Patient and spouse appraisals of health status in rheumatoid arthritis and fibromyalgia: discrepancies and associations with invalidation

Clin Exp Rheumatol. Nov-Dec 2011;29(6 Suppl 69):S63-9. Epub 2012 Jan 3.


Objectives: The health problems of patients with rheumatoid arthritis and fibromyalgia are mostly invisible to others, which can lead to a discrepancy between patients' and spouses' appraisals of the severity of the health problems. As a consequence, some patients may feel 'invalidation' from their spouse, such as not being understood and believed. Aim of this study was to compare patients' and spouses' appraisals of the health status of patients with rheumatoid arthritis and patients with fibromyalgia, and to examine whether discrepancies in these appraisals are associated with invalidation experiences of the patient.

Methods: Eighty-four patients with rheumatoid arthritis and 95 patients with fibromyalgia filled out a health status questionnaire (MOS short-form general health survey, SF-20) and a questionnaire on invalidation by the spouse (Illness Invalidation Inventory, 3*I). The spouses appraised the patients' health status independently from the patients using a spouse version of the SF-20.

Results: Patients with fibromyalgia and their spouses appraised the patients' health status significantly worse than patients with rheumatoid arthritis and their spouses. The agreement between patients and spouses was generally fair with somewhat more agreement in rheumatoid arthritis than in fibromyalgia. Patient-spouse discrepancies in health status appraisals were not associated with invalidation experiences.

Conclusions: The invisibility of health problems in fibromyalgia and rheumatoid arthritis is not accompanied by large patient-spouse discrepancies of health status appraisals, which suggests that invalidation by spouses is not dependent on observable evidence such as clinical signs of damage or pathology.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arthritis, Rheumatoid / physiopathology
  • Arthritis, Rheumatoid / psychology*
  • Arthritis, Rheumatoid / therapy
  • Chronic Pain / physiopathology
  • Chronic Pain / psychology*
  • Female
  • Fibromyalgia / physiopathology
  • Fibromyalgia / psychology*
  • Fibromyalgia / therapy
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Pain Management
  • Patient Satisfaction*
  • Process Assessment, Health Care
  • Spouses / psychology*
  • Surveys and Questionnaires
  • Syndrome