PATIENT PREDICTORS OF CAREGIVER BURDEN, OPTIMISM, AND PESSIMISM IN RHEUMATOID-ARTHRITIS

The authors of the present study investigated the relationship between rheumatoid arthritis (RA) patients' demographic, medical, and functio nal status and caregivers' burden, optimism, and pessimism. Subjects w ere 65 RA patients and their caregivers who were recruited from an out patient rheumatology clinic. Each caregiver completed the Burden Inter view to measure caregiver burden and the Life Orientation Test to meas ure optimism and pessimism. Each RA patient completed the Arthritis Im pact Measurement Scale to measure pain and physical disability as well as a number of cognitive measures to assess two summary psychological cognitive factors labeled self-efficacy expectations and distorted co gnitions. These cognitive factors were based on the following commonly used measures in RA research: the Cognitive Errors Questionnaire, the Arthritis Self-Efficacy Scale, the Coping Strategies Questionnaire, a nd the Pain Beliefs and Perceptions Inventory. Correlational analyses indicated that patients' functional and psychological measures (includ ing poor self-efficacy expectations regarding symptoms) were related t o caregiver burden, that patient self-efficacy expectations were relat ed to caregiver optimism, and that patient physical disability war rel ated to caregiver pessimism. Regression analyses revealed that, when c ompeting with other demographic and disease severity variables, the re lationships between patient self-efficacy expectations and caregiver b urden and caregiver optimism, and patient physical function and caregi ver pessimism remained significant. Taken together, these findings sug gest that patient expectancies about control over arthritis-related sy mptoms (including pain) are strongly related to caregiver burden and c aregiver optimism and that patient physical status ir; strongly relate d to caregiver pessimism.