This study examined agreement between patients and two role partners (spouses and physicians) on patients' pain severity and the relationships between dyadic agreement and patients' well-being. We hypothesized that compared to disagreement between patients and role partners, dyadic agreement would be related to better psychological well-being (more disease-specific self-efficacy and positive affect, and less depression). Participants were 114 older women with osteoarthritis, their caregiving husbands, and their rheumatologists. Among patient-spouse dyads, agreement was associated with better well-being, especially when compared to spouses' underestimation of patients' pain. Contrary to predictions, patient-physician agreement was not related to better patient well-being. Agreement between patients and physicians was associated with less (rather than more) self-efficacy and positive affect when compared to physicians' underestimation of patients' pain.

Despite relatively standardized surgical procedures, patients undergoing total knee replacement (TKR) surgery differ dramatically in the speed of their recovery. Previous research has suggested a relationship between the experience of pain and sleep disruptions among patients with chronic pain or those undergoing surgery, such that more severe pain is associated with more frequent awakenings throughout the night. This study examined sleep disruptions 1 month following surgery as a mediator of the relationship between pain 1 month following surgery and functional limitations 3 months following surgery. A total of 110 patients scheduled to undergo unilateral TKR were examined at three time points: 2-3 weeks prior to surgery, 1 month following surgery, and 3 months following surgery. After controlling for presurgical levels of pain, sleep disruptions, and functional limitations, sleep disruptions 1 month following surgery partially mediated the relationship between pain 1 month following surgery and functional limitations 3 months following surgery. The present findings underscore the importance of adequate sleep during postsurgical recovery and suggest that interventions targeting sleep disruptions may improve the speed and quality of patients' recovery from TKR and other surgical procedures.

Objectives: To examine the moderating effects of wives' pain expression (verbal disclosure, nonverbal behavior) on the relationship between wives' pain and husbands' well-being and support provision. Design: Interviews were conducted with couples at baseline; questionnaires were mailed 6 months later. Setting: All women were patients at a rheumatology clinic. Participants: The sample included older women (n ϭ 101) with a diagnosis of osteoarthritis (OA) and their caregiving husbands. Main Outcome Measures: Outcomes were husbands' psychological well-being (depressive symptoms, life satisfaction) and the quality of their support to wives (emotional support, critical attitudes). Results: Verbal and nonverbal expression of OA pain increased the likelihood that women experiencing severe pain would have husbands with poor psychological well-being. Moreover, verbal pain disclosure strengthened the association between the severity of wives' pain and less emotional support from husbands. Conclusions: Findings suggest that wives' verbal and nonverbal communications about their pain, especially about severe pain, have the potential to decrease the psychological well-being and support resources of their caregiving spouses.

No abstract