Spousal support for chronic pain can reduce well-being in some people

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

A new study by Martire and others from the Pennsylvania State University College of Health and Human Development found that people who were less satisfied with the pain management support they received from a spouse or long-term romantic partner experienced more depressive symptoms and worse mood compared to those who felt better about that support.

"Almost everyone has times 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," Martair said. "But people living with chronic pain need support over a long period of time. This study shows that if a person feels less supported or loved while receiving help, it can reduce their psychological well-being."

The study involved 152 long-term couples over 50 years old, in which one partner had knee arthritis. In each couple, one partner provided instrumental support to the other, such as providing pain medication or physical assistance to stand up. 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 Suyoung Na, lead author of the study and a current Presidential Postdoctoral Fellow in the Virginia Tech Gerontology Center. Na conducted the research as an undergraduate at Penn State, where she will receive her doctorate in human development and family studies in 2023.

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

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

After 18 months, the researchers surveyed the same couples again. People who reported a lack of positive emotional response to support at the start of the study remained more likely to experience worse psychological well-being than people who responded positively to support.

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, Na said.

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

"My main interest is in studying family relationships in late life, especially couples coping with chronic illness," Martair said. "Most older adults have at least two or three chronic illnesses, so helping them find the best ways to support each other is really important."

She agreed and stressed that accepting support can be difficult.

"Getting help does not always benefit all aspects of a person's life," she said. "Additionally, it can be difficult for couples to discuss and negotiate help. As a society, we need to make sure that older adults understand their partner's needs and desires for care so that both partners can maximize their physical, emotional and relationship quality of life."

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