Abstract
This conceptual article aims to propose a framework of understanding the risk and resistance factors that contribute to the adjustment of spousal caregivers of chronic pain patients (SCCPP). A comprehensive review of literature related to caregivers of patients with chronic pain was performed. Findings from the review were applied to the Wallander et al.’s Risk and Resistance Model of Adjustment, specifically examining outcomes among SCCPP. No statistical results are presented in this conceptual article. We advocate for the need to study and test the adjustment process of SCCPP in a systematic, comprehensive, and theory-driven manner to further understand caregivers’ strengths and challenges. This will allow for further rehabilitation interventions to address risk factors and promote resistance factors, allowing for more inclusive mental health care for SCCPP.
Highlights
Caregivers of persons with chronic illness are at risk of stress and adjustment-related problems, including physical and psychological health impairments, disruptions in family dynamics, and decreased relationship satisfaction and quality of life (Burton, Newsom, Schulz, Hirsch, & German, 1997; Chronister & Chan, 2006; De Frias, Tuokko, & Rosenberg, 2005)
The importance of understanding the role of the caregiver in the adjustment process is underscored by a general shift in the health care system
Literature on caregiver adjustment to other disabilities stresses the need for a caregiver of persons with chronic pain model that considers psychological protective factors such as family strength, resiliency, coping, and well-being
Summary
The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage” (IASP Subcommittee on Taxonomy, 2003). The second resistance construct consists of intrapersonal, that is, internal characteristics of the affected individual (in this case the SCCPP) when faced with the stresses and challenges of caregiving, as well as internal characteristics of the chronic pain patients Such variables will be discussed in relation to the SCCPPs’ framework of adjustment and include sense of coherence, self-efficacy, locus of control, optimism, and personality. Porter et al, (2012) reported that spouses of lung cancer patients with an anxious attachment style had higher levels of caregiving strain, and those with avoidant attachment style experienced lower levels of marital adjustment and lower self-efficacy in relation to assisting the patients This evidence supports the importance of examining the impact of intrapersonal variables of chronic pain patients and SCCPP in further understanding SCCPP’s adjustment process. There may be other environmental factors that may affect caregivers’ adjustment, including accessibility, availability, and affordability of health care
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