Couple-Oriented Education and Support Intervention for Osteoarthritis (Martire)

Name of Intervention: Couple-Oriented Education and Support Intervention for Osteoarthritis (OA)

Principal Investigator (s): Lynn M. Martire, Ph.D.

Institutional Affiliation: University of Pittsburgh

Caregiver Intervention Description

1. Summary of Intervention

A group education and support intervention that consisted of six weekly 2-hr sessions attended by

older individuals with OA and their spouses, based on the format of the Arthritis Self-Management Program (ASMP) developed by Lorig and colleagues. An overarching framework introduced in the first session was that (a) pain is a complex experience that can be influenced by thoughts, feelings, and behaviors; (b) spouses can influence and be affected by these same thoughts, feelings, and behaviors; and (c) spouses’ concerns and experiences as support providers are important to address. Each of the next five sessions was supplemented by a component that was linked to a topic covered in the ASMP and explicitly extended to couples: spouse encouragement and practice of cognitive or behavioral pain management strategies (e.g., distraction and progressive muscle relaxation); supportive and unsupportive spousal communications; reducing negative emotional contagion between partners; and couples’ strategies for managing medications. At the end of each weekly session, each individual with OA and his or her spouse set health-related goals for the following week, and their success in meeting these goals was reviewed with the group at the beginning of the next session.

Contrary to prediction, individuals with OA who received a patient-oriented intervention reported greater reductions in pain and improvements in physical function than those who received the couple-oriented intervention. 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. Female spouses and spouses with high marital satisfaction who received the couple-oriented intervention also experienced better outcomes in terms of depressive symptoms and caregiver mastery.

Key search terms

Couple-oriented, support, psycho-educational, arthritis

2. Intervention Materials

Description of materials used in the intervention

Informational handouts, goal setting activities and feedback. Citation: Martire, L. M., & Keefe, F. J. (2001). Psycho-educational material for osteoarthritis patients and spouses. Unpublished manual, University of Pittsburgh, Pittsburgh, PA.

Contact information for further information, materials, and training.

Lynn M. Martire, 121 University Place Room 508, University Center for Social & Urban Research, Pittsburgh, PA 15260

3. Implementing the Intervention

Training qualifications and guidelines for those delivering the intervention:

Interventionists were trained in the Arthritis Self-Management Program by staff of the Arthritis Foundation and in the couples materials by Lynn M. Martire and Francis J. Keefe.

Estimated costs of implementing the intervention:

Basically, the cost of the interventionist (ours had at least a Bachelor’s degree), part-time for 6 weeks; costs of parking for attendees and interventionists; costs of beverages and snacks; office supplies and Xeroxing. In general, a low-cost intervention.

Caveats/ limitations/ other information on the implementation of this intervention:

Participants must travel to the intervention site and this may eliminate many older patients or spouses with a high level of physical disability. The intervention is of low intensity and may have small effects on long-term outcomes.

The social aspect of interacting with other couples seemed to be enjoyed by many participants.

4. For more information

Matire, Lynn M.; Schulz, Richard; Keefe, Francis J.; Rudy, Thomas E.; Starz, Terence W. Couple-Oriented Education and Support Intervention for Osteoarthritis: Effects on Spouses' Support and Responses to Patient Pain. American Psychological Society 2008: 185-195. 

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 2007:52;121-132.