Dr. Shojania has received consultancy fees, speaking fees, and/or honoraria (less than $10,000 each) from Roche Canada, Bristol-Myers Squibb Canada, Abbott Canada, and Schering Canada.
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Psychosocial Factors
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Do spouses know how much fatigue, pain, and physical limitation their partners with rheumatoid arthritis experience? Implications for social support†
Article first published online: 28 DEC 2010
DOI: 10.1002/acr.20330
Copyright © 2011 by the American College of Rheumatology
Additional Information
How to Cite
Lehman, A. J., Pratt, D. D., DeLongis, A., Collins, J. B., Shojania, K., Koehler, B., Offer, R. and Esdaile, J. M. (2011), Do spouses know how much fatigue, pain, and physical limitation their partners with rheumatoid arthritis experience? Implications for social support. Arthritis Care & Research, 63: 120–127. doi: 10.1002/acr.20330
- †
Presented by Dr. Lehman in partial fulfillment of the requirements for a PhD degree, University of British Columbia, Vancouver, British Columbia, Canada.
Publication History
- Issue published online: 28 DEC 2010
- Article first published online: 28 DEC 2010
- Accepted manuscript online: 18 AUG 2010 02:50PM EST
- Manuscript Accepted: 10 AUG 2010
- Manuscript Received: 13 MAR 2009
Funded by
- Canadian Institutes of Health Research Doctoral Research award
- Canadian Arthritis Network Graduate Student award
- Michael Smith Foundation for Health Research Graduate Student award
- Pfizer Fellowship in Arthritis Research
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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 (R2 = 3.7%, P = 0.002), as did those whose spouses underestimated or overestimated physical limitation (R2 = 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.