Relationships Linked With RA Health
The quality of your personal relationships, particularly close ones, can affect your health. In fact, the absence of close ties has been just as strongly linked to morbidity and mortality as obesity, smoking and high blood pressure. Furthermore, social support that is not responsive to the needs of the recipient – perhaps providing unrequested assistance – may be stressful in itself and has been linked with increased depression.
|"... mutuality, measured as perceptions of responsiveness in couples’ communications, is linked with better physical and psychological health ..."|
The quality of a couple’s relationship may play a significant role in the social support of people with rheumatoid arthritis (RA). Studies have shown that criticism, avoidance or negative responses by spouses to RA patients’ pain can have a negative impact on the patient’s health. However, the effect of positive aspects of a couple’s relationship on RA health has not been studied.
What Problem Was Studied?
Shelley Kasle, PhD, of the Arizona Arthritis Center at the University of Arizona’s College of Medicine in Tucson, was awarded an Arthritis Foundation grant to study couple mutuality and its effect on the health of people with RA. Mutuality is a positive relationship quality of connectedness, characterized by sharing thoughts and feelings during important conversations, allowing partners to truly know and be known by each other.
The research team sought to determine whether the psychological and physical health of people with RA was linked with their perceptions of mutuality in important conversations with their spouses or life partners.
What Was Done in the Study?
A total of 148 people with RA who were married or partnered participated in the study, completing questionnaires measuring mutuality in their relationships, depression, anxiety, physical disability and arthritis impact. The mutuality questionnaire asked RA patients to rate the frequencies of their own and of their partners’ responsive behaviors using the stems “When we talk about things that are important to me, my spouse/partner is likely to …” and “When we talk about things that are important to my spouse/partner, I am likely to ….” Responses included such items as “pick up on my feelings,” “share similar experiences,” “show an interest,” “respect my point of view,” “feel moved,” “get involved” and “express an opinion clearly.” The mutuality measure was scored to reflect patients’ perceptions of their own responsiveness (“self-mutuality”), their partners’ responsiveness (“partner-mutuality”) and their combined inter-responsiveness (“overall mutuality”).
What Were the Study Results?
The research team found that people with RA who reported higher levels of overall mutuality, partner-mutuality and self-mutuality had fewer symptoms of depression and anxiety, less physical disability, and less arthritis impact on their lives, including pain, limitations of activities, and outlook. Kasle summarizes, “Findings suggest that mutuality, measured as perceptions of responsiveness in couples’ communications, is linked with better physical and psychological health in both men and women with RA.”
What Does This Mean to People With RA?
Although the nature of the study does not allow cause-and-effect conclusions, Kasle’s current results emphasize responses in communications with partners that are linked with better health – responses that are characterized by empathy, empowerment, validation, and authenticity (being yourself). In addition, she states “the current results revealed that it may be just as important for people with RA to be responsive to their partners as to have their partners be responsive to them.”
Although a supportive intervention based on these specific study findings has not yet been developed, Kasle recommends RA patients actively seek and spend time cultivating close relationships that provide a sense of connection and mutual engagement during important conversations. She believes, “such relationships should not be considered luxuries, as they contribute substantially to health and well-being.”
Kasle S, Wilhelm MS, Zautra AJ. Rheumatoid arthritis patients’ perceptions of mutuality in conversations with spouses/partners and their links with psychological and physical health. Arthritis Rheum (Arthritis Care Res) 2008;59(7):921-8.
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