Comparing the Effectiveness of Couple-oriented Emotional-Cognitive-Behavioral Intervention and Patient-oriented Cognitive-Behavioral Intervention on Improving the Quality of Marital Relationship in Women with Rheumatoid Arthritis: A Pilot Study

Rheumatoid Arthritis (RA) is a chronic autoimmune disorder. Besides its physical effect on the body، it could also cause depression and anxiety which could affect spouse and the rest of the family. The aim of this study was to design and test the effectiveness of a couple-oriented emotional-cognitive-behavioral intervention model and compare it with a patient-oriented cognitive-behavioral intervention model on improving the quality of the relationship between couples in women suffering from rheumatoid arthritis.

The research design was quasi-experimental with a pre-test، a post-test and 3 months of follow-up. The research samples consisted of 90 women with rheumatoid arthritis participated in this study through judgmental sampling. They were assigned to three groups including couple-oriented group، patient-oriented group and control group. The data was gathered through Golombok- Rust Inventory of Marital State (GRIMS) that was filled by participations at the pre-test، post-test and follow-up after 3 months. The inflammatory marker CRP levels were also measured through blood tests before and after interventions. The experimental groups participated in couple-oriented intervention (7 sessions with couples) and patient-oriented (7 sessions only with patients) and the control group remained on the waiting list. Data was analyzed using repeated measures multivariate analysis of variance (MANOVA) and Post hoc test through SPSS16.

Despite the effectiveness of both types of intervention، the couple-oriented intervention had more effect size (d = 0. 20) compared with patient-oriented intervention (d=0. 06) on the quality of the marital relationship even in three-month follow-up. Despite the reduction of inflammatory marker CRP levels in posttest، still there was no significant difference (F (2،87) = 0. 33; p<0. 71) in the levels of the inflammatory marker in pre and posttests of the 3 groups.

The couple-oriented emotional cognitive-behavioral-intervention can be used as an effective intervention to improve marital state in patients with rheumatoid arthritis.