University of British Columbia, Vancouver, British Columbia, Canada.
Arthritis Care Res (Hoboken). 2014 Apr;66(4):532-41. doi: 10.1002/acr.22161.
To examine the effects of depressive symptoms and spouse empathic responding on patient disability and marital quality over time and to identify factors that contribute to patients perceiving their spouses as responding empathically to their rheumatoid arthritis (RA).
Patients diagnosed with RA and their spouses (n = 133 couples) independently completed mailed questionnaires at baseline and 1 year later. Patients completed measures of functional impairment, marital quality, depressive symptoms, and perceived empathic responding from their spouse. Spouses reported their own depressive symptoms and empathic responding behavior.
Perceived empathic responding was found to interact with spouse depressive symptoms, contributing significantly to the prediction of patient functional impairment at followup. Only when spouse empathic responding was low was spouse depression associated with greater patient functional impairment 1 year later. Similarly, in the model predicting patient marital quality at followup, there were significant 2-way interactions between perceived empathic responding and both spouse depressive symptoms and patient depressive symptoms. Only when spouse empathic responding was low did patient or spouse depression significantly predict poorer marital quality at followup. Patient perceptions of spouse empathic responding were found to depend on spouse reports of their own empathic responding, patient marital satisfaction, and the interaction of patient depressive symptoms and marital satisfaction.
Empathic responding from the spouse was found to buffer against the negative effects of spouse depression on functional and marital outcomes for patients with RA. In developing couple-oriented RA treatments, increasing perceived empathic responding could serve as a useful target for intervention.
探讨抑郁症状和配偶共情反应对患者残疾和婚姻质量随时间变化的影响，并确定有助于患者感知配偶对其类风湿关节炎（RA）共情反应的因素。
诊断为 RA 的患者及其配偶（n=133 对）分别在基线和 1 年后通过邮寄问卷独立完成。患者完成了功能障碍、婚姻质量、抑郁症状和感知配偶共情反应的测量，配偶报告了自己的抑郁症状和共情反应行为。
发现感知到的共情反应与配偶的抑郁症状相互作用，对随访时患者的功能障碍有显著的预测作用。只有当配偶的共情反应较低时，配偶的抑郁才与 1 年后患者的功能障碍增加有关。同样，在预测随访时患者婚姻质量的模型中，感知到的共情反应与配偶抑郁症状和患者抑郁症状之间存在显著的双向交互作用。只有当配偶的共情反应较低时，患者或配偶的抑郁才会显著预测随访时婚姻质量较差。患者对配偶共情反应的感知取决于配偶对自己共情反应的报告、患者的婚姻满意度以及患者抑郁症状和婚姻满意度的交互作用。
配偶的共情反应被发现可以缓冲配偶抑郁对 RA 患者功能和婚姻结局的负面影响。在制定以夫妻为导向的 RA 治疗方法时，增加感知到的共情反应可以作为一种有用的干预目标。
