The differential effects of rheumatoid arthritis on distress among patients and partners

Abstract

This study investigated primary and secondary stressors of distress in rheumatoid arthritis patients and partners, analysing data of 61 couples. Patients’ disability was found to be a primary stressor of their distress. In addition, it also had an indirect effect on partners’ distress through partners’ primary stressor, perceived burden. Marital quality and negative transactions can be considered joint secondary stressors for partners, not for patients. An indication of an indirect effect of marital quality on patients’ distress was found, through partners’ burden. Using a multilevel model, which takes into account the dependence between patients’ and partners’ distress, 36% of the variance in patients’ distress could be explained, whereas 68% of partners’ distress variance was explained. More knowledge on how patient and partner influence each other's distress is needed to develop psychosocial interventions that will help patients and partners minimize their psychological distress and prevent deterioration of their marital quality.

Keywords:

• Rheumatoid arthritis
• distress
• marital quality
• negative transactions
• partner
• burden
• stress proliferation

Notes

Note

[1] Mean anxiety/insomnia is 5.8 and mean depression is 1.6 in a normal population (5.8 + 1.6 = 7.4 mean distress, adjusted for 1–4 coding: 7.4 + 14 points = 21.4) (Koeter & Ormel, 1991).