Abstract
This systematic review of qualitative studies synthesised evidence on the experience chronic pain from the perspective of romantic partners. Medline via Ovid, Embase via Ovid, CINAHL via EBSCO, APA PsycInfo via Ovid, Scopus, and Web of Science databases were searched. Studies exploring the impact of chronic pain from partners’ perspectives using qualitative data collection methods were eligible for inclusion. Thematic synthesis was conducted, and confidence in the review findings was assessed using GRADE CERQual criteria. A total of 198 participants were represented from 15 primary studies. Four interconnected analytical themes were developed: ‘life is different’, ‘internal conflict between two worlds’, ‘togetherness vs separateness’, and ‘coping in the longer term’. Out of 27 review findings, 9 were assessed as high confidence, 12 as moderate confidence, 4 as low confidence, and 2 as very low confidence. Socially isolated partners, those in strained relationships, and partners who continually sacrificed their own needs were more likely to experience distressing emotions. Greater recognition of partners’ needs is needed within pain management services.
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Data Availability
There is no dataset associated with this review as Copyright is held by publishers of the primary studies.
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References
Acitelli, L. K., & Badr, H. J. (2005). My illness or our illness? Attending to the relationship when one partner is ill. In T. A. Revenson, K. Kayser, & G. Bodenmann (Eds.), Couples Coping with Stress: Emerging Perspectives on Dyadic Coping (pp. 121–136). American Psychological Association. https://doi.org/10.1037/11031-006
Ayache, R. A., & Goutaudier, N. (2022). Posttraumatic growth and pain acceptance: A profile analysis of chronic pain experience. Canadian Journal of Behavioural Science, 54, 163–172. https://doi.org/10.1037/cbs0000289
Bailly, F., Foltz, V., Rozenberg, S., Fautrel, B., & Gossec, L. (2015). The impact of chronic low back pain is partly related to loss of social role: A qualitative study. Joint, Bone, Spine, 82, 437–441. https://doi.org/10.1016/j.jbspin.2015.02.019
Bair, M. J., Robinson, R. L., Katon, W., & Kroenke, K. (2003). Depression and pain comorbidity: A literature review. Archives of Internal Medicine, 163, 2433–2445. https://doi.org/10.1001/archinte.163.20.2433
Becvar, D. S. (2007). Families That Flourish: Facilitating Resilience in Clinical Practice. WW Norton & Company.
Blyth, F. M., MacFarlane, G. J., & Nicholas, M. K. (2007). The contribution of psychosocial factors to the development of chronic pain: The key to better outcomes for patients? Pain, 129, 8–11. https://doi.org/10.1016/j.pain.2007.03.009
Booth, A., Noyes, J., Flemming, K., Gerhardus, A., Wahlster, P., van der Wilt, G. J., Mozygemba, K., Refolo, P., Sacchini, D., Tummers, M., & Rehfuess, E. (2018). Structured methodology review identified seven (RETREAT) criteria for selecting qualitative evidence synthesis approaches. Journal of Clinical Epidemiology, 99, 41–52. https://doi.org/10.1016/j.jclinepi.2018.03.003
Braun, V., & Clarke, V. (2013). Successful Qualitative Research: A Practical Guide for Beginners. Sage.
Brown, K. S. (2007). Dyspareunia due to endometriosis: A qualitative study of its effect on the couple relationship. ProQuest Dissertations Publishing. [Doctoral dissertation, Syracuse University].
Busse, J. W., Wang, L., Kamaleldin, M., Craigie, S., Riva, J. J., Montoya, L., Mulla, S. M., Lopes, L. C., Vogel, N., Chen, E., Kirmayr, K., De Oliveira, K., Olivieri, L., Kaushal, A., Chaparro, L. E., Oyberman, I., Agarwal, A., Couban, R., Tsoi, L., ..., Guyatt, G. H. (2018). Opioids for chronic noncancer pain: A systematic review and meta-analysis. JAMA, 320, 2448–2460. https://doi.org/10.1001/jama.2018.18472
Cano, A., Corley, A. M., Clark, S. M., & Martinez, S. C. (2018). A couple-based psychological treatment for chronic pain and relationship distress. Cognitive and Behavioral Practice, 25, 119–134. https://doi.org/10.1016/j.cbpra.2017.02.003
Che, X., Cash, R., Ng, S. K., Fitzgerald, P., & Fitzgibbon, B. M. (2018). A systematic review of the processes underlying the main and the buffering effect of social support on the experience of pain. The Clinical Journal of Pain, 34, 1061–1076. https://doi.org/10.1097/AJP.0000000000000624
Cochrane Effective Practice and Organisation of Care (EPOC). (2019, October 03). EPOC Qualitative Evidence Syntheses guidance on when to sample and how to develop a purposive sampling frame. https://epoc.cochrane.org/sites/epoc.cochrane.org/files/public/uploads/Resources-for-authors2017/qes_guidance_on_sampling.pdf
Cohn, M. W. (2020). The caregiver’s experience of chronic headache: A qualitative study. ProQuest Dissertations Publishing. [Doctoral Dissertation, The Alder University].
Cooper, S., & Gilbert, L. (2017). An exploratory study of the experience of fibromyalgia diagnosis in South Africa. Health, 21, 337–353. https://doi.org/10.1177/1363459316677623
Critical Appraisal Skills Programme (2018). CASP Qualitative Checklist. https://casp-uk.net/wp-content/uploads/2018/01/CASP-Qualitative-Checklist-2018.pdf
Culley, L., Law, C., Hudson, N., Mitchell, H., Denny, E., & Raine-Fenning, N. (2017). A qualitative study of the impact of endometriosis on male partners. Human Reproduction, 32, 1667–1673. https://doi.org/10.1093/humrep/dex221
De Ruddere, L., & Craig, K. D. (2016). Understanding stigma and chronic pain: A-state-of-the-art review. Pain, 157, 1607–1610. https://doi.org/10.1097/j.pain.0000000000000512
Driscoll, M. A., Edwards, R. R., Becker, W. C., Kaptchuk, T. J., & Kerns, R. D. (2021). Psychological interventions for the treatment of chronic pain in adults. Psychological Science in the Public Interest: A Journal of the American Psychological Society, 22, 52–95. https://doi.org/10.1177/15291006211008157
Dueñas, M., Ojeda, B., Salazar, A., Mico, J. A., & Failde, I. (2016). A review of chronic pain impact on patients, their social environment and the health care system. Journal of Pain Research, 9, 457–467. https://doi.org/10.2147/JPR.S105892
Elphick, C. (2004). Involving partners in pain management programmes. Clinical Psychology Forum, 39, 23–36.
Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129–136. https://doi.org/10.1126/science.847460
Fallatah, F., & Edge, D. S. (2015). Social support needs of families: The context of rheumatoid arthritis. Applied Nursing Research, 28, 180–185. https://doi.org/10.1016/j.apnr.2014.10.004
Fernandez, I., Reid, C., & Dziurawiec, S. (2006). Living with endometriosis: The perspective of male partners. Journal of Psychosomatic Research, 61, 433–438. https://doi.org/10.1016/j.jpsychores.2006.06.003
Flemming, K., & Noyes, J. (2021). Qualitative evidence synthesis: Where are we at? International Journal of Qualitative Methods, 20, 1–13. https://doi.org/10.1177/1609406921993276
Flor, H., Turk, D. C., & Scholz, O. B. (1987). Impact of chronic pain on the spouse: Marital, emotional and physical consequences. Journal of Psychosomatic Research, 31, 63–71. https://doi.org/10.1016/0022-3999(87)90099-7
Garg, R., Rebić, N., Amiri, N., Hazlewood, G., Baldwin, C., Ensworth, S., Proulx, L., & De Vera, M. A. (2021). Partners of female patients with rheumatoid arthritis and reproductive decision-making: A constructivist grounded theory study. Rheumatology Advances in Practice, 5, 1–9. https://doi.org/10.1093/rap/rkab040
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007). The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin, 133, 581–624. https://doi.org/10.1037/0033-2909.133.4.581
Haddaway, N. R., Collins, A. M., Coughlin, D., & Kirk, S. (2015). The Role of Google Scholar in Evidence Reviews and its Applicability to Grey Literature Searching. PLoS ONE, 10, e0138237. https://doi.org/10.1371/journal.pone.0138237
Hudson, N., Law, C., Culley, L., Mitchell, H., Denny, E., Norton, W., & Raine-Fenning, N. (2020). Men, chronic illness and healthwork: Accounts from male partners of women with endometriosis. Sociology of Health & Illness, 42, 1532–1547. https://doi.org/10.1111/1467-9566.13144
International Association for the Study of Pain. (2019). Chronic pain has arrived in the ICD-11. https://www.iasp-pain.org/PublicationsNews/NewsDetail.aspx?ItemNumber=8340
Katon, W., & Ciechanowski, P. (2002). Impact of major depression on chronic medical illness. Journal of Psychosomatic Research, 53, 859–863. https://doi.org/10.1016/s0022-3999(02)00313-6
Keefe, F. J., Caldwell, D. S., Baucom, D., Salley, A., Robinson, E., Timmons, K., Beaupre, P., Weisberg, J., & Helms, M. (1996). Spouse-assisted coping skills training in the management of osteoarthritic knee pain. Arthritis Care & Research, 9, 279–291. https://doi.org/10.1002/1529-0131(199608)9:4%3c279::AID-ANR1790090413%3e3.0.CO;2-6
Khanom, S., McDonagh, J. E., Briggs, M., Bakir, E., & McBeth, J. (2020). Adolescents’ experiences of fluctuating pain in musculoskeletal disorders: A qualitative systematic review and thematic synthesis. BMC Musculoskeletal Disorders, 21, 645. https://doi.org/10.1186/s12891-020-03627-1
Kindt, S., Vansteenkiste, M., Loeys, T., Cano, A., Lauwerier, E., Verhofstadt, L. L., & Goubert, L. (2015). When is helping your partner with chronic pain a burden? The relation between helping motivation and personal and relational functioning. Pain medicine (Malden, Mass.), 16, 1732–1744. https://doi.org/10.1111/pme.12766
Knight, J. A., Green, S., & Hinson, W. (1997). Chronic pelvic pain: A systemic approach to assessment and treatment. Families, Systems, & Health, 15, 135–146. https://doi.org/10.1037/h0089796
Lewandowski, W., Morris, R., Draucker, C. B., & Risko, J. (2007). Chronic pain and the family: Theory-driven treatment approaches. Issues in Mental Health Nursing, 28, 1019–1044. https://doi.org/10.1080/01612840701522200
Lewin, S., Booth, A., Glenton, C., Munthe-Kaas, H., Rashidian, A., Wainwright, M., Bohren, M. A., Tunçalp, Ö., Colvin, C. J., Garside, R., Carlsen, B., Langlois, E. V., & Noyes, J. (2018a). Applying GRADE-CERQual to qualitative evidence synthesis findings: Introduction to the series. Implementation Science, 13, 1–10. https://doi.org/10.1186/s13012-017-0688-3
Lewin, S., Bohren, M., Rashidian, A., Munthe-Kaas, H., Glenton, C., Colvin, C. J., Garside, R., Noyes, J., Booth, A., Tunçalp, Ö., Wainwright, M., Flottorp, S., Tucker, J. D., & Carlsen, B. (2018b). Applying GRADE CERQual to qualitative evidence synthesis findings-paper 2: How to make an overall CERQual assessment of confidence and create a Summary of Qualitative Findings table. Implementation Science, 13, 11–23. https://doi.org/10.1186/s13012-017-0689-2
López-Martínez, A. E., Esteve-Zarazaga, R., & Ramírez-Maestre, C. (2008). Perceived social support and coping responses are independent variables explaining pain adjustment among chronic pain patients. The Journal of Pain, 9, 373–379. https://doi.org/10.1016/j.jpain.2007.12.002
MacAdams, E. I. (2021). Silent sufferers and unseen warriors: The significant other’s experience of chronic pain. ProQuest Dissertations Publishing. [Doctoral Dissertation, Michigan School of Psychology].
MacKay, A. (1996). The experience of female spouses of chronic low back pain sufferers. ProQuest Dissertations Publishing. [Doctoral dissertation, The University of Alberta].
McCracken, L. M. (2005). Social context and acceptance of chronic pain: The role of solicitous and punishing responses. Pain, 113, 155–159. https://doi.org/10.1016/j.pain.2004.10.004
McPhee, D. P., & Robinson, W. D. (2020). Couples living with chronic migraines: A phenomenological study. Contemporary Family Therapy, 42, 271–283. https://doi.org/10.1007/s10591-019-09513-w
Martire, L. M., Schulz, R., Keefe, F. J., Starz, T. W., Osial, T. A., Jr., Dew, M. A., & Reynolds, C. F. (2003). Feasibility of a dyadic intervention for management of osteoarthritis: A pilot study with older patients and their spousal caregivers. Aging & Mental Health, 7, 53–60. https://doi.org/10.1080/1360786021000007045
Mason, B. (2003). The development of a relational approach to the understanding, treatment and management of chronic pain [Doctoral dissertation, University of East London]. EThOS e-theses online service.
Matheson, L., Harcourt, D., & Hewlett, S. (2010). “Your whole life, your whole world, it changes”: Partners’ experiences of living with rheumatoid arthritis. Musculoskeletal Care, 8, 46–54. https://doi.org/10.1002/msc.165
Miller, J., & Timson, D. (2004). Exploring the experiences of partners who live with a chronic low back pain sufferer. Health & Social Care in the Community, 12, 34–42. https://doi.org/10.1111/j.1365-2524.2004.00466.x
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine, 6, e1000097. https://doi.org/10.1371/journal.pmed.1000097
National Institute of Clinical Excellence. (2021, April 07). Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. https://www.nice.org.uk/guidance/ng193.
Nevis, I. F., Sikich, N., Ye, C., & Kabali, C. (2015). Quality control tool for screening titles and abstracts by second reviewer: QCTSTAR. Journal of Biometrics & BiostatIstics, 6, 230–235. https://doi.org/10.4172/2155-6180.1000230
NHS Inform (2021, June 16) Chronic Pain. https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/chronic-pain
Noyes, J., Booth, A., Flemming, K., Garside, R., Harden, A., Lewin, S., Pantoja, T., Hannes, K., Cargo, M., & Thomas, J. (2018). Cochrane Qualitative and Implementation Methods Group guidance series-paper 3: Methods for assessing methodological limitations, data extraction and synthesis, and confidence in synthesized qualitative findings. Journal of Clinical Epidemiology, 97, 49–58. https://doi.org/10.1016/j.jclinepi.2017.06.020
Nichols, V. P., Ellard, D. R., Griffiths, F. E., Kamal, A., Underwood, M., Taylor, S., CHESS team. (2017). The lived experience of chronic headache: A systematic review and synthesis of the qualitative literature. BMJ Open, 7, e019929. https://doi.org/10.1136/bmjopen-2017-019929
Paulson, M., Norberg, A., & Söderberg, S. (2003). Living in the shadow of fibromyalgic pain: The meaning of female partners’ experiences. Journal of Clinical Nursing, 12, 235–243. https://doi.org/10.1046/j.1365-2702.2003.00733.x
Riva, P., Wesselmann, E. D., Wirth, J. H., Carter-Sowell, A. R., & Williams, K. D. (2014). When pain does not heal: The common antecedents and consequences of chronic social and physical pain. Basic and Applied Social Psychology, 36, 329–346. https://doi.org/10.1080/01973533.2014.917975
Rokach, A., Rosenstreich, E., Brill, S., & Goor Aryeh, I. (2016). Caregivers of chronic pain patients: Their loneliness and burden. Nursing and Palliative Care, 1, 111–117. https://doi.org/10.15761/NPC.1000128
Romero-Alcalá, P., Hernández-Padilla, J. M., Fernández-Sola, C., Coín-Pérez-Carrasco, M., Ramos-Rodríguez, C., Ruiz-Fernández, M. D., & Granero-Molina, J. (2019). Sexuality in male partners of women with fibromyalgia syndrome: A qualitative study. PLoS ONE, 14, e0224990. https://doi.org/10.1371/journal.pone.0224990
Sadownik, L. A., Smith, K. B., Hui, A., & Brotto, L. A. (2017). The impact of a woman’s dyspareunia and its treatment on her intimate partner: A qualitative analysis. Journal of Sex & Marital Therapy, 43, 529–542. https://doi.org/10.1080/0092623X.2016.1208697
Schulz, R., Newsom, J., Mittelmark, M., Burton, L., Hirsch, C., & Jackson, S. (1997). Health effects of caregiving: The caregiver health effects study: An ancillary study of the Cardiovascular Health Study. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 19, 110–116. https://doi.org/10.1007/BF02883327
Snelgrove, S., & Liossi, C. (2013). Living with chronic low back pain: A meta synthesis of qualitative research. Chronic Illness, 9, 283–301. https://doi.org/10.1177/1742395313476901
Söderberg, S., Strand, M., Haapala, M., & Lundman, B. (2003). Living with a woman with fibromyalgia from the perspective of the husband. Journal of Advanced Nursing, 42, 143–150. https://doi.org/10.1046/j.1365-2648.2003.02597.x
Tedeschi, R. G., & Calhoun, L. G. (2004). Target Article: “Posttraumatic growth: Conceptual foundations and empirical evidence.” Psychological Inquiry, 15, 1–18. https://doi.org/10.1207/s15327965pli1501_01
Tankha, H., Caño, A., Corley, A., Dillaway, H., Lumley, M. A., & Clark, S. (2020). A novel couple-based intervention for chronic pain and relationship distress: A pilot study. Couple & Family Psychology, 9, 13–32. https://doi.org/10.1037/cfp0000131
Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8, 1–10. https://doi.org/10.1186/1471-2288-8-45
Tong, A., Flemming, K., McInnes, E., Oliver, S., & Craig, J. (2012). Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Medical Research Methodology, 12, 1–8. https://doi.org/10.1186/1471-2288-12-181
Toye, F., Seers, K., Allcock, N., Briggs, M., Carr, E., Andrews, J., & Barker, K. (2013). A meta-ethnography of patients’ experience of chronic non-malignant musculoskeletal pain. NIHR Journals Library.
Toye, F., Seers, K., Hannink, E., & Barker, K. (2017). A mega-ethnography of eleven qualitative evidence syntheses exploring the experience of living with chronic non-malignant pain. BMC Medical Research Methodology, 17, 1–11. https://doi.org/10.1186/s12874-017-0392-7
Treede, R. D., Rief, W., Barke, A., Aziz, Q., Bennett, M. I., Benoliel, R., Cohen, M., Evers, S., Finnerup, N. B., First, M. B., Giamberardino, M. A., Kaasa, S., Korwisi, B., Kosek, E., Lavhomme, P., Nicholas, M., Perrot, S., Scholz, J., Schug, S., ..., Wang, S. J. (2019). Chronic pain as a symptom or a disease: The IASP classification of chronic pain for the International Classification of Diseases (ICD-11). Pain, 160, 19–27. https://doi.org/10.1097/j.pain.0000000000001384
Wallis, J. A., Taylor, N. F., Bunzli, S., & Shields, N. (2019). Experience of living with knee osteoarthritis: A systematic review of qualitative studies. British Medical Journal Open, 9, e030060. https://doi.org/10.1136/bmjopen-2019-030060
West, C., Usher, K., Foster, K., & Stewart, L. (2012). Chronic pain and the family: The experience of the partners of people living with chronic pain. Journal of Clinical Nursing, 21, 3352–3360. https://doi.org/10.1111/j.1365-2702.2012.04215.x
World Health Organization. (2020, February). International Classification of Diseases for mortality and morbidity statistics 11th Revision (ICD-11). https://icd.who.int/browse11/l-m/en
Acknowledgements
The library service at Newcastle University assisted with operationalising the search across databases. Kathryn Ragan (Trainee Clinical Psychologist, Newcastle University) contributed to the review by second-screening a random sample (10%) of papers at full-text level. Guidance on conducting a qualitative evidence synthesis was sought from Professor Mark Freeston (School of Psychology, Newcastle University) and Dr Rowan Tinlin (School of Psychology, Newcastle University). Published resources and training videos from the Cochrane Qualitative and Implementation Methods Group were used as guidance for carrying out the review.
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This study was completed in part-fulfilment of a Doctorate in Clinical Psychology degree. There was no grant funding associated with it.
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All authors contributed to the systematic review’s conception. Searching and screening were conducted by Claire Borthwick. Chris Penlington and Claire Borthwick carried out coding, data analysis, and synthesis. The original draft was written by Claire Borthwick, with supervision, reviewing, and editing from Lucy Robinson and Chris Penlington. All authors read and approved the final manuscript.
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Borthwick, C., Penlington, C. & Robinson, L. Partners’ Experiences of Chronic Pain: A Qualitative Evidence Synthesis. J Clin Psychol Med Settings (2024). https://doi.org/10.1007/s10880-024-10012-w
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DOI: https://doi.org/10.1007/s10880-024-10012-w