title: Couple perceptions of fibromyalgia symptoms: the role of communication.
abstract: The objectives of the current study were to describe fibromyalgia patient-spouse incongruence regarding patient pain, fatigue, and physical function; and to examine the associations of individual and interpersonal factors with patient-spouse incongruence. Two hundred four fibromyalgia patients and their coresiding partners rated the patient's symptoms and function. Multilevel modeling revealed that spouses, on average, rated patient fatigue significantly lower than patients. Couple incongruence was not significantly different from zero, on average, for pain severity, interference, or physical function. However, there was significant variability across couples in how they rated the severity of symptoms and function, and how much incongruence existed within couples. Controlling for individual factors, patient and spouse reports of communication problems were significantly associated with levels of couple incongruence regarding patient fatigue and physical function, albeit in opposing directions. Across couples, incongruence was high when patients rated communication problems as high; incongruence was low when spouses rated communication problems as high. An important within-couple interaction was found for pain interference, suggesting that couples who are similar on level of communication problems experience low incongruence; those with disparate ratings of communication problems experience high incongruence. Findings suggest the important roles of spouse response and the patient's perception of how well the couple is communicating. Couple-level interventions targeting communication or other interpersonal factors may help to decrease incongruence and lead to better patient outcomes.
authors.affiliation: School of Nursing, Oregon Health & Science University, Portland, OR, USA Psychology Department, University of Massachusetts at Amherst, MA, USA.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Lyons
authors.forename: Kim D
authors.initials: KD
authors.lastname: Jones
authors.forename: Robert M
authors.initials: RM
authors.lastname: Bennett
authors.forename: Shirin O
authors.initials: SO
authors.lastname: Hiatt
authors.forename: Aline G
authors.initials: AG
authors.lastname: Sayer
mesh_terms: D000465:Algorithms; D003142:Communication; D003627:Data Interpretation, Statistical; D003863:Depression / Q000523:psychology; D005221:Fatigue / Q000523:psychology; D005260:Female; D005356:Fibromyalgia / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009043:Motor Activity; D010146:Pain / Q000523:psychology; D010147:Pain Measurement; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Chronic pain; Communication; Couples; Multilevel modeling; Symptom incongruence