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PubMed1992

Reduced axial rotation in the spouses of sufferers from clinical idiopathic parkinsonism.

Axial rotation during recumbency was used to quantify the tendency towards parkinsonism with respect to one cardinal sign, brady/hypokinesia. Twenty-four elderly sufferers from idiopathic parkinsonism, their spouses, and 40 control subjects were studied. Significant differences in total angular displacement over 7 h were found between sufferers and their spouses (83% of grand mean) and between spouses of sufferers and controls (31%). These differences could not be accounted for by age or cognitive function. Moreover, the total angular displacement of the spouses was independent of whether they shared a bed with the sufferer. Neither the sufferers and their spouses, nor the 20 couples who constituted the control group, showed any relationship between partners with respect to angular displacement. These findings do not favour learned behaviour, or selective mating as an explanation of reduced movement in spouses of sufferers. Significantly more of the control couples had a single cardinal sign in both partners than expected on the basis of the frequency of a single sign in one partner. Environmental factors operating in adult life could be involved in the pathogenesis of parkinsonism.

Aged↗
PubMed1983

Spouse concordance for systolic and diastolic blood pressure.

Eighty-two per cent of all adult residents of Rancho Bernardo, California, participated in a study of the prevalence of heart disease risk factors in 1972-1974. Spouse correlations for systolic and diastolic blood pressure were examined in 1702 spouse pairs including 403 spouse pairs married 40 or more years. Both systolic and diastolic blood pressure showed significant spouse correlation after adjustment for spouse similarities in age and relative weight (r = 0.102 for systolic, r = 0.114 for diastolic, p less than or equal to 0.05). An examination of blood pressure correlations by duration of marriage and age of wife showed correlations to be influenced by age of wife rather than duration of marriage. Spouse correlations were lowest when the wife was aged 40-49 years and highest when the wife was 50-59 years of age. The differential concordance by wife's age is compatible with different degrees of shared behaviors for couples at different ages.

Adult↗
PubMed1990

Comparison of self- and spouse reports of snoring and other symptoms associated with sleep apnea syndrome.

We compared self- and spouse reports of snoring and other symptoms of sleep apnea syndrome ascertained from married couples in a community-based survey. Agreement between the two types of report varied between 70-98%, but was modest (kappa = -0.01-0.52) when adjusted for chance. For men, spouse reports yielded higher prevalence rates for snoring and for four other symptoms. For women, estimates of symptom prevalence were consistently lower by spouse report than by self-report. In multivariate analyses, the effect on snoring of gender and obesity increased and of age decreased when spouse reports were compared to self-reports. Snoring, according to spouse reports, was a significant risk factor for ischemic heart disease, but snoring according to self-reports showed a smaller effect and was not statistically significant. Snoring was not associated with hypertension when defined by either self- or spouse report. These observations suggest that questionnaire data of snoring and other symptoms of sleep apnea syndrome may be misclassified in part, and that such misclassification can affect estimates of prevalence and effects.

Adult↗
PubMed1981

Investigation of the response of the spouse to chronic pain behavior.

A study was conducted to assess the responses of spouses to chronic pain behavior. In this study, spouses watched videotapes of "painful" and "neutral" facial expressions emitted both by their mates, hospitalized chronic pain patients, and by a number of performers. Skin conductance and heart rate to each of these displays were monitored and spouses also rated the perceived pain intensity of each display. Spouses showed greater increases in skin conductance to painful than to neutral facial displays, whether emitted by performers or by patients. Additionally, spouses reporting relatively high levels of marital satisfaction showed greater increases in skin conductance to the painful displays of their mates than did relatively unsatisfied spouses, while both groups gave similar ratings to these same displays. Implications of these data for the development of psychiatric and psychosomatic difficulties in responses of chronically ill patients are discussed.

Chronic Disease↗
PubMed1998

Implications of genotyping of spouses to limit investigation of children in genetic hemochromatosis.

BACKGROUND: A genetic test for hemochromatosis has allowed for the first time, genotypic identification of heterozygotes. The purpose of this study is to determine whether genotyping of spouses of homozygotes results in fewer investigations of children and subsequent cost savings. METHODS: Two hundred and ninety one children of homozygotes were studied using HLA typing, transferrin saturation and serum ferritin. Ninety six percent of the probands were homozygous for the C282Y mutation of the HFE gene. Pedigrees were reviewed to determine cost savings incurred if the spouse had been genotyped to guide follow-up studies in the children. Paternity was confirmed by HLA studies. RESULTS: There were 13 homozygotes identified. All homozygous children tested (10/10) were homozygous for the C282Y mutation. There were no iron loaded children identified in homozygotes negative for the C282Y mutation. Genotyping of the spouse eliminated the need for the investigation of 269 children. The cost savings of this strategy were modeled using the cost of the family studies (consultation, iron studies) minus the cost of spouse assessment (consultation, genotyping) plus the cost of assessment of children in families in which the spouse was a heterozygote. The spousal genotyping strategy resulted in a cost savings of 39%. CONCLUSION: Genotying the spouse of a homozygote is the best cost-efficient strategy in pedigree studies because it leads to more selective investigation of children for the hemochromatosis gene.

Base Sequence↗
PubMed1992

A comparative study of the social conditions of spouses of long term patients cared for either in nursing homes or home care.

In order to study the social conditions of spouses of patients suffering from long term illnesses structured interviews were performed. The interviewees were divided into two groups: spouses of persons with chronic conditions cared for at home and spouses of patients cared for in nursing homes. Each group consisted of 27 spouses and there were no differences in physical health score, Mini mental score or ability to manage primary Activities of Daily Living functions between the groups. Home care spouses paid fewer visits to children, had fewer friends and paid fewer visits to friends and they also had time for hobbies or interests significantly more seldom (reading, visits to church) than nursing home spouses. There were no significant differences between the groups concerning sex, socio-economic class, housing conditions and amount of home health services. Their contact with children and their feelings of loneliness were reported to be the same.

Aged↗
PubMed1993

Transmission of Porphyromonas gingivalis between spouses.

Porphyromonas gingivalis has been associated with severe forms of periodontitis. The question can be raised about the origin of this suspected periodontal pathogen. The purpose of the present investigation was to study the possibility of transmission of P. gingivalis between spouses. 18 patients were selected with severe periodontitis and colonized with P. gingivalis. 10 of their spouses appeared to be colonized with P. gingivalis too. 8 of the patients and their spouses were investigated further clinically and microbiologically. Microbiological evaluation revealed mostly high %s of P. gingivalis in the pockets, not only of the patients (5-48% of the cultivable flora), but also in 7 of the 8 spouses (0.2-61%). Furthermore, this species was isolated often from the saliva, the tongue, the buccal mucosa and the tonsillar area from both patients and spouses. For typing purposes, bacterial DNA was isolated, treated with the restriction endonucleases Bam HI or Pst I, after which the DNA fragments were separated by agarose gelelectrophoresis. With one exception, each individual was colonized with only one clonal type of P. gingivalis. The DNA patterns of all P. gingivalis isolates from unrelated individuals were found to be distinct. In contrast, in 6 of the 8 couples, the DNA patterns of isolates from husband and wife were indistinguishable. From these data, it can be concluded that it is most likely, that P. gingivalis can be transmitted between spouses. It remains to be investigated whether transmission of P. gingivalis is a risk factor for developing periodontal destruction.

Adult↗
PubMed1994

Cardiac patients and spouses: family functioning and emotions.

This study examined the relationships among satisfaction with family function and emotional states of a nonprobability sample of sixty-six myocardial infarction (MI) patients and their spouses who were recruited from hospitals in the Delaware Valley. Patients and spouses completed the Family APGAR and the Affects Balance Scale. It was found that both patients and spouses experienced substantial emotional distress when compared with the norms for nonclinical subjects. They were highly correlated on both measures, particularly for positive emotion and satisfaction with family function (p < .0001). Satisfaction with family function was significantly correlated with positive affect for spouses (p < .05). These results suggest the importance of assessment of satisfaction with family function and emotional status of both MI patient and spouse, with spouses with lower satisfaction with family function being at greater risk for emotional distress.

Adaptation, Psychological↗
PubMed1976

The spouses of attempted suicides: a personality study.

The 16 PF was administered to 30 female attempted suicides and their spouses, to 20 male attempted suicides and their spouses and to 50 control men and their spouses. Both the female and male attempted suicides show personality disturbance, but there are also sex differences. The female attempted suicides and their spouses appear to share similar personality characteristics, but the spouses of male attempted suicides appear quite dissimilar from their husbands. The effect of the personality of the spouses is briefly discussed in the context of marital relationships of attempted suicides.

Affective Symptoms↗
PubMed1993

Recognizing cancer as a family disease: worries and support reported by patients and spouses.

Data were obtained via mailed questionnaire from 91 adults with cancer and 78 spouses of adults with cancer. Findings suggest that spouses and patients worry equally about their own personal health, and that spouses worry more about patients' futures than the patients do themselves. In addition, spouses and patients report participating equally in the treatment process, yet patients report receiving significantly more social support than do spouses. The results point to the need for expanded attention to the concept of cancer as a "family disease," with special emphasis on the unique and often neglected experience of spouses of adult cancer patients.

Adaptation, Psychological↗
PubMed1981

Spouse-aided therapy in psychiatry: an introduction.

This paper underlines the failure of contemporary individual and marital psychotherapies to help many married people with persisting psychological disorders. It examines the spouse's contribution to the maintenance of psychological disability, and discusses the problems of constructively involving such spouses in conjoint therapy. Spouse-aided therapy addresses this problem by inviting the patient's spouse to become a co-therapist. It is explicitly not a marriage therapy, and is conducted on a goal-orientated time-limited out-patient basis. During discussion of problems with achieving treatment goals, the focus of therapy shifts from the patient's symptoms to marital interaction. Confrontation of the spouse's contribution to the patient's continuing disability then becomes possible, and is followed by changes in marital interaction which generally facilitate the patient's improvement. Many couples choose to proceed with marital therapy after spouse-aided therapy has allowed them to reconstrue the patient's symptoms in interactional terms.

Ambulatory Care↗
PubMed1989

Loneliness of chronically ill adults and their spouses.

This comparative descriptive study was designed to determine if there was a significant difference in loneliness between 80 chronically ill adults and their spouses [N = 160] and to determine whether a significant relationship existed between loneliness and selected characteristics in the two groups. Chronically ill adults were purposively selected from several sources and represented a variety of illnesses. Loneliness of both groups was assessed using a single dichotomous item from the Oars Multidimensional Functional Assessment Questionnaire (1975). Data on selected characteristics were collected through four instruments: subscales from the Oars, Disability Classification Index, Social Role Rating Scale, and Life Satisfaction Index-Z Scale. Wilcoxon 2-Sample Test revealed no significant difference in loneliness between groups. For both groups, women were more lonely than men and this difference was significant for the ill group (p less than .001). The highest correlation between loneliness and sociodemographic characteristics was need for financial assistance for ill respondents and inability to afford luxuries for spouses; between lonely and disease-related characteristics, it was the number of chronic illnesses for ill and disability of the ill partner for spouses; between lonely and sociological characteristics, it was decrease in the homemaker role for ill and decrease in the leisure role for spouses. For both groups, loneliness was significantly related to lower life satisfaction and unrelated to mental health. Findings indicate that chronically ill adults and spouses are similar in frequency of self-reported loneliness. Differences in characteristics associated with loneliness found between the two groups suggest a need for different approaches in nursing interventions for ill adults and spouses.

Activities of Daily Living↗
PubMed1983

Medicaid program; deeming of income between spouses; categorically needy--HCFA. Final rule with comment period.

These final regulations revise Medicaid rules for determining the financial eligibility and the level of Medicaid payments for the institutional care of aged, blind, and disabled categorically needy individuals when one spouse is institutionalized and the other spouse is not. In accordance with a United States Supreme Court ruling, we are reinstating the rules that were in effect prior to imposition of lower court orders (now reversed) that required HCFA to change its regulations. The regulations affect those States that, as permitted by statute, use more restrictive eligibility criteria than those applied nationally under the Supplemental Security Income (SSI) requirements. They also apply in Puerto Rico, Guam, and the Virgin Islands. These reinstated rules permit these jurisdictions, in situations when one spouse is institutionalized, to consider a portion of the income of one spouse as available for the care of his or her institutionalized spouse, whether or not the income is actually contributed to the spouse. This practice is known as "deeming of income." We are also clarifying a regulation that applies in States that use the SSI eligibility criteria and may apply in States that use more restrictive eligibility criteria.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1999

Agreement between spouses and children in descriptions of personality change in Alzheimer's disease.

The purpose of the present study was to evaluate the agreement among spouses and children in their describing the current and past personality of patients with Alzheimer's disease (AD) and to determine the relations between their descriptions and selected demographic and clinical variables. The subjects were 22 dementia out-patients who fulfilled the DSM-III-R criteria for uncomplicated dementia of the Alzheimer's type and the NINCDS-ADRDA criteria for AD. Spouses and children of these patients were separately administered Brooks and McKinlay's personality inventory consisting of 18 pairs of adjectives that characterize the extremes of a behavioral dimension, and were asked to judge where the subject's demeanor fell on a five-point scale, varying from +2 to -2, in which zero was regarded as neutral. Spouses and children reported marked changes in most measured behavioral dimensions following the onset of AD. Spouses identified significant changes on 14/18 items and children on 13/18 items. Spouses and children agreed on practically all items concerning personality attributes before the onset of illness, and on 16/18 items after it. Changes in personality were not correlated with the studied demographic characteristics of patients, spouses and children, nor with the cognitive deficits and illness duration of the patients.

Aged↗
PubMed1992

Spouse adaptation to mate's CABG surgery: 1-year follow-up.

OBJECTIVE: The purpose of this study was to describe spouses' life stressors, supports, perceptions of illness severity, role strain, physical and mental symptoms of stress, and marital quality 1 year after the mate's coronary artery bypass graft surgery. METHODS: This descriptive study was the third component of a longitudinal panel investigation. (The first component was a period within 48 hours of surgery, and the second was 6 weeks after discharge.) One year after the mate's surgery, spouses received the following instruments in the mail: the Family Inventory of Life Events and Changes, the Norbeck Social Support Questionnaire, the Cantril Ladder Scale, the Strain Questionnaire, the Role Strain Scale and the Dyadic Adjustment Scale. Subjects were a convenience sample of 49 women whose husbands were alive 1 year after their first bypass surgery. Of the women in the sample (n = 49), 98% were white, and the mean age was 56 years. RESULTS: Social support was moderate and significantly less 1 year after surgery than during the first two components (48 hours and 6 weeks after surgery). Women still perceived their husbands to have some illness severity 1 year after surgery. They continued to have physical and mental symptoms of stress and had significantly greater role strain than during the first two periods. Marital quality was average. Spouses reported making several life-style changes. DISCUSSION: During the first year after the patient's bypass surgery, spouses experienced many changes. Although physical and mental symptoms of stress remained the same, role strain increased and social support decreased. The findings suggest testing of such interventions as stress management and time management techniques, support groups, and other psychoeducational interventions. CONCLUSIONS: Although the situation remains difficult for the spouse 1 year after the patient's surgery, nurses and physicians can foster and support spouses through many adjustments and changes.

Activities of Daily Living↗
PubMed1979

Psychosocial readjustment in the spouses of aphasic patients. A comparative Survey of 79 subjects.

The study set out to investigate readjustment to disability on the part of spouses of patients disabled by a cerebrovascular accident and to elicit the particular problems faced by the spouse of an aphasic patient. In a sample of 79 subjects, spouses of aphasic patients showed evidence of significantly poorer overall social adjustment then spouses of non-asphasic patients. The areas that were particularly impaired were social and leisure activities and marital relationships. In the marital area aphasia appeared to be particularly disruptive and the marriages were characterised by problems of interpersonal communication, diminished sexual satisfaction and loss of partnership. There was a raised incidence of minor psychiatric disorder in all spouses and again this was more pronounced amongst the spouses of aphasic patients.

Aged↗
PubMed1980

Depression in family practice: some effects on spouses and children.

Medical complaints and office visits of spouses and children of depressed patients were examined and compared to a matched comparison group of spouses and children of nondepressed patients. Both spouses and children of depressed patients showed increased numbers of visits and complaints which returned to control levels one year after the depression was diagnosed and treated. Infection, pain, functional, and anxiety complaints showed significant increases in spouses over controls. Definite diagnoses, infections, pain, and anxiety complaints were significantly increased in children compared to controls. In both spouses and children these complaints returned to control levels by the third period of the study, one year after the depression had been diagnosed (and treatment for depression started). The pain, functional, and anxiety complaints of spouses and children were very similar qualitatively to those of the depressed patients. The results demonstrate the validity of the family as a unit of medical care.

Anxiety↗
PubMed1994

[Support to spouses of patients with cancer].

Psychosocial problems frequently arise in the families of cancer patients. Using a questionnaire, information about the problems experienced by 120 spouses to cancer patients was collected. The response rate was 85%. The results show that the patient and the children are the most important persons in supporting the spouses. Sixty-one percent felt relieved of having somebody to talk to about their problems. The amount of contact to friends and family mainly remained unchanged. Approximately 1/3 of the spouses had to work more than the normal 37 hours a week, which compromised their abilities to support the patients. Professional help was sought by 1/4 of the spouses in an attempt to solve their problems in relation to the patient's disease. Men are more likely to have their problems solved by professional support than women. Among the spouses there is a great wish for information and support offered primarily by the oncological department. It is concluded that the spouses needed more support, wanted more information, and asked for the possibilities to talk about their emotional problems. This need is emphasized by the present strategy in the health system, where still more patients are treated on an out-patient basis. It is important that the professional support is offered from the time of the diagnosis.

Adult↗