Multilevel analysis of couple congruence on pain, interference, and disability

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.

Spousal support decreases the negative impact of pain on mental quality of life in women with interstitial cystitis/painful bladder syndrome

“…Similarly, solicitous responses to pain behaviour did not influence the relationship between pain and patient adjustment. Contrary to previous findings in the chronic pain literature [9][10][11][12], solicitous responses and distracting spousal responses were not significantly associated with measures of physical and mental HRQL, disability and depressive symptoms. This difference may be the result of random sampling differences (e.g.…”

A biopsychosocial formulation of pain communication.

“…Much of this research has examined partners' responses to pain communication (Romano, Jensen, Turner, Good, & Hops, 2000;Romano, Turner, Friedman, & Bulcroft, 1991;Romano et al, 1992;Romano et al, 1995). Spouses often make errors when estimating the pain and disability of persons with pain (Cano, Johansen, & Franz, 2005;Cano, Johansen, & Geisser, 2004b;Clipp & George, 1992;Miaskowski, Zimmer, Barrett, Dibble, & Wallhagen, 1997). The assumption in the pain field has been that each spouse shares the same symbol system, which may not always be the case as in a husband who values visual symbols of pain and a wife who primarily uses verbal symbols.…”

Perceived Spouse Responses to Pain: The Level of Agreement in Couple Dyads and the Role of Catastrophizing, Marital Satisfaction, and Depression

“…There is more research comparing patient and spouse perceptions of patient pain severity and interference in life activities due to pain (or a similar concept called pain related disability) than on patient and spouse perceptions of spouse responses to pain. The majority of past research reports that spouses typically overestimate patient pain (Cano et al, 2004b;Cremeans-Smith et al, 2003;Elliot et al, 1996;Miaskowski et al, 1997;Riemsma et al, 2000;Yeager et al, 1995), although a multilevel modeling study showed that there were no group differences between the individuals with pain and their spouses on perceptions pain severity (Cano et al, 2005). Moreover, spouses have been shown to overestimate disability associated with cancer pain (Elliot et al, 1996) and underestimate disability associated with musculoskele-tal pain (Cano et al, 2004b(Cano et al, ,2005.…”