Article Text

THU0581 Spousal Protective Buffering is Related to a Lower Physical and Mental Quality of Life in Patients with Sjögren’s Syndrome
  1. E. Bossema1,2,
  2. N. van Leeuwen1,
  3. A. A. Kruize3,
  4. H. Bootsma4,
  5. J. W. Bijlsma3,
  6. R. Geenen1,3
  1. 1Department of Clinical and Health Psychology, Utrecht University, Utrecht
  2. 2Master Advanced Nursing Practice, HAN University of Applied Sciences, Nijmegen
  3. 3Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, Utrecht
  4. 4Department of Rheumatology and Clinical Immunology, University Medical Centre Groningen, Groningen, Netherlands


Background Patients with Sjögren’s syndrome are hampered by dryness and fatigue, which impact on quality of life.1,2 Social support –such as the help and understanding of spouses– is assumed to have a beneficial effect on quality of life, either directly (’direct effects hypothesis’) or indirectly by reducing the negative effect of symptoms on quality of life (’buffering hypothesis’).3

Objectives To examine in patients with Sjögren’s syndrome 1) the direct effect of spousal response styles on quality of life, and 2) the moderating effect of spousal response styles on the relation between perceived dryness and fatigue on the one hand and quality of life on the other.

Methods Research participants were 217 female partnered patients with primary Sjögren’s syndrome (mean age 55 years). Three spousal response styles were assessed with the Active Engagement, Protective Buffering and Overprotection Questionnaire4 (Table 1), physical and mental quality of life with the RAND 36-item Health Survey,5 and perceived dryness (the mean of ocular and oral dryness) and fatigue with Visual Analogue Scales. Stepwise hierarchical regression analysis (’enter’ method) was applied, including age in the first step.

Results Of the three spousal response styles, only protective buffering was associated with a lower physical and mental quality of life (β = -0.20, p =.01 and β = -0.28, p <.001, repectively). There was no moderating effect of any spousal response style on the existing negative relations between symptoms on the one hand and physical or mental quality of life on the other (β ≤ 0.10, p ≥.19).

Conclusions The results suggest that the hiding of concerns by the spouse of a female patient with Sjögren’s syndrome could be harmful for quality of life. However, this protective buffering or other spousal response styles do not buffer or aggravate the impact of symptoms on quality of life. If future longitudinal research verifies the causality between spousal protective buffering and quality of life, then improving this spousal response style may lead to a better quality of life, irrespective of the severity of dryness or fatigue.


  1. Vitali et al. Ann Rheum Dis 2002;61:554-8.

  2. Meijer et al. Rheumatol (Oxford) 2009;48:1077-82.

  3. Cohen et al. Psychol Bull 1985;98:310-57.

  4. Buunk et al. Gedrag Gezondheid 1996;24:304–13.

  5. Van der Zee et al. Int J Behav Med 1996;3:104-22.

  6. Kool et al. J Sex Marital Ther 2006;32:409-23.

Disclosure of Interest None Declared

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.