PhD in Nursing Science Program

Sharon W. Dowdy

Synchronous Support Congruent Coping, or a Good Marriage:  Which is more important in reduction of the pain by spouses with rheumatoid arthritis?


Dissertation under the direction of Professor Mary Jo Gilmer


Living with a chronic illness requires adaptations for the individual and the entire family. The effects of stressors on individual health outcomes have been extensively studied. However, the effects of spousal interactions on the chronically ill individual's health have not been fully explored 

This study explores three processes that may add to the understanding of when the behaviors of a husband are perceived to be helpful by his wife when dealing with the pain of RA. Is it when the support offered by the husband is that which the wife desired and/or received, and/or when the support received was that which she desired -- as with synchronous support? Is it when the husband's and wife's coping strategies to deal with the wife's RA pain are similar -- as with congruent coping? Or is it when both spouses sense that they are loved, listened to, and valued -- as with a good marriage? The effect of these three processes is examined on the husband's helpfulness and subsequent reduction of the wife's RA pain.

A convenience sample of eighty couples was recruited from clinics and rheumatologists' practices. Husbands and wives completed mailed questionnaires separately. Dyadic data were analyzed using correlations and regression.

Although support synchrony between the husband and wife did not reduce pain, it was shown to have a positive relationship to the wife's perception of her husband's helpfulness. Being in a good marriage was even more important to the wife's rating of her husband's helpfulness. The relationship between congruent coping and the husband's helpfulness was complex. The woman's quality of life and her ability to deal with a chronic illness may be affected by her perception of her husband's helpfulness, even when pain is not abated. The relationships of the chronically ill person need further examination, including aspects of interactional support and coping, in predicting health and quality of life outcomes.