Couple-oriented education and support intervention: Effects on individuals with osteoarthritis and their spouses

Objective: To determine whether a couple-oriented intervention for osteoarthritis (OA) was more efficacious than a patient-oriented intervention and whether each intervention was more efficacious than usual medical care. Research Design: 242 older adults with OA and their spouses were randomly assigned to patient-oriented education and support, couple-oriented education and support, or usual care. Results: Intent-to-treat analyses indicated no significant differences between the 3 study conditions in outcomes for individuals with OA or their spouses. Completers analyses showed that at the 6-month follow-up, contrary to prediction, individuals with OA who received the patient-oriented intervention reported greater reductions in pain and improvements in physical function than those who received the couple-oriented intervention. At the postintervention assessment, spouses who received the coupleoriented 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. Moderator analyses indicated that 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. Conclusions: A couples approach to education and support for OA may offer no advantage for individuals with OA but may prove helpful for spouses, thereby indirectly benefiting individuals with OA over time.