Principal Investigator:

Allen J. Lehman, PhD
Research Scientist, Arthritis Research Centre of Canada
Abbott Postdoctoral Fellow in Aboriginal Arthritis Research

Why do this research?

People living with rheumatoid arthritis (RA) say that a key challenge is managing the variable periods of fatigue and pain. We know that people with RA have less pain and disability and improved physical and mental health when they receive empathy and support. Meanwhile, when people with RA receive problematic support, such as overly critical remarks and lack of empathy, they report poorer health outcomes with their arthritis. The spouses of people with arthritis can also play an important role on the fatigue, pain, and physical limitation caused by RA. For example, if spouses do not recognize that their partners are experiencing high levels of fatigue, they may be unsupportive. The objective of this study was to examine if differences exist in how people living with RA and their spouses perceive the impact of the disease, and if these differences were connected to spousal support.

What has been found?

The study found:

• A link between problematic spousal support and couples who reported differing views on fatigue and physical limitation.
• Results suggested that people with RA whose spouses underestimated their fatigue were more likely to report receiving problematic spousal support.
• Results also suggested a link between differing couple perception of physical limitation in RA and greater problematic support.
• These results were found even after accounting for peoples education, sex, physical health, years married, RA duration, and relationship satisfaction.

How was this study conducted?

English-speaking adults with RA for 6 months or more and their spouses (222 couples) were recruited from metro-Vancouver and throughout Canada. Both participants with RA and their spouses completed questionnaires about the person with RA’s fatigue, pain, and physical limitations. People also noted the level of beneficial spousal support and problematic spousal support for the person with RA. Couples were categorized into one of three areas based on their level of agreement about fatigue, pain, and physical limitation:

1. spousal over-estimators,
2. spousal agreement, and
3. spousal under-estimators.

The information was analyzed to find out if a link existed between couple agreement levels and spousal support for people with RA.

Funding:

Dr. Lehman’s work was supported by a Michael Smith Foundation for Health Research doctoral award, a Canadian Institutes of Health Research doctoral award, a Canadian Arthritis Network graduate award, and the Pfizer Fellowship in Arthritis Research.

Co-investigators:

John M. Esdaile, MD, MPH, FRCPC, Scientific Director, Arthritis Research Centre of Canada, Arthur JE Child Chair in Rheumatology Research &, Professor of Medicine and Community Health Sciences, University of Calgary, Professor of Medicine, Division of Rheumatology, Department of Medicine, University of British Columbia

Daniel D. Pratt, PhD, Department of Educational Studies, Faculty of Medicine, University of British Columbia

Anita DeLongis, PhD, The Centre for Health and Coping Studies, Department of Psychology, University of British Columbia

John B. Collins, PhD, Department of Educational Studies, University of British Columbia

Kam Shojania, MD, FRCPC, Head, UBC, St. Paul’s, and VGH Divisions of Rheumatology, Department of Medicine, University of British Columbia

Barry Koehler, MD, FRCPC, Clinical Professor Emeritus, Faculty of Medicine, University of British Columbia

Robert Offer, MD, FRCPC, University of British Columbia

Consumer (Patient) Advisory Panel:

Otto Kamensek, 
Consumer Advisory Board, Arthritis Research Centre of Canada

Colleen Maloney, Consumer Advisory Board, Arthritis Research Centre of Canada
Gordon Whitehead, Consumer Advisory Board, Arthritis Research Centre of Canada

Volunteers:

Tina Lee, Erica Amari, Natasha Eginli, Vendy Lai, Jeannie Lai, Phillip Choi, Pam Rogers, and Dr. Antonio Aviña