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Declaration of Independence: Relationships between Osteoarthritis Patients' Need for Independence, Spousal Support, and Patient and Spouse Outcomes
Kiste, Gwendolyn Margaret Ann

2009, MA, Kent State University, College of Arts and Sciences / Department of Psychology.
Need for independence refers to the importance that one places on being able to perform activities on one’s own. The present study investigated the impact of need for independence on osteoarthritis (OA) patients and their spouses. Specifically, the study examined patients’ need for independence as it related to their participation in instrumental activities in and around the household as well as the relationship between patients’ need for independence and spousal support as it related to patient and spouse outcomes. It was hypothesized that patients with higher need for independence would participate in more household chores and outdoor work after considering their OA-related disability. Using person-environment fit theory, it was predicted that among patients with high need for independence, as spouses provided more support, patients would report greater depressive symptoms and lower self-efficacy for coping with OA pain. Similarly, among couples in which patients had high need for independence, as spouses provided more support, spouses would report greater depressive symptoms and more critical attitudes toward patients’ ability to cope with OA pain. There was hypothesized to be no relationship at low need for independence for patients or spouses. Couples (N = 221) were recruited from rheumatology clinics in western Pennsylvania. Patients had to be married, at least 50 years old, and diagnosed with knee or hip OA that caused them at least moderate pain. Interviews were conducted separately with patients and spouses, and couples each underwent functional assessments as well completed questionnaires via mail. As predicted, patients with higher need for independence were involved with more household chores and outdoor work despite their disability. Also, as hypothesized, among patients with high need for independence, greater spousal support was associated with more depressive symptoms for patients. However, there was no relationship between spousal support and patients’ self-efficacy at high need for independence. Although it was not predicted, among patients with low need for independence, greater spousal support was related to fewer depressive symptoms and greater self-efficacy for patients. Finally, as predicted, among couples in which patients had high need for independence, greater spousal support was associated with more depressive symptoms and more critical attitudes among spouses. As hypothesized, there was no relationship for spouse outcomes at low need for independence. These results highlight the importance of patients’ need for independence and reveal that both patients and spouses can be negatively impacted by a mismatch between patients’ needs and spouses’ support.
Mary Ann Stephens (Advisor)
John Updegraff (Committee Member)
Joel Hughes (Committee Member)
Kristin Mickelson (Committee Member)
71 p.

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Kiste, G. (2009). Declaration of Independence: Relationships between Osteoarthritis Patients' Need for Independence, Spousal Support, and Patient and Spouse Outcomes. (Electronic Thesis or Dissertation). Retrieved from https://etd.ohiolink.edu/

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Kiste, Gwendolyn. "Declaration of Independence: Relationships between Osteoarthritis Patients' Need for Independence, Spousal Support, and Patient and Spouse Outcomes." Electronic Thesis or Dissertation. Kent State University, 2009. OhioLINK Electronic Theses and Dissertations Center. 27 Apr 2015.

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Kiste, Gwendolyn "Declaration of Independence: Relationships between Osteoarthritis Patients' Need for Independence, Spousal Support, and Patient and Spouse Outcomes." Electronic Thesis or Dissertation. Kent State University, 2009. https://etd.ohiolink.edu/

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