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Impact of cardiopulmonary resuscitation training on perceived control in spouses of recovering cardiac patients.

The objectives of this study were to determine whether there are differences in emotional distress among spouses of recovering cardiac patients based on level of perceived control, and to determine whether perceived control can be enhanced by cardiopulmonary resuscitation (CPR) training. A total of 219 spouses of cardiac patients recovering from an acute cardiac event were enrolled and 196 completed the study. Spouses were assigned to either a no-treatment control group or one of two CPR training groups. Perceived control and emotional adjustment were measured at baseline and again 1 month after subjects received CPR training. Spouses with high perceived control were less anxious, less depressed, and less hostile at baseline. Perceived control increased significantly in spouses after both CPR training groups, but was unchanged in the control group. After a partner's cardiac event, perceived control is important for psychological recovery in spouses and can be increased by CPR training.

Adaptation, Psychological↗

The psychosocial burden on spouses of the elderly with stroke, dementia and Parkinson's disease.

OBJECTIVE: To characterize the psychosocial burden on spouses living with the elderly suffering from mild dementia, stroke and Parkinson's disease, and to identify patient characteristics associated with it. Materials and methods Data on patient-spouse couples came from three studies of patients with stroke (36 couples), mild dementia (92 couples) and Parkinson's disease (58 couples). The psychosocial burden was recorded by the 15-item Relatives' Stress Scale (RSS). A factor analysis of this instrument produced a one-factor solution (CFI = 0.98) consisting of eight items with good face validity and acceptable reliability within each diagnostic group (Cronbach's alpha range 0.66-0.69). Covariates of this factor were identified using structural equation modeling (SEM) by regression on patient's age, gender, cognitive function (MMSE), activities of daily living (ADL) and depressive symptoms (MADRS). RESULTS: Disorganization of household routines, difficulties with going away for holidays, restrictions on social life, and the disturbances of sleep were the most frequently reported problems in all three groups. According to the mean sumscore on the RSS, the perceived psychosocial burden was similar across the diagnostic groups. In the final SEM model, a lower cognitive function of the patient was associated with a higher psychosocial burden on the spouses of patients with stroke (beta = -1.3, p = 0.01) and Parkinson's disease (beta = -0.89, p < 0.01), while in the dementia group, only an insignificant trend was demonstrated. In the dementia group, a significantly higher burden was identified on female spouses (beta = -0.56, p = 0.04). A heavier burden of care was also associated with depressive symptoms in the patients with Parkinson's disease. In neither group did the final model disclose any effect of ADL function on the spouse's psychosocial burden. CONCLUSION: Spouses caring for patients with dementia, stroke and Parkinson's disease perceive a similar type and level of psychosocial burden, independent of the disease. The cognitive functioning of the patient is a particularly important factor in this, especially when caring for patients with stroke or Parkinson's disease.

Activities of Daily Living↗

Spouse similarity in attitudes, personality, and psychological well-being.

The study of the origin of spouse similarity is interesting because the extent to which spouse similarity reflects genetic resemblance between husbands and wives affects the genetic structure of a population. The sources of observed spouse similarity in attitudes, personality, and psychological well-being are discussed. Analyses based on data collected from an American adult sample assessed longitudinally showed that spouse correlations were high for attitudes and low to moderate for personality and psychological well-being. Four competing explanations to spouse similarity were compared: initial similarity, attrition, convergence, and age covariation. The results did not support the latter three explanations, indicating that initial similarity may be an appropriate interpretation of observed spouse similarity. The findings are consistent with those of other comparable studies.

Adaptation, Psychological↗

Unmet needs in information flow between breast cancer patients, their spouses, and physicians.

This study focused on the needs and sources of disease information of breast cancer patients and their spouses during early disease in two settings: at the department of oncology (AD) and on a rehabilitation course (RC). The aim was to characterize those patients and spouses who are not content with average information. Eighty percent of AD and 31% of RC patients were content with the available information (p < 0.001) and 75% of AD spouses and 43% of RC spouses reported similarly (p = 0.008). Higher education, younger age, and shorter time (<1 year) since diagnosis indicated a greater need for information among patients, whereas among spouses, only education level was associated with it. More information was needed on prognosis, cancer as a disease, its influence on daily life, and treatment effects. In both groups, the same proportion of patients reported to have felt involved in decision making sufficiently (60%), inadequately (27%), and 19% versus 16% did not want to be actively participating in decision making. The patients were mostly satisfied with participation in decision making, but they expressed unsatisfactory needs on information during early years of breast cancer. Similarly, their spouses were not content with available information.

Adult↗

Chronic pain patient-spouse behavioral interactions predict patient disability.

Based on behavioral theory, it has been hypothesized that spouse solicitous responses to the pain behaviors of chronic pain patients may contribute to the maintenance of pain behaviors and disability. Self-report data support this hypothesis, but direct observational measures have not been used to study this association. In this study, 50 chronic pain patients and their spouses were videotaped while engaging in common household activities. and patient pain behaviors and spouse solicitous behaviors were coded from the tapes. Spouse solicitous responses to non-verbal pain behaviors were significant predictors of physical disability in the more depressed patients, and were significant predictors of rate of non-verbal pain behavior in patients who reported greater pain. Spouse solicitous responses did not predict psychosocial dysfunction or total self-reported pain behaviors. The result support behavioral theory and indicate the need for further study of the association between spouse solicitousness and patient pain behaviors/disability.

Adult↗

Depression and health-related quality of life in elderly patients suffering from heart failure and their spouses: a comparative study.

BACKGROUND: Little is known about the factors that influence the health outcome of elderly patients suffering from heart failure or the health of their spouses. The aim of this comparative study was to determine if older patients suffering from heart failure and their spouses experience similar levels of health-related quality of life (HRQOL) and depression. The aim was also to identify those factors that contribute to HRQOL and depression in patient-spouse pairs. METHODS: Data were collected from 47 couples, using the Short Form 36 (SF-36) and Zung Self-rating Depression Scale (SDS) questionnaires. RESULTS: Patients suffering from heart failure and their spouses differed significantly in their experience of the physical, but not the mental, health-related quality of life, with patients experiencing significantly worse physical functioning. Physical symptoms of heart failure seemed to dominate the experience of the patient and was positively related to mental health and inversely related to the New York Heart Association classification (NYHA class) and patients' depression. Depressive symptoms as reflected in SDS showed no significant difference between patients and spouses. Patients' depression was positively related to high NYHA class, while spouse depression was positively related with higher age of the patient. CONCLUSION: Physical symptoms seem to dominate the experience of heart failure.

Aged↗

The lifetime prevalence of abdominal aortic aneurysms among siblings of aneurysm patients is eightfold higher than among siblings of spouses: an analysis of 187 aneurysm families in Nova Scotia, Canada.

BACKGROUND: Abdominal aortic aneurysms (AAAs) are frequently familial. The aim of this study was to compare the prevalence of AAA among the siblings of AAA patients with that in the spouses' siblings. METHODS: The siblings of 375 AAA patients and the siblings of the spouses of the AAA patients were included in this study and offered ultrasonography screening for AAA. Participants were asked to complete a questionnaire to collect demographic and general health information. Statistical analysis was done with Fisher's exact test. Odds ratios and 95% confidence intervals were also calculated. RESULTS: Abdominal ultrasonography examinations were done for 309 individuals. The results indicated that 11 (11.2%) of 98 brothers of AAA patients, 4 (2.7%) of 147 sisters, and none of the 64 siblings of the spouses of the AAA patients were found to have an AAA. Combining the information from the ultrasonography screening and medical records on already known cases of AAA in these families, altogether 29.0% (44/152) of the brothers of AAA patients, 11.1% (20/181) of the sisters of AAA patients, and 2.3% (2/88) of the siblings of the spouses had an AAA. CONCLUSION: There was a significant difference between the siblings of the AAA patients and those of the spouses both in the frequency of AAA detected by ultrasonography screening and in the overall prevalence of AAA. The overall prevalence of AAA in the siblings of AAA patients was about eight times that observed among the siblings of their spouses (19.2% vs 2.3%). These findings confirmed previous reports on high prevalence of AAA among siblings of AAA patients and emphasized the importance of an ultrasonography screening program for siblings of AAA patients.

Age Distribution↗

Spousal congruence on disability, pain, and spouse responses to pain.

We examined congruence between chronic pain patients and their spouses on their reports of patient pain severity, patient disability, and spouse responses to pain. Patients reported that they were more physically and psychosocially disabled than their spouses reported them to be. However, spouses reported that the patients' pain was more severe than patients reported. Depressive disorders in the patient and gender interacted with patient-spouse ratings. For physical and psychosocial disability, depressed patient couples reported significantly larger differences in disability ratings than non-depressed patient couples. In addition, female patients' disability was rated as more severe by the female patients than by their husbands. Male patient couples did not report differences on physical disability. Findings relating to other forms of disability and to spouse responses are also described. The results are discussed in the context of an interpersonal perspective of chronic pain and have implications for the assessment of pain and disability.

Adult↗

The quality of life of spouse dementia caregivers: changes associated with yielding to formal care and widowhood.

The focus of the study was the effect on spouse dementia caregivers of relinquishing care. The study used a longitudinal design, in which a group of 150 dementia caregivers were interviewed 2 years apart (designated Time 1 and Time 2), with data collected from both continuing caregivers and those who had relinquished care. The aims were to determine the extent to which changes over time in quality of life differed between continuing caregivers, those who had yielded to formal care, and those who had been widowed; and to examine whether change in quality of life variables was associated with time since yielding to formal care and time since death of the spouse. Quality of life was defined in terms of health status, psychological well-being, and activity participation. All participants were interviewed in their own homes. Three groups of participants were identified at Time 2: those who continued to provide care for their spouses (n=60); those who had yielded their caregiver role by admitting their spouses to permanent residential care (n=53); and those who had admitted their spouses to permanent institutional care, but whose spouse had then died (n=37). Different patterns of quality of life changes were observed between the three groups, with both positives and negatives associated with disengagement from the caregiving role. Positive changes were particularly evident in psychological well-being and activity participation. These findings were discussed in terms of their relevance for a life transitions approach to the relinquishment of caregiving.

Adaptation, Psychological↗

Spouse similarity for antisocial behaviour in the general population.

BACKGROUND: In contrast with the large amount of research on the familial transmission of antisocial behaviour, few studies have investigated similarity between spouses for such behaviour. In addition, none of these studies have examined child conduct disorder (CCD) and adult antisocial behaviour (AAB) separately. METHOD: We studied 519 pairs of spouses who completed the Diagnostic Interview Schedule. In each pair, one spouse belonged to a random subsample of persons who had participated in a large population survey and was re-interviewed. Association between spouses for lifetime symptoms and DSM-III criteria of CCD, AAB, antisocial personality disorder and co-morbid psychiatric diagnoses was examined with bivariate and multivariate logistic regression analyses. RESULTS: We observed a moderate association between spouses for the presence of CCD (OR = 4.02, 95% CI = 2.03-7.96), and a strong association for the presence of AAB (OR = 20.1, 95 % CI = 5.97-67.5). This similarity for AAB was independent of the similarity for CCD and persisted after adjustment for spousal similarity for disorders co-morbid with AAB. An examination of the relationship between marital status and the presence of CCD and/or AAB in the general population sample (from which originated our sample of couples) suggested that the spousal similarity for AAB was more likely attributable to assortative mating rather than marital contamination. CONCLUSION: Our finding of a strong similarity between spouses for AAB has significant implications for both clinicians and researchers. It also suggests that adult antisocial behaviour should be considered as a distinct diagnostic entity, an approach which diverges from DSM-IV diagnostic criteria.

Adult↗

Expressed emotion and causal attributions in the spouses of depressed patients.

High levels of expressed emotion are thought to be related to the attributions relatives make about the causes of a patient's illness and problem behaviors. Causal attributions occurring during spontaneous speech in 43 spouses of depressed patients were examined. Consistent with theoretical prediction and with previous research in schizophrenia, high critical spouses were more likely than low critical spouses to attribute patients' symptoms and negative behaviors to factors that were controllable by and personal to the patients. High critical spouses also made more attributions that implied that they held patients responsible for their difficulties. Although predictive of spouses' criticism, these attribution dimensions did not predict patient relapse. The results suggest that causal attributions are important for understanding spouses' criticism but are of limited predictive validity with respect to depressive relapse.

Adult↗

Personality development in emerging adulthood: integrating evidence from self-ratings and spouse ratings.

The authors examined self-ratings and spouse ratings in a young adult newlywed sample across a 2-year interval. Rank-order stability correlations were consistently high and did not differ across the 2 types of ratings. As expected, self-ratings showed significant increases in conscientiousness and agreeableness--and declines in neuroticism/negative affectivity--over time. Spouse ratings yielded a very different pattern, however, showing significant decreases in conscientiousness, agreeableness, extraversion, and openness across the study interval. Spouse ratings also showed evidence of a "honeymoon effect," such that they tended to be more positive than self-ratings at Time 1. This effect had dissipated by the 2nd assessment; in fact, the spouse ratings tended to be more negative at Time 2. Analyses of individual-level change revealed little convergence between self- and spouse-rated change, using both raw change scores and reliable change index scores. Finally, correlational and regression analyses indicated that changes in spouse ratings were significantly associated with changes in marital satisfaction; in contrast, changes in self-ratings essentially were unrelated to marital satisfaction. These results highlight the value of collecting multimethod data in studies of adult personality development.

Adolescent↗

Spouses' provision of health-related support and control to patients participating in cardiac rehabilitation.

The authors examined spouses' provision of health-related support and control as predictors of health behavior and mental health among patients participating in cardiac rehabilitation (N = 94 couples). Cross-sectional analyses revealed that spouses' support was positively associated with patient health behavior. Prospective analyses of change over 6 months (N = 65 couples) revealed that spouses' support predicted increased patient mental health, whereas spouses' control predicted decreased patient health behavior and mental health. Findings suggest that spouses' efforts to facilitate patients' healthy lifestyle behaviors are associated with patients' health behavior and mental health, but not always as spouses might intend.

Female↗

Coping strategies and health-related quality of life among spouses of continuous ambulatory peritoneal dialysis, haemodialysis, and transplant patients.

In the study reported here 55 spouses of patients living with end-stage renal disease (ESRD) were investigated with respect to coping strategies and health-related quality of life. Findings from the study were compared to two random samples of the Swedish general population (n = 454, and n = 1200). The study design was correlational and comparative. Coping was measured by the Jalowiec Coping Scale, and quality of life (QoL) by the Swedish Health-Related Quality of Life Survey (SWED-QUAL). Data were analysed using a number of statistical tests including Pearson's product moment correlations, Student's t-test and two way ANOVAs. The combined sample of spouses used significantly more optimistic and palliative coping than the general population, but less confrontative, self-reliant, evasive and emotive coping. In the study fatalistic, evasive and emotive coping was associated with low perceived efficiency in handling various aspects of the partners' situation. The male spouses used significantly less optimistic, supportive and palliative coping than did the female spouses. The spouses of transplant patients had better overall quality of life than the continuous ambulatory peritoneal dialysis and haemodialysis spouse groups, most likely due to the lower age of the former group. The study findings suggest that emotive, evasive and fatalistic coping are less than optimal ways to deal with problems occasioned by the partner's treatment.

Adaptation, Psychological↗

Psychological effects of amniocentesis on women and their spouses: importance of the testing period and genetic counseling.

OBJECTIVE: To evaluate both women's and their spouses' reasons for undergoing amniocentesis, their concerns relating to the procedure as well as their psychological reactions and coping mechanisms during the testing period. METHODS: Eighty-five women undergoing amniocentesis and their spouses took part in the study. The couples completed a questionnaire that provided demographic data and insights into their experiences of amniocentesis. RESULTS: Age was the main reason for undergoing amniocentesis. When they first learned that they were going to undergo amniocentesis, women were more concerned about the potential danger to their fetus than their spouses. Most of participants believed that their pregnancy would continue after amniocentesis. However, they also stated that they were prepared for an abortion. Uncertainty and tension were two significant emotions experienced by couples while waiting for the test results. For the majority of women (80%) and men (42.3%) the strongest support was provided by their spouses during this period. In summary, we can conclude that the test did have a major psychological impact on both women and their spouses, but did not have a negative impact on their coping mechanisms. CONCLUSION: The psychological impact of amniocentesis on women and their spouses does not constitute a major obstacle to their ability to cope. However, a certain number of couples reported feelings of uncertainty, tension and anxiety about fetal injury. We strongly suggest that counseling should be given to high-risk families and that prenatal/antenatal care units must be established.

Adaptation, Psychological↗

Spouses of first-ever stroke victims: sense of coherence in the first phase after stroke.

According to Antonovsky, the individual's sense of coherence is assumed to be crucial in coping with stressful life events. The purpose of this study was to investigate the associations between the sense of coherence of the spouses of stroke victims, the objective severity of the stroke and the spouses' perception of life satisfaction, psychological well-being and cognitive image of life in the future in the first phase after stroke. Eighty-three consecutively enrolled spouses to first-ever stroke victims < 75 years participated. Multiple correlations were done to study the association between Antonovsky's 29-item Sense of Coherence scale and the objective impairments of the stroke victim, the Life Satisfaction Checklist, the "view of the future" and the Psychological General Well-being Index. The sense of coherence was significantly associated with satisfaction with life as a whole before stroke (p < 0.001), partnership (p = 0.002), sexual life (p = 0.005), family life (p < 0.001) and financial situation (p = 0.001). The severity of the impairments of the stroke victims was not significantly associated with the spouses' sense of coherence. However, the sense of coherence was significantly associated with the perception of the future life situation (p = 0.006). The sense of coherence was also significantly associated with the perception of positive well-being (p = 0.007), self-control (p = 0.009), general health (p = 0.009) and vitality (p = 0.002) at the present, whereas the association with anxiety and depressed mood were not statistical significant. In the experience of a stressful life event such as stroke, satisfaction with general life, close relationships and the socio-economic situation were significantly associated with the spouse's sense of coherence. Spouses with a low sense of coherence were more likely to have low psychological well-being and a more pessimistic view of their life in the future.

Activities of Daily Living↗

Physician beliefs about victims of spouse abuse and about the physician role.

Our purpose was to measure the beliefs of physicians about victims of spouse abuse and to examine factors related to holding positive (e.g., supportive) and negative beliefs about providing services to victims of domestic violence. This was a total site sample of 150 physicians (76 responded; RR 51%), surveyed at one time, practicing in a large general hospital and the surrounding urban/periurban area. Four specialities are represented: emergency medicine, family practice, obstetrics-gynecology, and psychiatry. Three aspects of beliefs are measured: beliefs toward physician role in assisting victims of spouse abuse, beliefs about victims of spouse abuse, and beliefs about resources available to physicians to assist victims of spouse abuse. Almost all (97%) physicians believe it is part of their role to assist victims of domestic violence. Almost one third (30%) hold victim-blaming attitudes toward victims of spouse abuse, and the majority (70%) do not believe that they have the resources available to them to assist victims of domestic violence. Being female, younger, practicing obstetrics-gynecology, and having fewer years in practice are all significantly related to holding supportive (positive) beliefs. The majority of negative beliefs held are about resource availability. Hence, training programs may need to be developed locally for physicians and tailored to individual community characteristics. Training programs should also emphasize the importance of understanding the victims of spouse abuse and of not blaming the victims for the violence.

Adult↗

Honeymoons and joint lunches: effects of retirement and spouse's employment on depressive symptoms.

With hypotheses derived from a life course perspective in conjunction with life event stress and role theories, we examine whether a spouse's employment and length of retirement affect a person's postretirement depressive symptoms and whether such effects differ by gender. Analyses use pooled data from Waves 1-4 of the Health and Retirement Survey, using a subsample of married individuals who either remained continuously employed over time or completely retired since the Wave 1 interviews (N = 2,695). Recently retired men seem to be negatively affected by their spouses' continuous employment when compared with men whose wives were continuously not employed. In contrast, spouses' joint retirement has a beneficial influence on both recently retired and longer-retired men. However, for recently retired men, the positive effect of wives' retirement seems to be contingent on spouses' enjoyment of joint activities. Among women, effects of spouses' employment occur only among very recently retired wives (0-6 months). These wives report more depressive symptoms if their spouses were already nonemployed prior to wives' retirement. These results demonstrate the complexity of retirement adaptation processes and suggest that marital context plays an important role in retirement well-being.

Adaptation, Psychological↗