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PubMed1994

Communication patterns in patients with erectile dysfunction and their partners.

Patients with erectile dysfunction (ED) and their partners (n = 18) were compared on perceived distress caused by the ED, attribution of responsibility for the ED and marital communication. Comparisons were also made between couples in whom the ED was organically based versus those in whom it was psychogenically based. No differences were found between organic versus psychogenic ED couples on perceived distress, attributions, or marital communication skills. Patients and partners differed on communication (P < 0.001), attributions (P < 0.001) and perceptions of distress experienced by their spouse (P < 0.001). However, both members of the couple found the ED equally distressing. Partners tended to attribute more responsibility for the ED to themselves when they believed it was psychogenic (P < 0.001), while patients claimed sole responsibility regardless of their perceptions of its etiology. Patients had clinically problematic communication scores (P < 0.001), while partners did not. Contrary to initial hypotheses, communication scores did not predict agreement/disagreement between patients and partners on perceived etiology, attributions or distress. Discussion is focused on the need for therapy to address couples' communication specific to sexual activity and the effects of the ED.

Communication↗
PubMed1992

The psychosocial sequelae of a second-trimester termination of pregnancy for fetal abnormality.

A retrospective study to investigate the psychosocial sequelae of a second-trimester termination of pregnancy (TOP) for fetal abnormality (FA) is described. After appropriate consent was obtained, 84 women and 68 spouses were visited 2 years after the event and asked to complete an extensive questionnaire. Most couples reported a state of emotional turmoil after the TOP. There were differences in the way couples coped with this confusion of feelings. After 2 years about 20 per cent of the women still complained of regular bouts of crying, sadness, and irritability. Husbands reported increased listlessness, loss of concentration, and irritability for up to 12 months after the TOP. In the same period, there was increased marital disharmony in which 12 per cent of the couples separated for a while and one couple obtained a divorce. These problems could be attributed to a lack of synchrony in the grieving process. Confusing and conflicting feelings led to social isolation and lack of communication. Difficulties in coming to terms with the fetal loss were not found to be linked to the type of fetal abnormality or religious beliefs but were related to parental immaturity, inability to communicate needs, a deep-rooted lack of self-esteem before the pregnancy, lack of supporting relationships, and secondary infertility. Suggestions for improved management are given.

Abortion, Therapeutic↗
PubMed2006

Cancer-related communication between female patients and male partners scale: A pilot study.

BACKGROUND: The study's objective was to evaluate the reliability and validity of the Cancer-Related Communication Problems within Couples Scale (CRCP), a measure to assess whether patients and their partners have difficulty talking about cancer with each other. METHODS: The CRCP Scale included 18 items concerning open communication/emotional support, treatment-specific issues, self-protection, and protective buffering. Patients and partners responded through the American Cancer Society's website and mailed questionnaires through Y-ME. The CRCP's validity was tested using the Hospital Anxiety and Depression Scale (HADS) and the Dyadic Adjustment Scale (DAS, marital relationship). RESULTS: 189 female patients and 135 male partners participated in the survey. Three items were deleted based on lack of clarity or an item not being applicable to many respondents, resulting in a 15 item scale. The number of CRCP problems' internal consistency in the 15 item scale was good for both patients and partners (alpha coefficient = 0.87, 0.81, respectively). The number of patients' CRCP problems correlated with the DAS (p < 0.0001), and the number of partners' CRCP problems correlated with the HADS (p < 0.0001) and the DAS (p < 0.0001). CONCLUSION: Analyses supported the CRCP Scale's reliability and validity for female cancer patients and male partners.

Adaptation, Psychological↗
PubMed2004

[Marital communication and depressive symptoms in couples in which the woman has cancer of the breast].

If doctor-patient communication is a frequent subject of research, couples communication where one partner has cancer is quite recent. Some studies deal with couples communication, but from an anecdotic perspective, without any operational measure. The aim of this paper is to study couples' communication frequency and link it to depressive symptomatology. Marital communication was assessed with three scales: frequency of general communication, frequency of communication about cancer and satisfaction with communication. About one month following surgery, 120 breast cancer patients were interviewed; only 11 partners (9%) refused to be interviewed. Results show less communication is associated with higher depressive level. Patients and partners with a passable level of communication, particularly about cancer, are clinically at risk for depression. Communicating frequently about cancer in the couple seems thus associated with a positive effect, i.e. a depressive level found in the general population. Direction of causality between frequency of marital communication and depressive symptomatology cannot be established from this study.

Breast Neoplasms↗
PubMed2005

Occupational exposures and reproductive health: 2003 Teratology Society Meeting Symposium summary.

Assuring reproductive health in the workplace challenges researchers, occupational safety and health practitioners, and clinicians. Most chemicals in the workplace have not been evaluated for reproductive toxicity. Although occupational exposure limits are established to protect 'nearly all' workers, there is little research that characterizes reproductive hazards. For researchers, improvements in epidemiologic design and exposure assessment methods are needed to conduct adequate reproductive studies. Occupational safety and health programs' qualitative and quantitative evaluations of the workplace for reproductive hazards may differ from standardized approaches used for other occupational hazards in that estimates of exposure intensity must be considered in the context of the time-dependent windows of reproductive susceptibility. Clinicians and counselors should place the risk estimate into context by emphasizing the limitations of the available knowledge and the qualitative nature of the exposure estimates, as well as what is known about other non-occupational risk factors for adverse outcomes. This will allow informed decision-making about the need for added protections or alternative duty assignment when a hazard cannot be eliminated. These policies should preserve a worker's income, benefits, and seniority. Applying hazard control technologies and hazard communication training can minimize a worker's risk. Chemical reproductive hazard training is required for workers by the Occupational Safety and Health Administration's Hazard Communication Standard. The National Institute for Occupational Safety and Health (NIOSH) has formed a National Occupational Research Agenda Team to promote communication and partnering among reproductive toxicologists, clinicians and epidemiologists, to improve reproductive hazard exposure assessment and management, and to encourage needed research.

Female↗
PubMed1992

Partnership after induced abortion: a prospective controlled study.

To study the social and psychological consequences of induced abortion on the relationship between the pregnant woman and her partner, 92 patients seeking a socially indicated abortion, who had a stable partner at the time of abortion, were interviewed. Standardized psychological measures were used to assess their partnerships before abortion and on follow-up 1 year later. A control group of 92 patients (matched for age, marital status, duration of partnership, number of children, and educational background), drawn from a larger sample of women using safe contraceptive methods, completed the same psychological measures. Prior to abortion, partnerships in the study group showed considerably more conflicts and were less harmonious than in the control group. One year after the abortion, the number of separations in the study group was not significantly higher than in the control group, nor were there any remaining qualitative differences in the partnerships of either group. When separations occurred, they had been more frequently initiated by women in the study group than in the control group.

Abortion, Induced↗
PubMed1992

An evaluation of therapeutic programs for the treatment of secondary inorgasmia in women.

This paper is concerned with a review and evaluation of programs for the treatment of secondary inorgasmia in women. Treatments address a wide range of factors. They include medical and psychiatric disorders, lack of sexual knowledge and communication between partners, marital disharmony, sexual anxiety, and performance anxiety. These treatment approaches are evaluated, along with the effectiveness of Masters and Johnson's therapy, and the many variants of this approach. The use of erotic fantasy in the treatment of this condition is also discussed. Conclusions are limited by the nature of research in this area. It is essentially clinical in form. Often it fails to define the characteristics of the conditions that are required to assess contributing factors, treatment strategies, and pre- and posttreatment measures.

Female↗
PubMed1994

Post-vasectomy erectile dysfunction.

We investigated two groups of men with regard to vasectomy acceptance, and subsequent erectile dysfunction. Group I was a group of 45 men chosen at random from 254 vasectomized patients. Group II was a group of 18 men who, out of 180 patients treated for erectile dysfunction, attributed their dysfunction to previous vasectomy. We analysed the social background, motivation for vasectomy and postoperative changes of sexual life or behaviour of the partners. The partnership constellation, particularly the role of a predominant female partner seems to be an important feature for vasectomy acceptance. Low acceptance might cause erectile dysfunction.

Adult↗
PubMed1996

The relationship of partner support to outcomes for teenage mothers and their children: a review.

This article reviews the literature on the relationship of partner support to outcomes for teenage mothers and their children. It discusses the changing alliance over time between men who father their babies and the young mothers and their children. This report considers both adults and adolescents who father children with adolescent women. The discussion focuses on the relationship between partner support and three outcomes for the mothers: educational outcomes, economic outcomes, and psychological well-being. The general association between partner support and the children's development is also examined. In addition, partner support is viewed within the context of the teenager's family system, providing a framework for assessing key features of support for teenage mothers. The article outlines suggestions for future research.

Adolescent↗
PubMed2003

Making waves: systems change on behalf of youth with HIV/AIDS.

PURPOSE: To document the effects of five Special Projects of National Significance (SPNS), funded by the Health Resources and Services Administration (HRSA), on HIV care, related service systems, policy, planning, and funding for youth with HIV/AIDS. METHODS: Literature on services and systems integration and technology transfer is used as a conceptual framework for the examination of HIV-informed, youth-specific changes at the local, state, and national levels. The Principal Investigators for each project and/or the Project Evaluators were interviewed several times to capture "snapshots" of evolving results from the Projects' varied activities in New York City; Newark, New Jersey; Chicago; and Miami. Some changes were consciously targeted, and others occurred serendipitously. This work covers the funding period from 1996 through 2000. RESULTS AND CONCLUSIONS: There were many "ripple" effects that emanated from these Projects' presence and activities. Important lessons were learned about why systems change is necessary to effectively serve youth with HIV, how to make constructive changes happen, and how to sustain changes once they are achieved. Successful strategies included, but were not limited to, consensus-building among stakeholders, participatory planning and decision-making, collaborative referral and linkage agreements, staff sharing, co-locating services, providing technical assistance, consultation, cross-training, and engaging consumers as partners in communicating new technologies and in advocating for change.

Adolescent↗
PubMed1998

Skills training for pregnancy and AIDS prevention in Anglo and Latino youth.

PURPOSE: This study tested social skills training (SST), didactic training (DT), and no training (NT) on adolescents' social skills for resisting peer pressure to engage in acquired immunodeficiency syndrome (AIDS) and pregnancy risk behavior. METHODS: A total of 307 Latino and Anglo youth ages 13-18 years were assigned at random to receive 18 h of SST, 18 h of DT, or NT. RESULTS: Significantly (p < 0.05) greater increases in assertiveness followed SST compared to DT or NT for three trained skills: condom negotiation, asking a friend about their sex/drug history, and discussing a friend's risk of AIDS. Untrained negotiation skills (e.g., purchasing a condom) did not increase significantly. SST did not result in increased assertiveness for refusal skills. DT increased knowledge of AIDS significantly more than SST; both DT and SST increased knowledge significantly more than NT. CONCLUSIONS: Social skills training can increase assertiveness for certain negotiation skills that may decrease risk of AIDS for Latino, Anglo, and male and female adolescents. Both DT and SST can increase knowledge of AIDS prevention. Differences between experimental groups were supported by differences between trained and untrained skills within the SST condition, adding to discriminant validity.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Prevalence and predictors of low sexual assertiveness

Background: Personal beliefs about sexual attitudes and rights likely affect reproductive health behaviors. We examined the prevalence and predictors of low sexual assertiveness (SA) among sexually active females across three age groups (14-17 yo, 18-21 yo, and 22-26 yo).Methods: 904 white, black, and Mexican-American females presenting at community-based family planning clinics in Southeast Texas between April 1997 and February 1998 completed an anonymous self-report questionnaire that assessed demographic and reproductive characteristics, dating behaviors, mental health measures and occurrence of physical and sexual assault. Subjects also completed a sexual assertiveness scale that assessed one's right to make various reproductive health decisions and sexual communications to partners. A total SA score was obtained by summing the 13 items; scores were then dichotomized so those scoring in the lowest quartile could be compared to the others. Data were analyzed using chi-square and logistic regression stratified by age group (244 aged 14-17; 392 aged 18-21; and 268 aged 22-26).Results: 27% of subjects aged 14-17, 22% aged 18-21, and 17% aged 22-26 were identified as having low SA. For 14-17 years olds, logistic regression analyses revealed that those with low SA as compared to adequate SA were significantly more likely to be Mexican American (OR = 4.8) or black (OR = 3.1) than white, to have hand </= 1 dating partner in the last 12 months (OR = 1.8), and to report inconsistent birth control in last 12 months (OR = 2.0). Among 18-21 years olds, low (SA) was related to reporting forced sexual contact in the last 12 months (OR = 5.2), moderate-to-severe depressive symptoms (OR = 3. 0), no history of physical abuse (OR = 2.5), believing that your partner is monogomous (OR = 2.6), married or living with a male partner (OR = 2.1), </= 3 lifetime sexual partners (OR = 1.8), not using alcohol before sex (OR = 1.8), and gravidity >/= 1 (OR = 1.8). Among 22-26 years olds, low SA was associated with gravidity >/= 1 (OR = 2.8), being a high school dropout (OR = 2.1), and inconsistent birth control use in the last 12 months (OR = 1.9).Conclusions: These data suggest that 1 in 4 sexually active women report low SA and for two age groups these attitudes are associated with inconsistent contraception. Among 18-21 years olds, low SA is also associated with forced sexual contact and depressive symptoms. Thus, efforts to prevent unintended pregnancy and unwanted sexual contact may be more effective if individual levels of SA are taken into account.

Journal Article↗
PubMed1999

Marriage structure and contraception in Niger.

Analysis of the 1992 Niger Demographic and Health Survey showed that although roughly two-thirds of both polygamous and monogamous women approve of birth control, polygamous wives are less likely than monogamous wives to discuss family size or birth control with their husband or to plan on using birth control. The study suggests that characteristics of polygamous couples have caused polygamous women to be more resistant to birth control use than monogamous women. The polygamous women tended to be married to older men who had not gone to primary school and who desired more children than monogamous husbands. The influence of marital structure is not significantly associated with intention to use birth control when the husband's age and the wife's ideal number of children were controlled for in the multivariate logistic regression model suggesting that background social factors may be more influential. In fact, educational level and age at first marriage were significantly associated with attitudes towards birth control and also with marital structure.

Adolescent↗