Patients and spouses coping with inflammatory arthritis: Impact of communication and spousal perceived social support and burden

摘要

Objectives: To guide Therapeutic Patient Education (TPE) programs to improve patients' and spouses' perceived health, we aimed to analyze the effect of the spouse health state and patient-spouse relationship on functional impairment, mental health and self-efficacy of patients with RA or SpA. Methods: In this observational cross-sectional study, inclusion criteria were age >= 18 years and diagnosis of RA or SpA. The outcome criteria were functional impairment and mental health measured by the Medical Outcomes Study Short-Form 12-item version (SF-12-MCS); mental health measured by the General Health Questionnaire (GHQ-12); and self-efficacy by the General Self-Efficacy Scale (GSE Scale). Caregiver-patient relationship was assessed by the Personal Assessment of Intimacy in Relationships (PAIR) questionnaire and the Dyadic Adjustment Scale (DAS); social support by the Social Support Questionnaire-6 and spousal burden by the Zarit questionnaire. Results: A total of 88 patient-spouse couples were included. Patients were mostly female (n = 68, 77%), with mean age 59 (SD 12.6) years; 69% had RA. On bivariate analyses, only spousal burden was associated with patients' functional impairment. Patients' mental health was associated with satisfaction with social support and the dyad relationship. Self-efficacy of patients was associated with spousal burden, satisfaction with social support, spousal anxiety/depression and the dyad relationship. On multivariate analysis, improved mental health and perceived self-efficacy of patients were associated with spousal satisfaction with social support (Beta = 0.8, P = 0.1 with GHQ-12) good communication in the couple (Beta = 0.5, P = 0.04 with SF-12-MCS and Beta = 0.4, P = 0.04 with GSE Scale) and low spousal-assessed burden (Beta = -0.2, P = 0.003 with GSE Scale).