Partner Burden: A Common Entity in Celiac Disease.

Abstract

Caregiver burden is documented in several chronic diseases, but it has not been investigated in celiac disease (CD). We aim to quantify the burden to partners of CD patients and identify factors that affect the perceived burden. We surveyed patients with biopsy-proven CD and their partners. Patients completed CD-specific questions, including the validated Celiac Symptom Index (CSI) survey. Partners completed the validated Zarit Burden Interview (ZBI) and questions regarding sexual and relationship satisfaction. Univariable and multivariable analyses were used to assess the association between demographics, CD characteristics, and partner burden. In total, 94 patient/partner pairs were studied. Fifteen patients (16%) reported a CSI score associated with a poor quality of life, and 34 partners (37%) reported a ZBI score corresponding to mild-to-moderate burden. Twenty-two partners (23%) reported moderate-to-low overall relationship satisfaction, and 12 (14%) reported moderate-to-low sexual satisfaction. The degree of partner burden was directly correlated with patient CSI score (r=0.27; p=0.008), and there were moderate-to-strong inverse relationships between partners' burden and relationship quality (r=-0.70; p<0.001) and sexual satisfaction (r=-0.42; p<0.001). On multivariable logistic regression, predictors of mild-to-moderate partner burden were low partner relationship satisfaction (OR 17.06, 95% CI 2.88-101.09, p=0.002) and relationship duration ≥10years (OR 14.42, 95% CI 1.69-123.84, p=0.02). Partner burden is common in CD, with more than one-third of partners experiencing mild-to-moderate burden. Partner burden is directly correlated with patient symptom severity, and it increases with poorer sexual and relationship satisfaction. Healthcare providers should address relationship factors in their care of patients with CD.