Illness perceptions and dyadic efficacy in women with rheumatoid arthritis and their husbands

This research addressed how married couples approach, conceptualize, and work as a team to manage rheumatoid arthritis (RA). This study examined from a dyadic perspective two important intrapersonal aspects of Leventhal's Self Regulatory Model (1984)---illness perceptions and self-efficacy. After a measure development pilot study, couple illness perception congruence (the degree of similarity between wife and husband illness perceptions) and dyadic efficacy (perceptions of confidence concerning the dyad's abilities to manage RA as a team) were independently examined as predictors of beneficial outcomes in women with RA. Women with RA and their husbands (n = 190 couples) were recruited for the study (with baseline and 4-month follow-up mailed surveys).; Factor analyses of the new dyadic efficacy items yielded three factors in both female and male versions, concerning Arthritis Problem Solving and Emotions, Active Arthritis Management Strategies, and Arthritis-related Couple Outcomes. The items in each subscale demonstrated high factor loadings and reliability (all alphas ≥0.90); initial evidence of construct validity was also demonstrated.; Illness perception congruence in couples significantly predicted women's subsequent psychological adjustment. When partners shared beliefs about women's personal control over RA and the cyclic nature of RA, women had better psychological adjustment. Women also had less negative affect when they shared beliefs with their husbands about the consequences of RA. Illness perception congruence concerning both illness emotions and timeline was unrelated to adjustment.; There was a reciprocal relationship between dyadic efficacy and marital satisfaction. Also, dyadic efficacy partially mediated the relationship between the extent to which women felt their husbands understood their RA and women's individual perceptions of illness control. Women who were more satisfied with their marriages and believed their husbands understood their arthritis more, had greater confidence in their abilities to work as a team with their husbands to manage RA. Further, women with enhanced dyadic efficacy believed they had more control over their illness.; This research offers support for a dyadic approach to understanding how couples cope with a long-term illness. Future research should examine how couples' illness perceptions and dyadic efficacy relate to support and self-management behaviors and explore intervention possibilities.