The effect of multidisciplinary rehabilitation treatment on spouses of patients with non-specific chronic pain
Main Article Content
Abstract
Background: Research has revealed the influence of spouses on the complaints of patients with non-specific chronic pain, and vice versa. The effect of multidisciplinary rehabilitation treatment (MRT) on patients’ spouses has not been studied yet.
Methods: Prospective cohort study. Patients with chronic pain admitted to an outpatient rehabilitation treatment and their spouses filled out questionnaires at pre-treatment (T0), start of treatment (T1), end of treatment (T2), and three months after treatment (T3). Primary outcome measure was psychological distress of the spouses (SCL-90-R). Secondary outcome measures were life satisfaction (Lisat-9), health-related quality of life (RAND-36), catastrophizing (PCS), self-efficacy (DGSES) and strain (CSI) of spouses.
Results: The analysis included 39 couples. Mean scores (SD) of the spouses on the SCL-90-R at T0–T3 were 112 (SD 21), 119 (SD 27), 114 (SD 33) and 107 (SD 17), respectively (differences non-significant). The PCS scores of the spouses and their mean scores on the social domain of the RAND-36 improved significantly, as did the score for the physical domain of the RAND-36 before treatment and the DGSES score after treatment. No differences were found in the spouses’ scores on the CSI and most Lisat-9 or other domains of the RAND-36. The patients benefited from the treatment, with significant changes in scores on the SCL-90-R and most domains of the RAND-36.
Conclusions: Spouses had favourable changes in their scores on social life and catastrophizing tendency. Our study also confirms that patients with non-specific chronic pain benefit from MRT.
Article Details
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References
2. Lousberg, R, Schmidt, AJ, Groenman, NH . The relationship between spouse solicitous and pain behavior: searching for more experimental evidence. Pain 1992, 51 (1),75-79.
3. Romano, JM, Turner, JA, Friedman, LS, Bulcrof, RA, Jensen, MP, Hops, H, Wright, SF. Sequential analysis of chronic pain behaviors and spouse responses. J Consult Clin Psychol 1992, 60 (5),777-782.
4. Smith, SJA, Keefe, FJ, Caldwell, DS, Romano, J, Baucom, D. Gender differences in patient-spouse interactions: a sequential analysis of behavioral interactions in patients having osteoarthritic knee pain. Pain 2004, 112 (1-2),183-187.
5. Schwartz, L, Slater, MA, Birchler, GR. The role of pain behaviours in the modulation of marital conflict in chronic pain couples. Pain 1996, 65 (2-3), 227-233.
6. Cunningham, JL, Hayes, SE, Townsend, CO, Laures, HJ, Hooten, WM. Associations between spousal or significant other solicitous responses and opioid dose in patients with chronic pain. Pain Med 2012, 13 (8),1034-1049.
7. Taylor, AG, Lorentzen, LJ, Blank, MB. Psychological distress of chronic pain sufferers and their spouses. J Pain Symptom Manage 1990, 5 (1), 6-10.
8. Geisser, ME, Cano, A, Leonard, MT. Factors associated with marital satisfaction and mood among spouses of persons with chronic back pain. J Pain 2005, 6 (8),518-525.
9. Leonard, MT, Cano, A. Pain affects spouses too: Personal experience with pain and catastrophizing as correlates of spouse distress. Pain 2006, 126 (1-3),139-146.
10. Strunin, L, Boden, LI . Family consequences of chronic back pain. Soc Sci Med 2004, 58 (7),1385-1393.
11. Schwartz, L, Slater, MA, Birchler, GR, Atkinson, JH . Depression in spouses of chronic pain patients: the role of patient pain and anger, and marital satisfaction. Pain 1991, 44 (1),61-67.
12. Flor, H, Turk, DC, Scholz, OB. The impact of chronic pain on the spouse: martial, emotional and physical consequences. Journal of Psychosomatic research 1987, 31 (1),63-71.
13. Turk, DC, Wilson, HD, Cahana, A. Treatment of chronic non-cancer pain, part 2. The Lancet 2011, 25 (377) , 2226-2234.
14. Hardt, J, Gerbershagen, HU, Franke, P. The symptom checklist, SCL-90-R-R: its use and characteristics in chronic pain patients. Eur J Pain 2000, 4 (2),137-48.
15. Fugl-Meyer, AR, Bränholm, IB, Fugl-Meyer, KS. Happiness and domain-specific life satisfaction in adult northern Swedes. Clin Rehabil 1991, 5 (1),25-33.
16. Hays, RD, Sherbourne, CD, Mazel, RM. The RAND-36 Item Health Survey 1.0. Health economics 1993, 2 (3),217-227.
17. Van der Zee, KI, Sanderman, R. Het meten van de algemene gezondheidstoestand met de RAND-36, een handleiding. Groningen: Rijksuniversiteit Groningen, Noordelijk Centrum voor Gezondheidsvragenlijsten. (1992).
18. Robinson, BC. Validation of A Caregiver Strain Index. Journal of Gerontology 1983, 38 (3),344-348.
19. Sherer, M, Maddux, JE, Mercandante, B, Prentice-Dunn, S, Jacobs, B, Rogers, RW. The Self-Efficacy Scale: Construction and Validation. Psychological Reports 1982, 51 (2),663-671.
20. Sullivan, MJL, Bishops, SC, Pivik, J. The Pain Catastrophizing Scale: Development and validation. Psychol. Assess 1995, 7 (4),524-532.
21. Osman, A, Barrios, FX, Kopper, BA, Hauptmann, W, Jones, J, O'Neill, E. Factor structure, reliability, and validity of the Pain Catastrophizing Scale. J Behav Med 1997, 20 (6),589-605.
22. Samsa, G, Edelman, D, Rothman, ML, Williams, GR, Lipscomb, J, Matchar, D. Determining clinically important differences in health status measures: a general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics 1999, 15 (2),141-155.
23.Ali FM, Cueva AC, Vyas J, Atwan AA, Salek MS, Finlay AY, Piguet V. Systematic review of the use of quality-of-life instruments in randomized controlled trials for psoriasis. Br J Dermatol. 2017,176 (3),577-593
24. Glassman, SD, Coapy, AG, Berven, SH, Polly, DW, Subach, BR, Carreon, LY. Defining substantial clinical benefit following lumbar spine arthrodesis. J Bone Joint Surg am 2008, 90 (9),1839-1847.
25. Boonstra, AM, Reneman, MF, Waaksma, BR, Schiphorst Preuper, HR, Stewart, RE. Predictors of multidisciplinary treatment outcome in patients with chronic musculoskeletal pain. Disability and Rehabilitation 2015, 37 (14),1242-1250.
26. Volker, G, Van Vree, F, Wolterbeek, R, Van Gestel, M, Smeets, R, Köke, A, Vliet Vlieland, T. Long-term outcomes of multidisciplinary rehabilitation for chronic musculoskeletal pain. Musculoskelet. Care 2017, 15 (1), 59-68
27.Sjöström, R, Asplund, R, Alricsson, M. Evaluation of a multidisciplinary rehabilitation program with emphasis on musculoskeletal disorders: A 5-year follow-up. Work 2013, 45 (2),175-182
28. Singer JD, Willet JB. Applied longitudinal data analysis, Modeling change and event occurrence. New York: Oxford University Press, Inc; 2003.