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PubMed1999

Stress and coping strategies in spouses of depressed patients.

The relationships between the coping strategies used by spouses of clinically depressed patients and spouses' anxiety, depression, and marital maladjustment were investigated. Fifty spouses of clinically depressed patients completed a biographical questionnaire, the Coping Strategy Indicator (J. H. Amirkhan, 1990, 1994), the Beck Depression Inventory (A. T. Beck, 1967; A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961), the State-Trait Anxiety Inventory (C. D. Spielberger, R. E. Lushene, B. A. Vagg, & E. Jacobs, 1983), and the Locke-Wallace Marital Adjustment Test (H. J. Locke & K. M. Wallace, 1959, 1987). Anxiety was highly prevalent in the spouses; more than half were depressed, and half showed marital maladjustment. Significant positive correlations were found between an avoidant coping strategy and anxiety as well as depression, and a significant negative correlation was found between an avoidant coping strategy and marital adjustment. These findings indicate the ineffectiveness of an avoidant coping strategy for spouses of clinically depressed patients.

Adaptation, Psychological↗
PubMedDate not supplied

The role of spouses of substance abusers in treatment: gender differences.

Studies exploring gender differences among substance abusers in treatment have been fairly consistent in finding that females who enter treatment express more severe psychological and psychosocial disturbances than males, despite presenting with shorter and less intense substance abuse histories. However, strands of evidence suggest that the presence of a spouse, generally perceived as an asset in the treatment of the substance abuser, may have different implications for females than for males. In order to clarify this issue, 67 male and 18 female married substance abusers in treatment and their spouses were questioned on their substance use and psychological and social functioning. Similar to other studies, the female substance abusers reported greater disturbance on dimensions of employment and psychological functioning, but less severity of alcohol abuse. Comparison of male and female spouses, however, revealed that male spouses were likely to present with the following characteristics: (1) more symptoms of substance abuse and depression, (2) less overall physical well-being, and (3) to be less inclined to help others or be involved with their children than the female spouses. These findings are consistent with the view that the process of substance abuse is telescoped in females and is associated with more disturbed functioning in women on admission to treatment than in men. However, contextual differences--specifically in terms of availability of spousal support--may contribute significantly both to the understanding of differences in female versus male substance abusers in treatment as well as to the development of guidelines for adapting treatment based on gender.

Adult↗
PubMed1998

Social and depressive stress suffered by spouses of patients with mild dementia.

OBJECTIVE: To identify stressors and their correlates in spouses of patients with mild dementia. DESIGN: Retrospective study of patient records. SETTING: Patients attending a Memory Clinic at Ullevaal Hospital in Oslo. SUBJECTS: 92 mildly demented patients living at home (mean age 75.7 years, 51% women, mean MMSE score 22.3) and their spouses. MAIN OUTCOME MEASURES: Frequency and types of stress suffered by spouses using validated and factor-analyzed instruments as measures. RESULTS: Twenty-five per cent or more of the spouses reported often/always having problems with the following: being depressed by the situation, having difficulties getting away on holiday, social life being affected, household routines being upset, and sleep being interrupted. Factor analysis of the Greene Caregiver Stress Scale (15 items) identified two factors; 'Social stress' and 'Depressive stress'. Social stress was associated with the patient's I-ADL level, and depressive stress with mood and behaviour of the patient. The depressive symptomatology of the patient as expressed by the spouses was related to both depressive and social stress, whereas cognitive function, as measured by the MMSE, was not an independent predictor of carer strain. CONCLUSION: Even in mildly demented patients, symptoms of carer stress are frequent. Supportive strategies such as early diagnosis, information for carers and intervention strategies are discussed.

Activities of Daily Living↗
PubMed2001

Effects of coping skills training, group support, and information for spouses of alcoholics: a controlled randomized study.

Our aim was to compare the effect of three different interventions in spouses of alcoholics with regard to coping strategies, mental symptoms, hardship, and drinking patterns. The spouses were randomized to three different interventions: 1) information, 2) individual coping skills training, and 3) group support. Follow-up periods were at 12 and 24 months. In this paper the 12-month results are presented. Thirty-nine spouses attended the study. They were recruited from the services of the Department of Alcohol and Drug Diseases, Malmö University Hospital, Malmö, Sweden, and advertisements in the local daily press. The spouses were randomized to 1) 1 standard information session, 2) 4 individual coping skills training sessions, once a month, and 3) 12 group sessions, twice a month. Background data were obtained, and four self-report scales-the Coping Behaviour Scale, Hardship Scale, SCL-90, and AUDIT-were administered at admission and follow-up examinations. At follow-up all three groups had improved significantly with regard to coping behaviour, hardship, and mental symptoms. The coping skills training group and the support group together showed a stronger decrease in psychiatric symptoms (P = 0.1) than the single information session group. The three groups did not differ in coping behaviour and hardship. The findings indicate that changing of coping strategies in spouses of alcoholics can be successful with only one single information session, whereas the reduction of mental symptoms may need longer treatment.

Adaptation, Psychological↗
PubMed2002

Problem-solving skills and emotional distress in spouses of men with prostate cancer.

BACKGROUND: Prostate cancer, the most common cancer in American men, may increase the risk of emotional distress in patients and their spouses. Problem-solving skills may be related to the emotional distress of the spouses. METHOD: Thirty-two spouses of prostate cancer patients completed measures of problem-solving skills and emotional distress. RESULTS: Proactive problem-solving skills were related to less emotional distress in spouses. Subtypes of problem-solving skills were differentially related to emotional distress. CONCLUSIONS: Enhancement of problem-solving skills may contribute to improved health-related quality of life of spouses of prostate cancer patients.

Adaptation, Psychological↗
PubMed2006

Spouse caregivers of Alzheimer patients: problem responses to caregiver burden.

This paper reports on comparisons of patterns of responses by 199 spouses of Alzheimer disease patients to stresses of functioning as caregivers. Focusing on gender and age of spouses, we examine effects of the total burden of caregiving and perceived patient problems on a set of emotional and social responses of caregivers. We also examine ways in which depressive symptoms and anxiety of spouse caregivers were associated with patterns of their responses to caregiving stresses. Total patient problem burden was most strongly associated positively with caregiver anger-resentment toward the patient, followed by caregiver concerns about personal time restriction and limitation of social life. Among individual areas of patient problems, emotional lability of the patient rather than cognitive impairment appeared strongest by far in affecting caregiver response measures. Negative impact of caregiving on their social life and associations appeared to have particularly marked effects on effects on caregiver depressive symptoms and anxiety scores. Spouse caregivers did not differ by age in clinically significant ways in their patterns of reaction to stresses of caregiving. The study suggests the importance of considering potential spouse caregiver reactions in such areas as anger and aggressive response to patients, the impact of feelings of social deprivation and personal sacrifice, as well as the implications of caregiving stresses for patient care and maintenance of family cohesion and quality of life.

Aged↗
PubMed2004

Retirement transitions and spouse disability: effects on depressive symptoms.

OBJECTIVES: The purpose of this study was to investigate the effects of type of retirement (forced, early, abrupt) and spouse's disability on longitudinal change in depressive symptoms. METHODS: The analyses rely on Waves 1-4 of the Health and Retirement Survey (N = 2,649). Generalized estimating equations models with bootstrapped standard errors and adjustment for survey design and non-independence of dyad members estimate effects of retirement, type of retirement, and spouse's disability on depressive symptoms, controlling for relevant covariates. RESULTS: The results suggest that depressive symptoms increase when retirement is abrupt and perceived as too early or forced. Women retirees who stopped employment and were either forced into retirement or perceived their retirement as too early report significantly more depressive symptoms with increasing spouse activities of daily living (ADLs) limitations. There is no similar effect for men. In contrast, for working retirees who retired on time, depressive symptoms decrease with increasing spouse ADLs. DISCUSSION: These results highlight the importance of retirement context on postretirement well-being. They suggest that both type of retirement transition and marital contexts such as spouse's disability influence postretirement well-being, and these effects differ by gender.

Activities of Daily Living↗
PubMed2006

Well-being in older Mexican American spouses.

PURPOSE: There is a strong connection between marriage and well-being, with evidence suggesting that the well-being of one spouse is closely correlated with that of the other. However, among older Mexican Americans, there is little information about this phenomenon. To address this, we explore two research questions: Does one spouse's well-being predict the other spouse's well-being? Are there gender differences in these effects? DESIGN AND METHODS: We assess information from 553 couples who participated in Wave 1 (1993-1994) of the Hispanic Established Populations for the Epidemiologic Studies of the Elderly. Using structural equation models, we examined three aspects of well-being among older Mexican American couples: depressive symptoms, life satisfaction, and self-rated health. RESULTS: The findings revealed evidence of an association between the well-being of one spouse and that of the other. Specifically, the self-rated health of husbands and wives predicts that of their partners. However, there is evidence that husbands' depressive symptoms and life satisfaction influence wives' well-being, but not the reverse. IMPLICATIONS: The findings from this study are important because they add to the literature on the connection of well-being among spouses, point to important gender differences, focus on an understudied minority group with unique cultural characteristics, and have implications for the examination of well-being within a marriage framework.

Aged↗
PubMed2005

Estimation of the risk of transmission of hepatitis C between spouses in Egypt based on seroprevalence data.

BACKGROUND: Transmission of hepatitis C virus (HCV) between spouses could be due to sexual contact, sharing needles, or other routes. There is uncertainty regarding the degree to which HCV is transmitted between spouses. METHODS: Data from a 1997 cross-sectional serological survey of HCV in two communities in Egypt were used to estimate the risk of transmission between spouses by simultaneously modelling the probabilities of community acquisition and spousal transmission of HCV as functions of known predictors. RESULTS: We estimate that the probability of wife-to-husband transmission was 34% (95% CI: 15-49%) and 10% (95% CI: 0-26%) for anti-HCV-positive wives with and without detectable HCV RNA, respectively. The probability of husband-to-wife transmission was estimated to be 3% (95% CI: 0-13%) and 0% (95% CI: 0-9%) for husbands with and without detectable HCV RNA, respectively, at the time of the survey. There was moderate evidence that the probability of wife-to-husband transmission differed from that of husband-to-wife transmission (P = 0.076), and there was greater risk of transmission from those with detectable RNA at the time of the survey (P = 0.046). We estimate that 6% of those infected acquired HCV from their spouse. CONCLUSION: Our study results support the possibility that HCV is transmitted between spouses in Egypt. Further research is needed to identify the exact routes of transmission so that preventive measures can be instituted.

Adolescent↗
PubMed1999

Psychosocial issues for spouses of brain injury survivors.

Brain injury has a profound effect on the family system. When the survivor is a spouse, the impact is especially devastating. Roles in the family are changed, responsibilities are shifted and economic stability is often challenged. The noninjured spouse frequently faces these difficult circumstances without the customary support of his or her marriage partner. The cognitive and behavioral changes which are associated with brain injury alter the survivor as a person. This creation of a "new" member of the family system necessitates major adjustments as this individual is reincorporated into the family. It is not unusual for friction to develop between the noninjured spouse and the in-laws. Because the experience of spouses is different from the experience of parents of persons with brain injury they may benefit from a mutual support group exclusively for spouses.

Brain Injuries↗
PubMed2002

Spouses' attributions for helping: the effects of styles of help-seeking, self-serving bias, and sex.

This paper examines the effects of (a) how clearly the desire for help is presented, (b) self-serving bias, and (c) sex differences on the source of the cause of helping happening (or not) that spouses attribute to a potential helper. In two studies, a total of 138 couples imagined situations in which a person wanted his or her spouse to do a chore. How clearly the desire for help was expressed, whether help was given, and whether it was the participant or the spouse who was expected to help were manipulated. The participants reported their attributions for the cause of helping (or not) to themselves and the spouse on visual analog scales. There was strong support for a proposed interaction between how clearly the desire for help was expressed and whether help was given in predicting spouses' attributions. No support was obtained for a predicted self-serving bias or for a suggestion that men make more self-enhancing attributions than women, the findings were instead congruent with a relationship-enhancing bias. The findings are discussed in terms of the context of housework.

Adult↗
PubMed2005

The impact of a nurse-led support and education programme for spouses of stroke patients: a randomized controlled trial.

AIMS AND OBJECTIVES: The aim of the present study was to determine the impact of a nurse-led support and education programme for improving the spouses' perceived general quality of life, life situation, general well-being and health state. BACKGROUND: Stroke is a disease with great consequences for the patients and their families. The spouses often feel obligated to care for the patient, providing psychological and physical support and having to cope with the patient's physical and cognitive impairments. This might lead to increased problems, as family members struggle to adapt to their new roles and responsibilities. DESIGN AND METHODS: Longitudinal, randomized controlled trial. One hundred spouses were randomly assigned to intervention or control groups, 50 in each group. The intervention group participated in a support and education programme, six times during six months, led by stroke specialist nurses. Both groups were followed for 12 months. RESULTS: No significant differences were found, between intervention and control groups, over time. In the sub analyses, we found that the group attending 5-6 times had a significant decrease in negative well-being and increased quality of life over time, while the group attending fewer times had a significant decrease in positive well-being and health state, similar to the control group, which also had a significant decrease in negative and general well-being. CONCLUSIONS: A support and education programme might have a positive effect on spouses' well-being, on condition that they attend at least five times. RELEVANCE TO CLINICAL PRACTICE: To facilitate the spouses' role as informal caregivers to the stroke patients, further development of the support and education programme used in the present study is needed, including empowerment approach and implementation of coping strategies.

Adaptation, Psychological↗
PubMed2006

'The intruder': spouses' narratives about life with a chronically ill partner.

AIM: The aim of this study was to illuminate the meaning of middle-aged spouse's experiences of living with a chronically ill partner. A purposive sample of four female spouses was selected for interviews using a narrative approach. BACKGROUND: When someone is diagnosed with a chronic illness, it is easy to understand that a considerable number of devastating consequences follow, both for the afflicted as well as for the family. Families often feel neglected and that their problems and needs are underestimated, if they do not personally draw attention to this fact. METHODS: A phenomenological hermeneutic method, inspired by the philosophy of Ricoeur, was used when interpreting the interview text. RESULTS: The experiences of spouses living with a chronically ill partner often brought a feeling of detachment from their partner's lives. The women experienced changes in their relationships because of their partners' disabilities; they had emotions of loneliness, despite living together as a couple. Through their actions, the women sought reassurance and support in order to maintain a meaningful partnership with their spouses and this is expressed in three themes: feelings of limitation, the struggle of everyday life and a striving for normalization. CONCLUSIONS: Middle-aged women living with a chronically sick partner are still of an active disposition and regard themselves as still being in mid-life. They wish to be loved as a wife and not as a care provider. RELEVANCE TO CLINICAL PRACTICE: The findings from this study can help increase the knowledge and understanding of the problems and concerns encountered by middle-aged spouses living with chronically ill partners and can be useful in the education and supervision of nurses and in relationship with relatives.

Adaptation, Psychological↗
PubMed2004

Loneliness, depression, and social support of Turkish patients with chronic obstructive pulmonary disease and their spouses.

PURPOSE: To identify the differences in loneliness, depression, and social support among Turkish patients with COPD and their spouses. DESIGN: The convenience sample consisted of 30 patients with COPD and their spouses. Descriptive statistics, Student's t tests, and Pearson product moment correlations were used to analyse the data. METHODS: Data were collected during structured interviews in an outpatient clinic in Turkey by using the UCLA Loneliness Scale, the Beck Depression Inventory and Perceived Social Support from Friends and Family scales. FINDINGS: Levels of loneliness, depression, and perceived social support from family and friends were similar for patients and spouses. Loneliness and depression were positively related, but both loneliness and depression were greater with less perceived social support from family and friends for both patients and their spouses. CONCLUSIONS: Patients' and spouses' psychologic reactions to COPD might include feelings of loneliness and depression, which might be alleviated by social support.

Adaptation, Psychological↗
PubMed2001

Intestinal permeability is increased in a proportion of spouses of patients with Crohn's disease.

OBJECTIVE: Increased small intestinal permeability has been found in patients with Crohn's disease and in a proportion of their healthy relatives. This may reflect a shared environment or shared genes. The finding of abnormal permeability in the healthy spouses of patients would favor an environmental cause for this observation. METHODS: The healthy spouses of patients with Crohn's disease attending three gastroenterology clinics were invited to participate. Eligible subjects consumed a 350-ml solution containing lactulose, mannitol, and sucrose before bedtime. All overnight urine was collected, assayed by high performance liquid chromatography, and the ratio of fractional excretion of lactulose to mannitol was calculated as an index of permeability. The results were compared with those of a previously determined control group. RESULTS: Sixty spouses completed the study. Increased permeability was present in eight (13.3%, 95% CI = 6.0-24.6%). The presence of increased permeability was not related to age, gender, duration of cohabitation, alcohol use, nonsteroidal anti-inflammatory drug use or to disease activity in the patient with Crohn's disease. There was a nonsignificant trend for abnormal permeability to occur in those spouses cohabiting with the patient with Crohn's disease at the time of disease diagnosis (p = 0.128). CONCLUSIONS: Small intestinal permeability is increased in a proportion of healthy spouses of patients with Crohn's disease. The presence of abnormal permeability studies in patients with Crohn's disease and a proportion of their healthy close contacts suggests that this phenomenon is caused by environmental factors.

Adult↗
PubMed1996

Longitudinal evaluation of the development of periodontal destruction in spouses.

The aim of the present investigation was to study longitudinally the periodontal condition of married couples. The data are derived from a longitudinal study in a young population living in a remote village in Indonesia and showing a relatively high prevalence of periodontal destruction. In 23 married couples, clinical measurements were carried out in 1987 and 1994. During the latter examination, a pooled gingival sample was obtained for microbiological evaluation. In 1994, the mean age of the group was 29.1 years and the couples were married for on the average 10 years. In each couple, the partner showing in 1994 the highest score for mean loss of attachment (LA) was classified as the diseased proband and the other partner as the spouse. Evaluation of the clinical data showed that: (1) the diseased probands already had in 1987 a worse periodontal condition compared to that of the spouses; (2) in both groups the mean LA increased during the 7-year period; (3) the difference in mean LA between diseased probands and spouses increased between 1987 and 1994. The microbiological evaluation revealed a relatively high prevalence of Actinobacillus actinomycetemcomitans (50%), Porphyromonas gingivalis (67%) and Prevotella intermedia 61%. Analysis showed no differences in microbiota between diseased probands and spouses. The 23 Actinobacillus actinomycetemcomitans positive subjects included 2 positive couples. Furthermore, the 31 Porphyromonas gingivalis and 28 Prevotella intermedia positive subjects included 9 and 7 positive couples respectively. In conclusion, 10 years of cohabitation showed no influence on the periodontal condition of the spouses.

Adult↗
PubMed1997

A comparison of hospice and hospital care for the spouses of people who die.

To compare the quality of care for spouses of dying people in St Christopher's Hospice, London and nearby hospitals in 1994 and to make comparisons with earlier studies of the same setting, interviews were undertaken with spouses of people who had died from cancer in these settings, matched by the deceased's age and sex. The subjects comprised 66 people whose spouses had died in 1994, 33 of whom had died in the hospice, 33 in local hospitals. The mean age was 69.3; 61% were female. No significant differences between groups were found on the outcome measures (adjustment to bereavement, anxiety and psychosomatic symptoms at the time of the final admission), largely replicating earlier studies in the same setting. In various respects hospitals have moved closer to hospice practice: in contrast to earlier studies, there were no differences in visiting patterns or in spouses helping with inpatient care. Bereavement follow-up is now initiated in some cases by hospitals. Liberal visiting hours could be stressful, however, and spouses sometimes helped with care to remedy staff shortcomings. Regret at not being present at the death was more common in the hospital group. Bereavement interventions may have more effect on subsequent adjustment if targeted on high-risk individuals. Other benefits than adjustment, however, may be achievable. Steps to create a calm atmosphere on hospital wards where people can be with their relatives near the time of death are desirable.

Aged↗
PubMed1998

Associations of individuals' health-related behavior with their own or their spouses' smoking status.

BACKGROUND: Many studies indicated that smokers have poor health habits such as high alcohol consumption and imbalanced nutrient intakes. These habits could affect the health-related behavior of smokers' families. METHODS: To investigate the relationship between an individual's health-related behavior (nutrient intakes and participation in cancer screening) and their spouses' smoking status, we analyzed data collected using a self-administered questionnaire during a cohort study. We compared nutrient intakes and cancer screening participation rates between subjects grouped according to their spouses' smoking status, using a multivariate linear regression model to adjust for each subject's age and alcohol consumption. RESULTS: There was an association between husbands' and wives' smoking status (never and current only). Poor micronutrient intakes and cancer screening participation rates were associated with both the subjects' and their spouses' smoking habits. This tendency was most apparent among male smokers and nonsmoking women. However, among nonsmoking men and female smokers, there were no statistically significant differences between groups classified according to their spouses' smoking status. CONCLUSION: Spouses' smoking habits were associated with poor health-related behavior in their partners.

Adult↗