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PubMedDate not supplied

Prospective study of cancer patients and their spouses: the weakness of marital strength.

In a prospective study, 133 married cancer patients and their spouses were interviewed within a month of diagnosis and administered three self-reports: The Brief Symptom Inventory (BSI) to assess psychological distress, the Impact of Events Scale (IES) to assess coping, and the Family Adaptability and Cohesion Scales (FACES III) to assess family relations. Patients and spouses were moderately distressed. The patient's psychological distress was explained by the level of intrusion, by the spouse's psychological distress and cohesion which had a protective effect (R2.41). The spouse's distress was explained by intrusion, gender and, to some extent, by the patient's distress (R2.41); but cohesion had no influence. Only half of the group (as couples) reached the last follow-up nearly 2 years later. A disassociation seems to have occurred; family relations, as well as partner's distress, did not have an influence on either the patient's or spouse's distress. The information gathered at the beginning of the study explained about 25% of the distress 2 years later of male patients and their wives, and that of female patients but not of their husbands.

Adaptation, Psychological↗
PubMed2003

Effectiveness of spouse involvement in cognitive behavioral therapy for binge eating disorder.

OBJECTIVE: This study examined whether involving the spouse in group cognitive behavioral therapy (CBT) for binge eating disorder (BED) enhances treatment outcome relative to standard group CBT. METHOD: Ninety-four overweight women with BED were randomly assigned to either (1) standard group CBT, (2) group CBT with spouse involvement, or (3) a wait-list control group. Eating and general psychopathology assessments were completed at baseline, after treatment, and at 6-month follow-up. RESULTS: Although both CBT groups fared significantly better than the wait-list control group on measures of binge eating, weight, eating psychopathology, and general psychopathology, CBT with spouse involvement did not result in any additional benefit over and above standard CBT. DISCUSSION: These results are in contrast to the success of spouse involvement in the treatment of several other physical and psychological disorders. Possible reasons for this disparity, and suggestions for improving spouse involvement in BED treatment, are discussed.

Adult↗
PubMed2003

Familial brain tumours-genetics or environment? A nationwide cohort study of cancer risk in spouses and first-degree relatives of brain tumour patients.

Our study investigated whether the familial aggregation of glioma is due to environmental or genetic effects and it investigated and compared the risk to spouses and first-degree relatives (FDR) of patients with primary brain tumours (PBT) for developing both PBT and the risk for other types of cancer. All PBT patients identified in Sweden from 1958-97 in The Swedish Cancer Registry (SCR) were linked to the nationwide Swedish Family Database, including persons in Sweden born from 1932-97. The cohorts of spouses and FDR were linked to the SCR to identify observed cases of PBT and other cancer. Standardised incidence ratios (SIR) were calculated using the incidence rates from SCR as the reference. We found that there were no increased risks for any specific type of PBT in the cohort of spouses. In the FDR cohort, generally the risk for a PBT was significantly increased by 2 to 3 times for the same histopathology as the probands. Spouses of PBT patients had an increased risk of skin cancer. We conclude that FDR, not spouses, have a significantly increased risk, which indicates a genetic origin of the familial aggregation of brain tumours.

Adult↗
PubMed1994

Comparison of spouse and nonkin controls: the experience of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD).

Normal spouses may be an excellent source of control subjects in research on noninstitutionalized Alzheimer's disease (AD) cases. To determine to what extent spouses might differ from nonkin controls, we compared information on 145 spouses of AD patients with 158 nonkin community volunteers enrolled by 23 centers of the Consortium to Establish a Registry for Alzheimer's Disease. Chi square and 1-way ANOVA analyses indicate that neither at entry nor over the next two years did the two groups of controls differ significantly on demographic characteristics, health status, or performance on neuropsychological measures. However, hierarchical logistic regression showed that, after controlling for demographic characteristics and physical status, dropout was nearly twice as high among spouse controls. Dropout was related to nonreturn of the AD case. Thus, as controls, spouses are viable as long as the cases to whom they are married remain in the study.

Aged↗
PubMed2004

Impact of cancer patients' quality of life on that of spouse caregivers.

GOALS OF WORK: This study aimed to examine the correlation between quality of life (QOL) in cancer patients and that of their spouse caregivers and to identify factors that influence this correlation. PATIENTS AND METHODS: This cross-sectional study collected data from 121 cancer patient/spouse caregiver dyads. The Functional Assessment of Cancer Therapy Scale-General (FACT-G) was used to measure patients' QOL, and the Caregiver Quality of Life Index (CQLI) was used to measure spouse caregivers' QOL. Correlation coefficients between patients' and caregivers' QOL were computed for four dimensions of QOL, as well as a total score for QOL. Correlations between patients' and caregivers' total QOL scores were furthered analyzed by three groups of factors: disease-/treatment-related, caregiving-related, and relationship-related variables. MAIN RESULTS: Only the social/family and functional dimensions of patient QOL and total score for patient QOL were associated with each dimension of their caregivers' QOL and with the total score ( r=0.27-0.44). Physical and emotional dimensions of patients' QOL did not significantly influence spouse caregivers' QOL for any dimension nor for the total score. Factors influencing the association between patients' and caregivers' overall QOL included cancer diagnosis, length of hospitalization, caregiving intensity and duration, marital satisfaction, and caregiving self-esteem. CONCLUSIONS: Social and functional aspects of patients' QOL play a significant role in determining the QOL of their spouse caregivers. The strength of association between patients' and spouse caregivers' overall QOL can be moderated by some factors.

Adaptation, Psychological↗
PubMed2007

Effect of immigrant status on risk of depressive symptoms associated with spouse's chronic conditions.

The aim of this prospective cohort study was to assess whether the prevalence of chronic disease of one spouse would be associated with a change in depressive symptoms of the other spouse and whether this relationship varies by immigrant status. Negative binomial regression was used to calculate risk ratios from a matched sample of 553 husbands and 553 wives aged 65 years or older of Mexican Americans. Overall, prevalence of chronic disease of one spouse was associated with change in high depressive symptoms for the other spouse. When the results were stratified by immigrant status, respondents born in the US exhibited higher risk of depressive symptoms associated with the chronic conditions of their spouse, while foreign born respondents did not exhibit higher risk for depressive symptoms. These findings highlight how immigrant status and the marital relationship may be related to chronic disease and depression.

Age Factors↗
PubMed2004

Gender differences in patient-spouse interactions: a sequential analysis of behavioral interactions in patients having osteoarthritic knee pain.

Theory and research suggest that spousal responses to displays of pain behavior can vary markedly. To our knowledge, observational research on spousal responses to pain behavior has been carried out only in chronic low back pain patients, but not in other populations. In this study systematic observations were conducted of interactions occurring between 50 married osteoarthritis patients (25 male and 25 female) and their respective spouses. Observations were conducted as the patient and spouse performed three common household tasks: sweeping the floor, folding laundry, and carrying small, artificial logs from one side of the room to the other. Contrary to prior research on chronic low back pain this study found that in osteoarthritis patients spouse facilitative behavior preceded and followed patient pain behavior significantly more often than did spouse solicitous behavior. A gender difference in spousal responding to pain behavior also was observed in that wives were significantly more likely to show facilitative behavior preceding and following patient pain behavior than were husbands. The implications of these findings for future research and clinical interventions focused on patient-spouse interactions are discussed.

Ambulatory Care↗
PubMed2005

Whose informational needs are considered? A comparison between cancer patients and their spouses' perceptions of their own and their partners' knowledge and informational needs.

The present study examines information exchange patterns between 98 married couples in Israel where one is a cancer patient and the other is the main caregiver. Specifically, the accuracy of each spouse's perception of the extent of knowledge and the need to receive more disease-related information is examined as a function of the role (patient-caregiver) and gender of the participants. The results showed that women, regardless of their role, were inaccurate in their perception of their husbands' knowledge and motivation to know more. For men, a difference between the roles was found for the perception of their wives' knowledge. As caregivers, they were inaccurate while as patients they were accurate in this estimation. Their perception of their wives' needs to know more was accurate. Moreover, female patients, more than male, relied on their perception of themselves when assessing their spouse's knowledge and informational needs. Thus, it is concluded that female patients were more egocentric and their perception of their spouse's preferences was influenced by their own needs. The results demonstrated that in the context of cancer patients and their spouse as caregivers, neither partner considered the informational needs of his or her spouse.

Adult↗
PubMed2002

In the eye of both patient and spouse: memory is poor 1 to 2 years after coronary bypass and angioplasty.

BACKGROUND: The study aimed to investigate patient and spouse perception of cognitive functioning 1 to 2 years after coronary artery bypass grafting. METHODS: Seventy-six married patients who had undergone coronary artery bypass grafting were selected and sex- and age-matched with 75 concurrent married patients who had undergone percutaneous transluminal coronary angioplasty. Couples received a letter of explanation and then completed telephone interviews. Forty-seven questions assessed memory, concentration, general health, social functioning, and emotional state. Response choices were: improved, unchanged, or deteriorated function after coronary artery bypass grafting/percutaneous transluminal coronary angioplasty. RESULTS: Patients who had undergone coronary artery bypass grafting did not differ in subjective ratings on any measure from patients who had undergone percutaneous transluminal coronary angioplasty. There were no differences between spouses in the respective groups; spouse ratings also did not differ from patient ratings. Only in memory function did patients and spouses report a postprocedural decline. CONCLUSIONS: No subjective differences were found in patients who had undergone either coronary artery bypass grafting or percutaneous transluminal coronary angioplasty. Spouse ratings agreed with each other and with patient ratings. Positive correlations were found between the questionnaire factors, suggesting that perceived health and well-being are associated with subjective cognition.

Activities of Daily Living↗
PubMed1996

Depressive symptoms across older spouses: longitudinal influences.

Cross-sectional findings that depressive symptoms in one older spouse influence those of the other and that marital closeness increases the influences (R.B. Tower & S.V. Kasl, 1995) were tested longitudinally. Independent interviews in 1982, 1985, and 1988 with spouse-pairs who participated in the Established Populations for the Epidemiologic Study of the Elderly showed that changes in depressive symptoms in one older spouse contributed to changes in depressive symptoms in the other. For wives in 1985 and for husbands in 1988, a spouse's baseline depressive symptoms also contributed independent variance to an increase in respondent's score on the Center for Epidemiologic Studies Depression Scale. These findings were stronger when a couple was close. These results held when known intrapersonal risk factors and the health status of the spouse were controlled.

Aged↗
PubMed2000

Negative and positive health effects of caring for a disabled spouse: longitudinal findings from the caregiver health effects study.

Data from the first 2 waves of the Caregiver Health Effects Study (n = 680) were analyzed to examine the effects of changes in caregiving involvement on changes in caregiver health-related outcomes in a population-based sample of elders caring for a disabled spouse. Caregiving involvement was indexed by levels of (a) spouse physical impairment, (b) help provided to the spouse, and (c) strain associated with providing help. Health-related outcomes included perceived health, health-risk behaviors, anxiety symptoms, and depression symptoms. Increases in spouse impairment and caregiver strain were generally related to poorer outcomes over time (poorer perceived health, increased health-risk behaviors, and increased anxiety and depression), whereas increased helping was related to better outcomes (decreased anxiety and depression). Results suggest that caring for a disabled spouse is a complex phenomenon that can have both deleterious and beneficial consequences.

Aged↗
PubMed2006

Older spouses' perceptions of partners' chronic arthritis pain: implications for spousal responses, support provision, and caregiving experiences.

This study of older patients with osteoarthritis and their spouses examined concordance between patients' and spouses' reports of patients' pain severity and the association of concordance with support and caregiving outcomes. Patients and spouses independently viewed videotapes of the patient performing simulated household tasks and provided ratings of patients' pain. Spousal overestimation of patients' pain was the most common type of nonconcordance. Spouses who were accurate in their perceptions of their partner's level of pain during a log-carrying task responded less negatively and provided emotional support that was more satisfying to patients. In addition, spouses who were accurate in their perceptions of their partner's pain during the log-carrying task reported less stress from providing support and assistance. Future research that uses such observational methods may be highly useful for understanding the effects of chronic illness on older couples.

Activities of Daily Living↗
PubMed2004

Beyond the "self" in self-efficacy: Spouse confidence predicts patient survival following heart failure.

Ratings of patient efficacy to manage illness, made by 191 congestive heart failure patients and their spouses, were examined as predictors of patients' survival over the next 4 years. When considered alone, both the patient's self-efficacy and the spouse's confidence ratings predicted survival, but only spouse confidence remained significant when both partners" efficacy ratings were included in the same Cox regression model. The overlapping prognostic significance of spouse confidence and a global, multicomponent measure of marital quality positioned the former as a proxy for the latter, reflecting a fundamentally social protective factor in patient survival. Successful adaptation to heart failure appears to involve more than the patient's personal agency, and psychosocial data from spouses can improve prediction of patient outcomes.

Adult↗
PubMed2006

Life task appraisals, spouse involvement in strategies, and daily affect among short- and long-term married couples.

The purpose of this study was to examine predictors and consequences of spouses' involvement in each others' strategies for pursuing important personal goals called life tasks. Husbands and wives within 39 short- and long-term marriages described five life tasks and provided appraisals of whether each was shared with their spouse. Participants later completed 14 consecutive diary entries recording daily life task pursuit strategies, the extent of spouse involvement in each, and measures of positive and negative affect. Results indicated that interdependence in life task appraisals prospectively predicted greater spouse involvement, and greater spouse involvement was associated with more positive affect for that day. Life task appraisals may provide avenues for understanding couples' strategies for dealing with goals or stressors and how those strategies affect mood.

Adult↗
PubMed2000

Low incidence of hepatitis C virus transmission between spouses: a prospective study.

BACKGROUND: Interspousal transmission of hepatitis C virus (HCV) has been documented; however, the annual risk of interspousal transmission remains unclear. METHODS: A long-term prospective study to define the risk of interspousal transmission of HCV was conducted. One hundred and twelve index patients with chronic hepatitis C and their anti-HCV seronegative spouses were enrolled. RESULTS: The mean follow-up period was 45.9 months. Antibodies to HCV (anti-HCV) and HCV-RNA were tested for in each seronegative spouse every year. Seroconversion of anti-HCV occurred in only one spouse, 2 years after enrollment, with a concomitant acute hepatitis. This subject and his spouse were infected with HCV genotype 1b. Nucleotide sequence comparison of the hypervariable region of their HCV genomes showed a homology of 98%. Further phylogenetic analysis suggested that they had virtually the same isolate. Accordingly, the annual risk of interspousal transmission of HCV infection was 0.23% per year. CONCLUSIONS: These findings suggest a low incidence of interspousal transmission of HCV; however, the risk may be cumulative and such couples should be educated to avoid HCV infection from their spouses.

Disease Transmission, Infectious↗
PubMedDate not supplied

[Educational needs among spouses of depressive patients and their illness models of depression].

BACKGROUND: Psychoeducational workshops for families of depressive patients emphasize the provision of information about the patient's illness and methods of coping with it effectively. However, intervention programmes for the specific needs of patients' spouses are rare. To further explore the situation of patients' spouses we examined how spouses of depressive patients view illness behaviour and what kind of further information they need. METHOD: Interview data from 54 spouses of patients with unipolar depression were analysed as part of the baseline assessment of a study on the economic and health burden experienced by families with mentally ill relatives. RESULTS: Results are discussed in terms of the consequences of spouses' illness models for designing psychoeducational workshops for the families of depressive patients. The results document the great need for negotiated partnership between families and professionals. Furthermore, the need for educating the public about the disorder and its psychosocial costs for the patients' families is highlighted.

Adaptation, Psychological↗
PubMed2004

[Illness related costs for spouses of patients suffering from a mental illness: results of a study with repeated measurements].

OBJECTIVE: Aim of this study is the documentation of illness-associated costs for spouses, whose relative is suffering from a mental illness. METHOD: Over a period of 12 month, 117 spouses of patients who are suffering from schizophrenia, depression or anxiety disorders repeatedly filled in a standardized questionnaire about illness related expenses and financial losses. RESULTS: 90 % of the spouses reported direct cash expenditures on behalf of the patients' illness. On average, these costs amounted to yearly expenditures of euro 1146 (range: euro 0 - 11 910). Costs did not differ significantly across types of illness and income was not found to be a significant covariate. CONCLUSIONS: Spouses reported substantial direct cash expenditures on behalf of the patients' illness. Since these expenditures varied to a large extent over the three points of measurement, repeated measurement designs seem to be a prerequisite for a reliable assessment of illness-associated costs. Since living together with a mentally ill partner is associated with an increased risk of developing a burden-related psychiatric illness for spouses themselves which may lead to double costs and double decreases in income, these aspects should be taken into consideration when planning changes in health policy.

Adult↗
PubMed1997

Spouses as adjuncts in fluency therapy.

Couples with one partner who stutters completed questionnaires about the fluent partners' awareness of their spouses' stuttering; their general knowledge about stuttering; how fluent spouses had helped their partners; and the nature and benefits of spousal participation in therapy. Findings strongly suggested that spouses may be helpful in therapy. Considerations and suggestions for involving spouses are made on the basis of these findings and those of surveys completed by speech-language pathologists (SLPs) who include spouses in fluency therapy.

Female↗