Spousal support for chronic pain may reduce well-being for some people

As people age, they often need help from a spouse or partner to manage their health problems. While research has examined the emotional and psychological effects that this support has on the caregiver, less research has been done on how it affects those receiving the help, according to Lynn Martire, a professor of human development and family studies at Pennsylvania State University.

A new study by Martyre and other authors from the College of Health and Human Development at Pennsylvania State University found that people who were not satisfied with the pain management support they received from a spouse or long-term romantic partner experienced more symptoms of depression and worse mood. Compared to those who responded better to this support.

"Almost every person has a time in their life when they don't want to accept help because it makes them feel helpless or because they don't think they need it," Martire said. "But people living with chronic pain need support over a long period of time. This research shows that if a person feels less supported or loved while receiving help, it may reduce their psychological well-being."

The study involved 152 long-term couples over 50 years of age, in which one of the partners had arthritis of the knee. In each couple, one partner provided instrumental support to the other, such as providing pain medication or physically helping the other to stand. Previous research has shown that emotional support generally has a positive effect on well-being, but the researchers noted that instrumental support may have different effects on the recipient's psychological well-being depending on how it is perceived.

"Knee osteoarthritis can be a complex condition," said Sooyoung Na, lead author of this study and current Presidential Postdoctoral Fellow at Virginia Tech's Gerontology Center. Na conducted this research while an undergraduate at Pennsylvania State University, where she will receive her PhD in Human Development and Family Studies in 2023.

"People with this condition will eventually need help managing their pain. Moreover, they are likely to need to continue to receive help managing their pain throughout their lives. The circumstances of patients with knee osteoarthritis allowed us to understand how perceptions of support received influence on them immediately and over time."

The researchers asked each couple what kind of instrumental support they received and then asked the recipients how they felt about the support they received. Most people reported positive feelings, such as gratitude or feelings of love, in response to the help they received. However, a minority of respondents reported negative feelings, such as anger or resentment, in response to help.

Participants who reported positive feelings in response to the support they received had fewer depressive symptoms, were more likely to experience positive mood, and were less likely to experience negative mood.

Participants who reported negative emotions in response to support had higher levels of depressive symptoms, were more likely to experience negative mood, and less likely to experience positive mood.

After 18 months, the researchers interviewed the same couples again. People who reported a lack of positive emotional response to support at baseline remained more likely to experience poorer psychological well-being compared to people who reported positive emotional responses to support.

Na said this finding demonstrates the need for clinicians to provide interventions that promote communication between couples when one or both partners receive long-term instrumental support for pain management.

Martair previously found that couples typically do not discuss whether instrumental support is needed or how it is perceived. The researchers noted that communicating about expectations and feelings related to caregiving can improve quality of life for the partner in need of care.

"My main interest is in the study of family relationships in late life, especially couples coping with chronic illness," Martyre said. "Most older people have at least two or three chronic conditions, so helping them find better ways to support each other is really important."

Na agreed and emphasized that accepting support can be difficult.

"Receiving help does not always benefit all aspects of a person's life," she said. "Additionally, it can be difficult for couples to discuss and agree on care. As a society, we need to ensure that older people understand their partner's care needs and desires so that both partners can maximize their physical, emotional and relational quality of life."

The study was published in the Journal of Aging and Health.