The Impact of Chronic Pain on Marriage and Family

The global impact of chronic pain was borne out by a survey of 4611 individuals (Smith et al., 2001), in which 14.1% reported significant chronic pain and another 6.3% severe chronic pain. The presence of any significant and severe chronic pain had progressively more marked adverse effects on employment, daily activities, and all measured dimensions of general health. The scope of the pain problem is illustrated by a recent survey that reported that 43% of households have at least one family member with chronic pain (King, 2003). In a telephone survey of 2012 adult Canadians, chronic noncancer pain was reported by 29% of the respondents. Almost half were unable to attend social and family events, and the mean number of days absent from work in the past year due to chronic pain was 9.3 (Moulin et al., 2002).

The impact of chronic pain on the general welfare of the family is substantial. A Dutch study revealed that as a result of chronic pain in a partner, spouses invested more time on housekeeping and household maintenance, which resulted in less time for personal needs and leisure activities (Kemler and Furnee, 2002). In a qualitative study of 25 women with fibromyalgia, patients reported on many changes in their family life (Soderberg and Lundman, 2001). The major theme to emerge was that their relationship with their in husband and children had changed. Some of the husbands were understanding, but others were not so understanding of their wife's changed situation. The women's role in the family became more passive; they needed more help from family members. The children had to provide more help than before. Many of the women regretted that they could not take proper care of their aging parents, and that in their intimate relationships the sexual patterns had changed the most. This is indeed a comprehensive list of changes in the overall functioning of the family. In an investigation of the loss of roles and emotional adjustment, Harris et al. (2003) found that greater losses were observed in friendships, occupation, and leisure roles, compared with the family roles. This finding is contrary to the general trend, and it also raises a fundamental question: Can changes in friendships, finances, and leisure leave the family roles unaffected?

That appropriate information about chronic pain can lower the impact on family was reported by Pai (2002) and Loftin (2002). Both investigators found that greater knowledge about chronic pain enhanced patients' coping with this problem.

However, Pai noted that the responsibility of seeking information mostly lay with the patient and his or her partner. Loftin demonstrated that the partner's greater awareness of the patient's pain predicted lower pain severity, lower medication frequency, and greater improvement in the course of the pain condition. In short, the partner's having information about the patient's chronic pain enhanced the patient's quality of life.

Chronic pain or illness in a spouse, depending on a number of factors, is capable of producing profound changes in the functioning on the family. Chronic pain conditions vary in many respects, and yet the population seen at pain clinics tends to be at the extreme end of the continuum of severity and associated disability. This chapter examines, through a comprehensive review of the literature, the impact of a few selected chronic medical conditions on family and couple functioning, role-related issues, and psychological reaction to chronic illness in the healthy spouse or partner. Even a quick review of the chronic pain and family functioning literature reveals a paucity of research on the systemic perspective of family functioning. It is for that reason alone that a somewhat broader net was cast to include a variety of chronic disorders.

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