A Stepped Approach to Examine the Dyadic Influence of Pain Communication on the Psychosocial Adjustment of Knee Osteoarthritis Patients and their Spouses
Open Access
- Author:
- Tate, Ashley M
- Graduate Program:
- Human Development and Family Studies
- Degree:
- Master of Science
- Document Type:
- Master Thesis
- Date of Defense:
- December 05, 2017
- Committee Members:
- Lynn Margaret Martire, Thesis Advisor/Co-Advisor
Martin John Sliwinski, Committee Member
Jon F Nussbaum, Committee Member - Keywords:
- Osteoarthritis
Pain Communication
Interpersonal Process Model of Intimacy
Psychosocial Adjustment - Abstract:
- Spouses of chronic pain patients are seldom accurate regarding patients’ level of pain and functional limitations. Spouse accuracy regarding the pain experience of older patients has been shown to be psychologically and relationally beneficial for both members of the dyad. However, lessor known are the factors that may lend spouses to understand chronic pain patients’ pain or the potential psychosocial benefits of spouses’ understanding for both dyad members. The primary aim of this project was to fill these gaps using a sample of 152 couples (N = 304) managing one dyad member’s knee osteoarthritis (OA). Reis and Shaver’s interpersonal process model of intimacy (1988) and Bandura’s self-efficacy theory (1977) guided the stepped approach used to study pain communication (i.e., patient self-efficacy for pain communication, patient disclosure about pain, and patient and spouse perception of spouse understanding of patient pain) and psychosocial adjustment (i.e., marital satisfaction and depressive symptomatology) in a sample of OA patients and their spouses. Patients with a higher level of self-efficacy for communicating pain were expected to be more likely to disclose their pain-related experiences to their spouse (H1). Higher pain disclosure was expected to be associated with increased marital satisfaction for only those patients who feel understood in their pain (H2). Lastly, using dyadic modeling, it was anticipated that patients and spouses who reported increased levels of spouse understanding patient pain would report, and have a partner who reports, greater marital satisfaction (H3a) and lesser depressive symptoms (H3b). Results partially confirmed hypotheses. Patients with a higher efficacy for communicating their pain to their spouse tended to disclose more of their pain to the spouse. Contrary to hypothesis, patients who felt more understood in their pain and disclosed more were not more satisfied in their marriages. Additionally, results suggested that patients who feel more understood by their spouse report, and have spouses who report, higher levels of marital satisfaction. Neither patient nor spouse perceptions of spouse understanding had an influence on depressive symptomatology for patients or spouses. In sum, results suggest the complexity of patient pain disclosure and highlight the importance of patient perceptions of spouse understanding for both dyad members’ relational well-being. Theoretical implications and avenues for future research are discussed.