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PubMed1995

Job autonomy and control over one's spouse: a compensatory process.

This research addresses the relationship between work conditions and family life by examining job autonomy and control over one's spouse. While research has shown that low job autonomy can lead to depression, this study examines a different response to low job autonomy: controlling one's spouse. Using a sample of newly married couples from the first two waves of a three-year longitudinal study where respondents are queried about their job, relations with their spouses, and self-feelings, the results show that individuals respond to reduced job autonomy not only by becoming depressed, but also by controlling their spouses. Depression and control over one's spouse are independent and not alternative responses to low job autonomy. These results hold for Year 1 and for Year 2, and they hold for husbands as well as wives. The findings are understood in terms of the compensatory process of control. Broadly speaking, negative work conditions influence relations at home, and controlling the spouse may serve to reclaim the self-view that one has control over the environment.

Adaptation, Psychological↗
PubMedDate not supplied

Spouse abuse, patient-physician communication, and patient satisfaction.

INTRODUCTION: This study examines differences in physician communication and patient satisfaction with physician care, contrasting women who have and have not been abused by spouses or intimate partners. METHODS: A nationally representative sample of women participated in a telephone survey including questions on spouse abuse, health status, satisfaction with physicians, and communication with physicians. This article uses data from the survey describing 1,082 married or cohabitating respondents 18-64 years of age who had a regular physician and made at least one doctor visit in 1992. RESULTS: Overall, 7.3% of respondents reported being physically abused by a spouse during the previous year. Abused women were much more likely than other women to report both poor communication and dissatisfaction with physicians. Only 9.7% of the abused women had discussed the abuse with a physician. Controlling for socio-demographic and health-related factors in logistic regression analysis, we found that spouse abuse more than doubled respondents' odds of being dissatisfied with physician care. When the quality of patient-physician communication was added to the model, the influence of spouse abuse became insignificant. Instead, women reporting poor communication with physicians were four times more likely than others to be dissatisfied with physician care. CONCLUSIONS: Spouse abuse creates barriers to patient-physician communication, and poor communication contributes to lower satisfaction with care. Careful interviewing by trained clinicians is essential to identify and address abusive situations and to prevent further damage to women's physical and mental health.

Adolescent↗
PubMed1996

Generalized versus spouse-specific anger/hostility and men's violence against intimates.

The present study examined the extent to which generalized versus spouse-specific anger/hostility was associated with partner violence in 263 men seeking conjoint marital therapy. Clinic men were classified as nonviolent (NV), moderately violent (MV), and severely violent (SV). A community comparison group of relationship-satisfied, non-violent men (CO) was also included. All clinic men reported higher levels of generalized and spouse-specific anger, spouse-specific aggression/hostility, depressive symptomatology and lower spouse-specific assertiveness than community men. SV men reported higher levels of spouse-specific anger/hostility, relationship discord, depressive symptomatology, and lower general problem-solving ability than NV men. Regression analyses confirmed that spouse-specific anger/hostility, low problem-solving ability, and relationship discord were significant predictors of men's violence. Overall, generalized anger and hostility were not unique predictors of men's violence against intimates.

Adult↗
PubMed1998

Are spouses of patients with hypertension at increased risk of having hypertension? A population-based case-control study.

BACKGROUND: Studies of couples, who tend to share an environment but are genetically dissimilar, can shed light on the contribution of environmental factors to hypertension. There has been renewed interest in these environmental factors following the re-analysis of the INTERSALT study. AIM: To determine whether patients whose spouses have hypertension are at increased risk of hypertension, using a population-based case-control study. METHOD: The total study population consisted of all 3923 patients over 30 years old registered with one general practice. Male cases with hypertension were matched to male controls without hypertension. Female cases with hypertension were matched to female controls without hypertension. The variables were: diagnosed hypertension; having a spouse with diagnosed hypertension; age; sex; weight; height; body-mass index; couple status; diabetes; and systolic and diastolic blood pressure readings. RESULTS: On multivariate analysis, when age, body-mass index, diabetes, couple status, and having a blood pressure reading were included, men whose spouses had hypertension had a two-fold increased risk of hypertension (adjusted odds ratio (OR) 2.24; 95% CI 1.77-2.72; P = 0.001). Similarly, on multivariate analysis, women whose spouses had hypertension had a two-fold increased risk of hypertension (adjusted OR = 2.23; 95% CI 1.75-2.72; P = 0.001). The risk for both male and female subjects persisted after adjustment for other variables. There was a significant correlation between systolic (r = 0.41; P < 0.0001) and diastolic (r = 0.25; P < 0.0001) blood pressures between spouse pairs. CONCLUSION: The independent association between having a spouse with hypertension and increased risk of hypertension supports the view that there are significant environmental factors in the aetiology of hypertension. The finding has implications for the screening and treatment of hypertension in primary care.

Adult↗
PubMed1999

The role of the chair's spouse in academic departments of family medicine.

BACKGROUND AND OBJECTIVES: Family medicine has the highest percentage of unfilled budgeted faculty positions of all clinical and basic science departments. To successfully recruit and retain academic leaders, personal and professional issues need to be recognized and valued. This study reports the results of a national survey of chairs and an important, often overlooked factor in recruitment and retention--the spouse of the department chair. METHODS: Questionnaires were sent to 107 chairs of academic departments or divisions of family medicine and their spouses. RESULTS: There was a usable response rate of 86%, and data from 85 questionnaires (79%) were analyzed. The spouses' highest role priority was family, perhaps reflecting their relatively young mean age of 48.6 years. There was a statistically significant correlation between those who were "oriented" to the role of chair's spouse and a higher level of participation in departmental activities. Data are also reported on spouse role satisfaction, expectations, and factors in deciding to stay or leave their current location. CONCLUSIONS: The results suggest that with the increased competition for family physicians in a multitude of practice settings, search committees for family medicine department chairs need to be innovative and attentive to personal as well as professional factors in recruiting and retaining future and current department chairs. It would be prudent to acknowledge the role of the spouse in decisions concerning job selection and satisfaction.

Adult↗
PubMed1976

The spouse's role in home hemodialysis.

The role of the spouse as a factor in the success or failure of home dialysis becomes increasingly important as expectations rise that hemodialysis patients be home-trained. Home hemodialysis offers advantages to the patient but may add stress to the spouse. We present cases illustrating the types of responses spouses have to home hemodialysis. Present conditions are such that the spouse's ability to participate in home hemodialysis may be less affected by aspects of the patient-partner's chronic renal disease than the potential change in the marital relationship that can derive from home hemodialysis. Success in home dialysis is at risk when the spouse is naturally dependent on the patient-partner. These spouses will often require special supportive measures.

Adult↗
PubMed1990

Spouse adjustment to cancer surgery: distress and coping responses.

Although often acknowledged, the impact of the surgical treatment of cancer on the spouse of the adult cancer patient is a largely unexplored area. The present study examined distress, coping, and appraisal among spouses (N = 36) and patients (N = 43) assessed prior to and following surgery. The results indicated that at both the presurgical and postsurgical period, spouses were exhibiting significantly greater distress than patients. Surprisingly, spouses' levels of distress remained fairly constant across the presurgery to postsurgery period, while the patients' distress decreased. Escape and avoidance behaviors were found to be maladaptive for spouses coping with their partners' surgical treatment. Appraisal was also found to be a critical factor in understanding individual reactions to the stress of cancer surgery. Spouses of cancer patients undergoing surgical treatment appear to be an underacknowledged population at risk.

Adaptation, Psychological↗
PubMed1994

Designing psychoeducational services for spouses of persons with serious mental illness.

Psychoeducational and support groups for families of mentally ill adults may not be adequately addressing the needs of spouses with mentally ill partners. This paper describes a group psychoeducational approach which has been developed and implemented through collaboration between professionals and well spouses. The high attrition of spouses in a general family psychoeducational group was dramatically reduced in this spouse psychoeducational group. Significant improvements were found in well spouse knowledge about the illness and coping strategies, personal distress, and negative attitudes towards the ill spouse over the 3-month intervention and at 1-year followup. Implications for practitioners and researchers are discussed.

Adaptation, Psychological↗
PubMed1996

Perfectionism, marital satisfaction, and contributing factors to sexual dysfunction in men with erectile disorder and their spouses.

The relationship among perfectionism, marital satisfaction, and male sexual functioning was examined. Thirty-two men with DSM-III-R erectile disorder participated. Of this group, 18 men had spouses who were able/willing to participate in their assessment. Subjects completed the Multidimensional Perfectionism Scale (MPS) as well as the Dyadic Adjustment Scale (DAS), a measure of marital satisfaction. Additionally, physician ratings of organic contribution to the sexual dysfunction as well as clinician ratings reflecting the degree to which dysfunctional males' sexual difficulties were due to psychogenic factors were assigned. Psychogenic ratings were significantly positively correlated with overall MPS scores, whereas organic ratings were not. No significant group differences were detected on any measure among those whose spouses participated and those who did not have spouses or whose spouses were unable/unwilling to participate. In addition, for the subset of this sample that included dysfunctional men and their spouses (n = 18), results indicated that DAS scores for both dysfunctional men and their spouses were unrelated to clinician psychogenic ratings and physician organic ratings with the exception of a significant positive relationship between men's DAS scores and their organic ratings. It was revealed that women's, but not men's, total MPS scores were negatively related to both their own and their partner's DAS scores. Implications of these findings for the treatment of sexual dysfunction are discussed.

Adolescent↗
PubMedDate not supplied

Communication between physicians and surviving spouses following patient deaths.

The authors evaluated the perceptions and adjustments of surviving spouses following patient deaths. Of 128 married patients dying in a university hospital in 1983, the surviving spouses of 105 (82%) were personally interviewed a year after the death. The physicians' perspectives were recorded through chart review. Half of all spouses had had no subsequent contact with the physicians who had cared for the decreased, and 55% of spouses still had unanswered questions regarding the death a year later. Survivors of unexpected deaths were found to be at high risk for poor subsequent adjustment. Spouses with poorer adjustments consulted their own physicians more frequently, and used more alcohol and tranquilizers. The results identify areas where improvement is needed in communication with surviving spouses after patients' deaths.

Adaptation, Psychological↗
PubMed2005

Marital and sexual satisfaction in testicular cancer survivors and their spouses.

GOAL: To compare marital and sexual satisfaction of men who survived testicular cancer (TC) and their spouses to a reference group, and to compare marital and sexual satisfaction of couples who had a relationship at time of diagnosis (couples during TC) to couples who developed a relationship after completion of treatment (couples after TC). PATIENTS AND METHODS: Two hundred and nineteen couples during TC and 40 couples after TC completed the Maudsley Marital Questionnaire, a validated instrument to measure marital and sexual satisfaction. RESULTS: Survivors and spouses of both couple groups reported similar marital satisfaction as men and women of the reference group. Survivors (t=2.9, p<0.01) and spouses (t=2.9, p<0.01) of couples during TC and survivors of couples after TC (t=1.9, p=0.05) reported less sexual satisfaction than the reference groups. Survivors of couples after TC reported less sexual satisfaction than survivors of couples during TC (F=4.0, p<0.05). Correlations between sexual satisfaction of survivors and spouses in couples during TC (r=0.76, p<0.001) and couples after TC (r=0.77, p<0.001) were high. CONCLUSION: Testicular cancer did not appear to have a negative effect on marital satisfaction in couples during TC, although TC survivors and their spouses reported less sexual satisfaction than men and women of the reference group. Survivors who developed a relationship after completion of treatment seemed to form a vulnerable group: their sexual satisfaction was lower than that of men in the reference group and of TC survivors with a longer relationship. Besides that, they more often reported marital problems than their spouses did.

Adult↗
PubMed1994

Effect of premature myocardial infarction in men on the eating habits of spouses and offspring.

OBJECTIVE: To investigate whether family members comply with a healthier diet after the father has had a myocardial infarction. DESIGN: Cohort study with administration of a dietary history questionnaire. SETTING: Outpatient lipid research clinic, Cincinnati, Ohio. SUBJECTS: Male subjects (referred to as father) who had had myocardial infarction before age 56 years were recruited along with their spouse and at least one offspring (myocardial infarction [MI] group; n = 136). Control families (comparison group; n = 237) were also recruited. STATISTICAL ANALYSES: The t test, analysis of covariance, analysis of variance, least-squares means, chi 2, and Kruskal-Wallis. RESULTS: Significant differences in dietary intake were found for percentage of energy from total and saturated fat (P < .0001), ratio of polyunsaturated fat to saturated fat (P:S ratio) (P < .0001), and cholesterol intake (P = .001) between fathers in the MI and comparison groups. The fathers in the MI group consumed 4.5% and 2.6% less energy from total and saturated fat, respectively, and less cholesterol (135 vs 151 mg/1,000 kcal) and demonstrated a higher P:S ratio (0.76 vs 0.62) than the fathers in the comparison group. Spouses in the MI group consumed less total energy (P = .02) and less energy from fat and saturated fat than spouses in the comparison group (P = .04 and P = .004, respectively). When spouses were grouped by time since the father's myocardial infarction, no differences were found in energy from saturated fat intake between the comparison population and those spouses 3 years or more after the myocardial infarction. The diet of the offspring in the MI group closely resembled that of the offspring in the comparison group. CONCLUSIONS/APPLICATIONS: Fathers who had experienced a myocardial infarction complied with a diet lower in fat and cholesterol than did fathers in a control comparison group. Spouses only complied with an improved diet for an initial period after the cardiac event. The cardiac event demonstrated little to no effect on the diet of the offspring. Offspring who have a high risk for cardiovascular disease, as well as the parents, need to be educated about the importance of establishing and maintaining a proper dietary regimen.

Adolescent↗
PubMed1990

Chronic low back pain patient and spouse.

Marital adjustment, psychological distress, health attitudes and prevalence of musculoskeletal pain symptoms were studied and compared between 63 chronic low back pain (CLBP) patients and their spouses. The CLBP patients experienced somatization significantly more than their spouses, while other psychological distress scores did not reveal statistically significant differences between the couples. The CLBP patients experienced significantly more feelings of guilt at having pain than their spouses. The patients experienced significantly more internal control, while their spouses experienced more external locus control of health. The female spouses had had significantly more musculoskeletal pain symptoms in neck and shoulders during the past week than the male spouses. The prevalence of musculoskeletal pain symptoms in the CLBP patients did not differ significantly between sexes. The results of this study are compared to population studies where the same methods have been used.

Adaptation, Psychological↗
PubMed1980

Behavioral treatment of chronic pain: the spouse as a discriminative cue for pain behavior.

Twenty married chronic pain patients (pain duration > 8 mo.) consecutively admitted to a pain management program were administered a taped structured interview designed to elucidate the responses of their spouses to pain behavior. Additionally, patients were required to report their pain levels in two different observational conditions: when observed by their spouse and when observed by a "neutral observer", the ward clerk. Those patients who reported that their spouses were relatively non-solicitous in responding to pain behavior reported significantly lower pain levels in the spouse-observing condition than in the neutral-observer condition. Patients who reported that their spouses were relatively solicitous in responding to pain behavior reported marginally higher levels of pain in the spouse-observing condition than in the neutral-observer condition.

Behavior Therapy↗
PubMed2000

Perception of ill spouse and dyadic relationship in couples with affective disorder and those without.

BACKGROUND: This study compares the perception of spouses and the quality of the dyadic relationship of patients with severe affective disorders in remission with healthy couples. METHOD: The sample included spouses of patients between the ages of 20 and 65 who had been hospitalized with severe affective illness and who were currently in remission (depressive, n=23; bipolar, n=11) and a control group matched by socioeconomic status. Both groups completed three instruments measuring the quality of the dyadic relationship, attributed characteristics of the spouse and non-formal social support. RESULTS: The spouses of patients, as compared to spouses of controls, scored lower on consensus, unity and expressions of affection in their marital relationship, ranked their ill spouses lower on the positive qualities and higher on the negative qualities and reported receiving less emotional and practical support. LIMITATIONS: The limitations of the study are the small sample size and cross sectional design. CONCLUSIONS: The results suggest that severe affective disorders are associated with marital dysfunction, even during periods of symptom remission.

Adult↗
PubMed1993

Physical health and cognitive ability among married long-term-care patients and among their spouses--a comparison between home care and nursing home care.

The purpose of this study was to establish whether physical health and cognitive function in married long-term patients or in their spouses determines why some patients are cared for in home care while others reside in nursing homes. Out of 38 married couples with a sick spouse cared for in a nursing home, 23 couples were studied; out of 34 couples with a sick spouse cared for in home care, 22 patients and 25 spouses were studied. The results showed no significant differences in physical health score either between the two groups of patients, or between the two groups of spouses. Both home-care patients and nursing home patients had low cognitive function scores, but nursing home patients had significantly lower scores. A multivariate analysis showed that physical health and cognitive function explained only 20% of patients' residence. Between the two groups of spouses there was no difference in cognitive function score. The conclusion is that physical health status and cognitive function explain only to a small extent why married long-term care patients are cared for in nursing homes or in home care.

Activities of Daily Living↗
PubMed1992

Sequential analysis of chronic pain behaviors and spouse responses.

Social reinforcers such as spouse behaviors have been hypothesized to be important in maintaining chronic pain behavior. This study used direct observation to test whether solicitous and aggressive spouse behaviors systematically precede and follow patient pain behaviors. Fifty chronic pain patients and spouses and 33 control couples were videotaped performing specified tasks. Spouse solicitous behaviors were significantly more likely to precede and follow nonverbal pain behaviors, and nonverbal pain behaviors were significantly less likely to follow spouse aggressive behaviors in pain than in control couples. Within couples, spouse solicitous behaviors preceded and followed verbal and nonverbal pain behaviors beyond chance levels more often in pain than in control couples. Results support an operant conceptualization of factors maintaining chronic pain behaviors.

Adult↗
PubMed1989

Spouse criticism and support: their association with coping and psychological adjustment among women with rheumatoid arthritis.

Examined whether psychological adjustment of women with rheumatoid arthritis would be related to the support and criticism the patient received from the husband. Interviews were conducted with the husbands of 103 women with rheumatoid arthritis. Spouse interviews were content coded for critical remarks. Wives completed a revised version of the Ways of Coping Scale and a scale of the perceived supportiveness of the spouse. Husbands completed rating scales assessing their perceived vulnerability to illness and the degree of burden they experienced in providing assistance to their wives. Path analyses revealed that patient adjustment was significantly related to the attitude of the spouse. Patients with a highly critical spouse engaged in more maladaptive coping behaviors and reported a poorer psychological adjustment. Independent of spousal criticism, patients who perceived their spouse as being supportive engaged in more adaptive coping. A path model was fit to the data that suggested that the spouse may affect adjustment indirectly through influencing the patient's selection of adaptive or maladaptive coping responses.

Activities of Daily Living↗