Spouses' and physicians' perceptions of pain severity in older women with osteoarthritis: dyadic agreement and patients' well-being.

This study examined agreement between patients and two role partners (spouses and physicians) on patients' pain severity and the relationships between dyadic agreement and patients' well-being. We hypothesized that compared to disagreement between patients and role partners, dyadic agreement would be related to better psychological well-being (more disease-specific self-efficacy and positive affect, and less depression). Participants were 114 older women with osteoarthritis, their caregiving husbands, and their rheumatologists. Among patient-spouse dyads, agreement was associated with better well-being, especially when compared to spouses' underestimation of patients' pain. Contrary to predictions, patient-physician agreement was not related to better patient well-being. Agreement between patients and physicians was associated with less (rather than more) self-efficacy and positive affect when compared to physicians' underestimation of patients' pain.

Emotional congruence in older couples coping with wives' osteoarthritis: exacerbating effects of pain behavior.

The authors examined congruence in the negative emotions (depression, anger) of 101 female osteoarthritis patients (M age = 69 years) and their caregiving husbands (M age = 71 years) and the extent to which patients' pain behavior (e.g., limping, rubbing joints) exacerbated linkages between partners' negative emotions. Associations between patients' and husbands' emotions were examined within domains (e.g., depression-depression) and across domains (e.g., depression-anger) over a 6-month interval. Regression analyses revealed that patients' initial levels of depressive symptoms and anger were related to increases in their husbands' anger over time. The associations between patients' depressive symptoms and their husbands' depressive symptoms and anger were conditioned by pain behaviors. Patients who were more depressed and who engaged in high levels of pain behavior had husbands who became more depressed and angry.

Negative reactions to received spousal care: predictors and consequences of miscarried support.

This study focused on the negative reactions of older women with osteoarthritis to the receipt of instrumental support (i.e., physical assistance) from their husbands and the effects of such negative reactions on the women's psychological well-being and self-care. Applying a person-environment fit model, the authors predicted that women's negative reactions to spousal support would be determined by the fit between this support and the personal centrality (importance) of being functionally independent. Consistent with this prediction, women who received high levels of support from the husband and for whom being functionally independent was not highly central reacted less negatively to this support. More negative reactions to spousal support were related to greater concurrent depressive symptomatology and fewer self-care behaviors. In addition, negative reactions were predictive of the women's increased depressive symptomatology and decreased life satisfaction. Findings illustrate a useful theoretical approach to the examination of support from family caregivers.