners’ Overestimation of Patients’ Pain Severity: Relationships with Partners’ Interpersonal Responses

“…For patient reports of support received from the partner, no significant effects of couple concordance were found. These null results agree with prior findings by Cano and colleagues [14] and Lehman and colleagues [18], who also did not find evidence that concordance on perceptions of pain relates to patientreported support.…”

“…Using this criterion, we found that approximately half of the couples (54%) were in agreement about patients' levels of pain severity. This result is comparable with work by Lehman and colleagues [18] in rheumatoid arthritis who found that 46% of their couples were in agreement about patient pain severity.…”

“…Accordingly, partner overestimation was defined as a positive difference of more than 0.5 SDs, and partner underestimation was defined as a negative difference of more than 0.5 SDs. This threshold is consistent with related work on defining patient-spouse concordance levels in rheumatoid arthritis [18], and, more generally, it has been considered a reasonable benchmark to identify minimal clinically important differences on the MPI pain severity subscale [30][31][32][33].…”

Predicting Daily Satisfaction with Spouse Responses Among People with Rheumatoid Arthritis

“…Previous research has found that relationship satisfaction is related to perceived beneficial support in people with RA [24]. The results were less clear in the current study, where marital satisfaction-although improving model fit and showing a significant association at the bivariate level-was not significant in the model itself.…”

Orthopaedic Hand Patient Support Systems Have Valuable Insight to Patient Function and Pain

“…28 However, the UBC study found that patients who reported problematic support from their spouse (e.g., gave you information that you found upsetting) had dissimilar views of physical function (DASH), suggesting that more solicitous SO's would have a similar understanding of physical function. 3,30 Similarly, our work finds that patients who report more solicitous SOs have a more congruent understanding of physical function as measured by QuickDASH (Table 3). Thus, the opinion of concerned SOs may provide even more value in assessing patient outcomes.…”