Psychobiological Pathways, Osteoarthritis Interventions - Pittsburgh Mind-Body Center (www.pghmbc.org)

The primary goal of this study was to determine if osteoarthritis (OA) patients and their spousal
caregivers experience greater health benefits from an educational intervention targeted at both
individuals than from an educational intervention targeted only at the patient. A sample of 262
married individuals with hip or knee OA and their spouses was recruited for this study. At baseline
the average age of patients and spouses was 69 and 70 years, respectively, and couples had
typically been married for 42 years. The typical patient reported having OA for 16 years. Data
were collected at three time points via in-home interviews (psychosocial and health data),
functional assessments at local hospitals (e.g., physical performance tests, blood pressure),
and biological sampling (salivary cortisol and urinary catecholamines).

Analyses of primary patient and spouse outcomes revealed that, contrary to prediction, individuals
with OA who received the patient-oriented intervention reported greater increased physical function
than those who received the couple-oriented intervention, at the 6 month follow-up. As predicted,
spouses who received the couple-oriented intervention reported greater reductions in stress and a
trend toward less critical attitudes than spouses of individuals with OA who received the patient-
oriented intervention, at the post-intervention assessment (Martire, Schulz, Keefe, Rudy, & Starz,
2007). Analyses of secondary outcomes showed that, at the post-intervention assessment,
patients in the couple-oriented intervention reported a greater decrease in their spouses’ punishing
responses (e.g., anger, irritation) than patients in the patient-oriented intervention. At the 6 month
follow-up, patients in the couple-oriented intervention reported greater increased spouse support
than those in the patient-oriented intervention (Martire, Schulz, Keefe, Rudy, & Starz, in press).

For further information about this project, contact Lynn Martire, Ph.D.

Publications

Martire LM, Keefe FJ, Schulz R, Ready R, Beach SR, Rudy TE, Starz TW. Older spouses’

perceptions of partners’ chronic arthritis pain: Implications for spousal responses, support

provision, and caregiving experiences. Psychology and Aging, 21:222-230, 2006.

Martire LM, Schulz, R, Keefe FJ, Rudy TE, Starz TW. Couple-oriented education and

support intervention: Effects on individuals with osteoarthritis and their spouses.

Rehabilitation Psychology, 52 : 121-132 , 2007.

Martire LM, Schulz R, Keefe FJ, Rudy TE, Starz TW. Couple-oriented education and

support intervention: Effects on spouses’ support and responses to patient pain.

Families, Systems, & Health, in press.

Revised 2/26/2008 la/tc