Schmaling K B, Smith W R, Buchwald D S
University of Washington, Seattle 98195-6560, USA.
Psychosom Med. 2000 May-Jun;62(3):444-50. doi: 10.1097/00006842-200005000-00018.
The predictive power of partners' responses to illness behavior for illness outcomes was investigated among couples in which one person had chronic fatigue syndrome (CFS).
One hundred nineteen participants who met case-definition criteria for CFS and were living with a significant other (SO) completed self-report measures of relationship satisfaction, responses of their SO to fatigue symptoms, and outcome measures of fatigue and functional status.
The results indicated that more frequent solicitous SO responses to illness behavior were predictive of greater fatigue-related severity and bodily pain. Solicitous SO responses to fatigue behavior were particularly influential in the context of a satisfactory relationship. In highly satisfactory relationships, solicitous SO responses were associated with significantly greater fatigue severity and fatigue-related disability than in relationships characterized by low or average satisfaction.
Solicitous SO responses to CFS-related symptoms are associated with poorer patient outcomes, especially in the context of a satisfactory intimate relationship. Because of the cross-sectional nature of the study, the direction of effects cannot be interpreted unambiguously. SOs may be inadvertently positively reinforcing illness-related behavior: Solicitous partners may help the patient more with tasks of daily living, thereby decreasing the patient's activity level, which may lead to deconditioning and disability. Alternatively, patients with more severe symptoms and disability may present more opportunities for concerned SO responses, which again may be heightened in the context of a caring, satisfactory relationship. In either case, the results suggest that additional research on the role of solicitous SO responses is warranted.
在一方患有慢性疲劳综合征（CFS）的夫妻中，研究伴侣对患病行为的反应对疾病结局的预测能力。
119名符合CFS病例定义标准且与重要他人（SO）共同生活的参与者完成了关于关系满意度、其SO对疲劳症状的反应以及疲劳和功能状态结局指标的自我报告测量。
结果表明，SO对患病行为更频繁的关切反应预示着更高的疲劳相关严重程度和身体疼痛。在关系满意的情况下，SO对疲劳行为的关切反应尤其具有影响力。在高度满意的关系中，与满意度低或中等的关系相比，SO的关切反应与明显更高的疲劳严重程度和与疲劳相关的残疾相关。
SO对CFS相关症状的关切反应与较差的患者结局相关，尤其是在亲密关系满意的情况下。由于该研究的横断面性质，无法明确解释效应的方向。SO可能在无意中对与疾病相关的行为起到了正向强化作用：关切的伴侣可能在日常生活任务上给予患者更多帮助，从而降低患者的活动水平，这可能导致身体机能下降和残疾。或者，症状和残疾更严重的患者可能会带来更多让SO做出关切反应的机会，而在关怀备至、令人满意的关系中，这种反应可能会更强烈。无论哪种情况，结果都表明有必要对SO关切反应的作用进行更多研究。
