Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Spousal Social Support and Well-Being among Persons with Rheumatoid Arthritis: Is Support in the Eye of the Beholder?

Lehman1,  Allen J., DeLongis3,  Anita, Pratt3,  Daniel D., Collins3,  John B., Esdaile2,  John M.

Arthritis Research Centre of Canada; Simon Fraser University, Vancouver, BC, Canada
Arthritis Research Centre of Canada; University of British Columbia, Vancouver, BC, Canada
University of British Columbia, Canada

Background:

Much evidence suggests that social support is beneficial to persons with RA, both in terms of disease course and quality of life. It is essential that research identify the pathways through which support is beneficial. Several recent studies of people undergoing relatively chronic, but ultimately time-limited stress, suggest that spousal support is most health protective when it is "invisible" (the beneficiary of support is unaware that it has been provided). The stress associated with living with RA, however, is not time-limited. Whether extant findings on invisible support can be extended to couples in which one spouse has RA is unclear. Our study objective was to determine if invisible support for the person with RA is associated with significantly better well-being for the recipient than when both spouses agree that support was provided.

Methods:

English speaking adults with RA >= 6 months and their spouses (N=222 couples) independently completed standardized questionnaires that assessed the perceptions of each regarding social support received by the person with RA and support provided by the spouse, as well as relationship satisfaction, positive affect, and depression. A dummy-coded 2×2 table summarized spousal congruence or divergence on perceptions of support for the person with RA (present, absent). Couple congruence on support present for the person with RA served as the reference category. Separate hierarchical regression models tested the effects of spousal support congruence or divergence on persons with RA's relationship satisfaction, positive affect, and depression, after adjusting for gender, RA severity, and spouse depression.

Results:

Questionnaire response rate for couples was 82%. Of the persons with RA, 73% were female, the mean RA duration was 12 yrs, with mean relationship duration 31 yrs. Spousal congruence or divergence on perceptions of support for the person with RA include congruence on support present (65%) or absent (16%), and "invisible support" (13%). Even after statistically adjusting for the effects of RA, gender, and spouse depression on well-being among persons with RA, couple congruence or divergence on perceptions of support explained additional variability in relationship satisfaction (R2= 0.492, p<0.001), positive affect (R2= 0.099, p<0.001), and depression (R2= 0.084, p<0.001). Invisible support from the spouse showed a significant negative association with well-being in the person with RA, including poorer relationship satisfaction (b=-0.503, p < 0.001), less positive affect (b=-0. 269, p < 0.001), and higher depression levels (b=0.168, p < 0.01).

Conclusion:

Perceptions of social support from the spouse were significantly associated with positive well-being among persons with RA, regardless of whether the spouse reported having provided support. Contrary to findings of previous studies in non-RA samples, invisible support was associated with poorer well-being. Our findings suggest that what is most important is the recipient's perception of support received from the spouse. Such findings will be useful in designing evidence-based family and couple clinical interventions for those with RA and their families.

To cite this abstract, please use the following information:
Lehman, Allen J., DeLongis, Anita, Pratt, Daniel D., Collins, John B., Esdaile, John M.; Spousal Social Support and Well-Being among Persons with Rheumatoid Arthritis: Is Support in the Eye of the Beholder? [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1324
DOI: 10.1002/art.29090

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