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PubMed1992

Coping and adjustment of spouses of critically ill patients with cardiac disease.

An acute cardiac illness represents a significant stressor to both patients and families. In a convenience sample of 100 spouses of critically ill adults, the relationships among personality factors, coping responses, social network, age, education, and emotional and physical distress were investigated. Results indicated a significant positive relationship between positive personality factors and problem-focused coping and between negative personality factors, emotion-focused coping, and emotional and physical distress. As expected, spouses who reported more negative personality factors and used greater emotion-focused coping scored higher on emotional and physical distress. Moreover, spouses who scored higher in emotional distress reported greater physical distress. No statistically significant relationships were found among the variables of personality factors, problem-focused coping, and support provided by the spouses' social network and the outcome variables of emotional and physical distress. Regression analysis revealed negative personality factors, emotion-focused coping, and education explained 52% of the variance in emotional distress. Future studies using experimental design are needed to evaluate the influence of a multitude of factors on coping and health outcome of spouses of critically ill patients with cardiac disease.

Adaptation, Psychological↗
PubMed2005

The positive impact of hospice care on the surviving spouse.

The study discussed here examined the possible indirect benefits of hospice care for older adults whose terminally ill spouses received hospice care. Surviving spouses whose husband/wife received hospice care had lower mortality rates 18 months after the spouse's death compared to older adults whose spouse had not received hospice care. The impact was larger for bereaved wives and the effect was statistically significant. The results illustrate that hospice care benefits patients and their spouses thereby mediating the effects of caregiver burden and the widow/er effect.

Adaptation, Psychological↗
PubMed1991

Relationship between birth order of spouses with different degrees of consanguineous relationship.

The relationship between birth order of spouses with different degrees of consanguinity is examined in a sample of 1826 couples belonging to the endogamous Vadde Fisherfolk of Kolleru Lake, Andhra Pradesh, India. We attempt to explain the wide variation in the frequency of different kinds of consanguineous marriages through the age-sex structure of the population in general and especially of the related families. This structure may also be manifested in the association between the birth orders of spouses. A highly significant and large correlation between the birth orders of spouses in uncle-niece marriages and a gradual decrease in the correlation with increase in remoteness of the relationship between the spouses were observed. Given the distribution of age differences between the spouses and assuming a standard age-sex structure, it seems possible to estimate the optimum frequency with which at least close consanguineous marriages occur in any particular population.

Age Factors↗
PubMedDate not supplied

Spouse similarities in high blood pressure knowledge: implications for control of high blood pressure.

This study describes the general knowledge about high blood pressure of husbands and wives using data from all 1,260 white spouse pairs from the 1982 Connecticut Blood Pressure Survey and examines the relationship between high blood pressure knowledge and control of hypertension. We found the average level of knowledge to be high; about 70% of the items were answered correctly. The correlation between spouses' knowledge about high blood pressure was significantly high (r = .41). Multiple regression analysis was used to control for other variables that might influence the spousal correlation in knowledge. When controlling for education, age, socioeconomic status, and hypertension status of both spouses, the correlation between spouses' knowledge remained significant (r = .24). Respondents' knowledge and spouses' knowledge about high blood pressure were significantly related to high blood pressure control among hypertensive persons, particularly to being aware of hypertension and being in current treatment.

Adolescent↗
PubMed1988

Adjustment problems of spouses of patients undergoing coronary artery bypass graft surgery during early convalescence.

Our purpose was to assess the social adjustment of spouses of patients who had undergone coronary artery bypass surgery during the patients' early convalescence. Specifically the study focused on social support and social activities, affective responses, and financial, marital, and sexual difficulties. Following an exploratory descriptive design, we conducted a semistructured interview using Benson's (1984) Social Adjustment Scale. A sample of 26 spouses were interviewed in a cardiology clinic 4 to 10 weeks after their mate's bypass surgery. Associations between demographic characteristics and the level of adjustment were determined by chi-square (adjusted for continuity) analysis. Nineteen spouses reported a high level of vigilance, with 13 reporting that this was a change since their mate's surgery. Ten spouses reported their economic level to be highly inadequate, and all of those stated that their economic situation had changed since surgery. A small number of subjects rated their mate as being dependent on them, and they had feelings of anxiety, fear, and depression. All of those subjects described this as a change since surgery. The majority of subjects had a low level of marital friction and a high level of communication with their spouse. Those married 30 years or longer were generally those satisfied with their level of social support.

Adult↗
PubMedDate not supplied

Increasing the effectiveness of community workers through training of spouses: a family planning experiment in Guatemala.

As community-based distribution (CBD) systems for the delivery of contraceptive methods are implemented in developing countries around the world, there is growing interest in making these programs more effective. Previous research on the CBD program in Guatemala indicated the importance of the role of the spouse: those community volunteers (called "distributors") who received assistance from their spouses were more effective in selling contraceptives than those who did not. The current experiment was designed to test the effect of providing the spouses of distributors with a formal 3-day training course on family planning and contraceptives. "Effect" was operationally measured in terms of the level of contraceptive sales. To this end sales data were compared for the experimental group (33 distributors whose spouses received the training) and the control group (33 distributors whose spouses wanted to attend the training but could not because their primary occupation did not allow them to be absent) for periods of 6 months prior to and 6 months following the training. The results indicate that sales among the experimental group increased significantly, whereas no such increase was found among the controls. This suggests a strategy for increasing the effectiveness of community volunteer workers that has received relatively little attention in the literature to date.

Community Health Services↗
PubMedDate not supplied

Patients' and spouses' causal explanations of a myocardial infarction.

This study examined lay explanations of an illness episode, myocardial infarction, at acute and convalescent phases of illness. Data were collected by interviews, using a structured questionnaire during the acute phase of illness (in hospital) and convalescent phase (at home) after discharge, from 50 first-time MI patients and 50 spouses or significant others. Tension (at work, in the home situation, and in general) was the most frequent cause given for the heart attack by both patients and spouses at both phases. Half the patients and half the spouses changed their mind regarding the cause of the heart attack between the acute and the convalescent phases. Further, over 50 percent of the patient/spouse pairs disagreed regarding the cause of illness at both phases. A high percentage of patients changed their smoking, diet, and exercise behavior, even when they did not list these factors as causes of the heart attack. Findings also suggested spouses should be included in discharge planning and special problems which spouses may face after patients' discharge should be addressed.

Adult↗
PubMed1981

Chronic pain patients and spouses: marital and sexual adjustment.

Fifty married patients who were referred to a pain-management program and their spouses were interviewed independently concerning marital-sexual adjustment. The effect of pain on frequency and quality of sexual activity, and the effect of sexual activity on pain, showed a consistent trend toward deterioration in sexual activity after the onset of pain complaints in both patient and spouse groups. Ratings of overall sexual adjustments and adjustment in marriage were essentially the same for both groups before the onset of pain; but after pain onset a significantly large number of spouses rated their marriage below average, whereas most patients rated it average or above average. For the pain patient and his or her spouse, it seems very important that open and candid communication exist about the constant problem of adjusting to chronic pain, and the spouse should participate in the treatment program.

Adaptation, Psychological↗
PubMedDate not supplied

Coping in spouses of patients with acute myocardial infarction in Taiwan.

OBJECTIVE: The purpose of this study was to determine the usage and perceived effectiveness of coping strategies of spouses of patients with acute myocardial infarction in Taiwan, the Republic of China, during the acute phase of the illness. DESIGN: Survey. SETTING: Visitors room for a coronary care unit in Taiwan, the Republic of China. SUBJECTS: Twenty-one female and 10 male spouses of patients with acute myocardial infarction. OUTCOME MEASURES: The Revised Ways of Coping Scale was modified to assess both frequency of use and perceived effectiveness of coping strategies. It was also translated into Chinese. RESULTS: Seeking Social Support was the most frequently used coping strategy, whereas Confrontive Coping was used the least. There were significant positive relationships between the extent of usage of coping strategies and their perceived effectiveness. Men used Planful Problem-Solving more often and found it be more effective than did women; they also found the Self-Controlling and Accepting Responsibility strategies to be more effective than did women. Older spouses reported the Planful Problem-Solving strategy to be more effective than did younger subjects. The more family members living with a spouse, the less Accepting Responsibility was used as a coping strategy. CONCLUSIONS: Spouses of patients with acute myocardial infarction in Taiwan, the Republic of China, report using a variety of coping strategies. Those used most often are perceived to be the most effective.

Adaptation, Psychological↗
PubMed1996

The effects of caring for a spouse with Parkinson's disease on social, psychological and physical well-being.

BACKGROUND: Several previous studies have examined the health of carers, but they have usually focused on elderly subjects and have often not had representative control samples. AIM: To determine whether caring for a partner with Parkinson's disease is associated with a worsening social, psychological and physical well-being than people with partners who do not suffer with Parkinson's disease. METHOD: One hundred and fifty-four carer spouses of subjects with Parkinson's disease, and 124 non-carer spouses of randomly selected population controls recruited from a national case-control study of early-onset Parkinson's disease in the Republic of Ireland, between 1992-1994, were studied. Outcome was measured along three dimensions: social functioning, assessed by the frequency of social contacts, outings and holidays; psychological well-being, measured by the General Health Questionnaire; and physical health, measured by the career's use of medical services, medications and episodes of chronic illness. RESULTS: Carer spouses were less likely to get out of the house once a week at least (odds ratio 1.79, 95% confidence intervals 1.00-3.20) or to have had a holiday in the last year (odds ratio 1.71, 95% confidence intervals 1.01-2.90). Contact with friends and neighbours decreased with increasing care provision. For spouses providing a lot of care, there was an almost fivefold increase in psychiatric morbidity (odds ratio 4.86, 95% confidence intervals 1.5-15.9) after adjusting for other variables. Most of the medical outcomes were less favourable among carers, but only the use of tranquilizers (odds ratio 3.73, 95% confidence intervals 1.18-11.8) and episodes of chronic illness (odds ratio 2.96, 95% confidence intervals 1.27-6.94) were significant. CONCLUSIONS: Overall, career spouses have slightly worse social, psychological and physical profiles. For social outcomes, increasing care provision is associated with fewer contacts, outings and holidays. For psychological and physical measures, carers providing a lot of care experience worse health. These results have implications for targeting appropriate interventions.

Caregivers↗
PubMed1998

Do education and income buffer the effects of death of spouse on mortality?

In this paper, we estimate the effects of the death of a spouse on the mortality of the survivor in different education and income groups. These socioeconomic resources may buffer the harmful effects of the stressful life event of the loss of one's spouse. The data come from a prospective study of mortality among all 35- to 74-year-old married Finnish persons. Follow-up was established by record linkage to death certificate registers for 1986-1991 (about 86,000 deaths, of which almost 5,500 occurred among the bereaved). The relative mortality after the death of one's spouse was broadly similar in different education and income groups. Absolute differences in mortality rates between bereaved and nonbereaved persons were larger in the lower end of the social spectrum, however. This pattern held for four broad categories of death: both sexes and two age groups (35-64 years and 65-74 years). The degree to which socioeconomic resources buffer the effects of death of spouse depends on whether it is assessed in terms of rate differences or rate ratios. Nevertheless, regardless of measurement choice, the effects of bereavement exist in all socioeconomic groups analyzed in this study. Furthermore, because of the high absolute level of mortality, the burden of excess mortality experienced after the death of one's spouse is heavier in the lower social strata.

Adult↗
PubMed1995

[French people acquiring citizenship by marriage and their spouses: a diverse and changing situation].

"After a brief presentation on the history of the law concerning acquisition of French nationality by marriage, the authors analyse the new bill passed in 1993. They go on to describe the social characteristics of people who acquire French nationality by marriage and their spouses....The social and cultural characteristics of the spouse explain the recent changes among those who have acquired French nationality by marriage. For instance, the number of couples that consist of a French husband and a foreign wife, as compared to those where the situation is reversed, depends on the nationality of the foreign spouse. The increasing age-gap between spouses can be attributed to their increasing socio-professional level and to changes in the distribution by nationality among the foreign population." (SUMMARY IN ENG AND SPA)

Age Factors↗
PubMed1999

EUROCARE: a cross-national study of co-resident spouse carers for people with Alzheimer's disease: II--A qualitative analysis of the experience of caregiving.

BACKGROUND: Spouses caring for a partner with dementia are subject to physical, psychological and social stresses. In view of the part played by spouse carers in preventing admission to institutional care, a fuller understanding of the subjective experience of caring is an important area of enquiry. Qualitative analysis of their accounts of the difficulties and rewards in looking after their partners may indicate strategies to support them and to alleviate the stresses that they experience. METHOD: Twenty co-resident spouses of people with NINCDS-ADRDA probable dementia of the Alzheimer's type, who had been diagnosed as such within the past 12-36 months, were recruited from service contacts in each of 14 out of the 15 countries of the EU. All completed a semi-structured interview that included open-ended questions about the experience of caring. RESULTS: Overall, the most commonly expressed difficulties reflected: loss of companionship through diminished quality of communication; loss of reciprocity as carers experienced their partners' growing dependency; and deterioration in their partners' social behaviour. Satisfaction from caring stemmed from: a feeling of job satisfaction; continued reciprocity and mutual affection; companionship; and the fulfillment of a sense of duty. CONCLUSION: Spouse carers in the 14 countries described the difficulties and rewards of caring in similar terms. This suggests commonality of experience, in spite of diversity in informal and statutory provision of care for older people between different countries.

Aged↗
PubMed2003

Effects of spouses on distress experienced by BRCA1 mutation carriers over time.

Concerns about psychological distress have arisen regarding genetic testing for susceptibility to late-onset diseases such as breast and/or ovarian cancer. Early results do not show large-scale psychological distress among those tested; therefore, research is now focusing on identifying subgroups that may be at risk for negative outcomes. Social support has been shown to buffer both negative physical and psychological outcomes in health research. The role of spouses as part of the tested person's social support system is shown to be significant in a sample of 57 BRCA1 mutation carriers. Separately, the tested person's perception of his/her spouse's anxiety and his/her perception of the spouse's support at the time of testing are predictive of the tested person's psychological distress up to 2 years after testing. The interaction of the two variables is even more predictive. For those tested who perceived their spouse to be both anxious and nonsupportive at the time of testing, distress levels reached clinically significant levels 1 week after results were received and remained above clinical threshold measured 4 months, 1 year, and 2 years after testing. While the effects were greatest for women, they were significant for both male and female carriers. These findings are an important addition to the literature and will augment clinicians' ability to identify individuals potentially at risk for negative responses to adverse genetic test results.

Concept Formation↗
PubMed1991

The effects of chronic illness on the spouse. Social resources as stress buffers.

This study examined the effects of rheumatoid arthritis (RA) on spouses' psychological well-being and the role of social resources in enhancing adaptation in the face of illness-related stress. Spouses of 42 patients with RA completed a mailed questionnaire assessing marital adjustment, social support received from the person with RA and from the close social network, and depressive symptoms. Illness-related stress was assessed using rheumatologists' assessments of patients' disease severity and patients' self-reports of depressive symptoms. Social resources within and outside the marriage were related to spouses' well-being through different pathways. Marital adjustment had a direct effect on well-being, such that greater marital adjustment was related to lower depression. In contrast, support from the social network operated in a stress-buffering fashion: When the patient's illness was more severe, spouses with greater network support experienced fewer depressive symptoms. Implications of these findings for psychosocial interventions are discussed.

Adult↗
PubMed2005

Caregiving burden and psychiatric morbidity in spouses of persons with mild cognitive impairment.

BACKGROUND: While the deleterious psychosocial and mental health effects of dementia caregiving are firmly established, very little is known about the burdens or psychiatric outcomes of providing care to a spouse with less severe cognitive impairment, such as mild cognitive impairment (MCI). We characterized the nature and level of caregiver burden and psychiatric morbidity in spouses of persons diagnosed with MCI. METHODS: Interview assessments were completed on a cohort of 27 spouses of persons with a recent diagnosis of MCI. Patient medical records were reviewed to collect information regarding the MCI patient's medical history. RESULTS: Respondents endorsed elevated levels of both task-related responsibilities and subjective caregiver burden. Depression and anxiety symptom levels also showed some elevations. Measures of caregiver burden were significantly associated with depression and anxiety levels. In particular, even after controlling for demographic risk factors for distress, nursing task burden was correlated with elevated depressive symptoms, and greater lifestyle constraints were correlated with higher anxiety levels. CONCLUSIONS: Although caregiver burden and psychiatric morbidity levels were lower than those typically observed in family dementia caregiving samples, our findings suggest that MCI caregivers have already begun to experience distress in association with elevated caregiving burden. These individuals may be ideal targets for selective preventive interventions to maximize their psychological well-being as caregiving burdens related to their spouses' cognitive impairment increase.

Activities of Daily Living↗
PubMedDate not supplied

Discrepancies between attainment and importance of life values and anxiety and depression in gastrointestinal cancer patients and their spouses.

Patients' satisfaction with life, viewed in terms of the discrepancy between the perceived attainment and subjective importance of various life values, is a less often studied phenomenon for understanding the psychological adaptation in cancer patients. The main aim of the present study is to investigate the relation between the degree of attainment and importance of life values on the one hand, and anxiety and depression, on the other. A consecutive series of 85 newly diagnosed patients with gastrointestinal (GI) cancers, 52 potentially cured and 33 with an advanced disease, and 26 spouses to the patients with an advanced disease participated. The patients and spouses of non-cured patients filled out questionnaires twice, close to the diagnosis and after 1 (non-cured patients) or 3 months. Overall, large discrepancies between the perceived attainment and importance of life values were associated with high anxiety and depression. For the patients (both cured and non-cured), the discrepancies decreased for several life values over time, as did anxiety and depression. For the spouses of the non-cured patients, there was no decrease either for life value discrepancies or for anxiety/depression. This suggests that patients, in contrast to their spouses, strive to achieve small discrepancies between the perceived attainment and importance of life values, as part of their adjustment to serious diseases, e.g. cancer.

Adult↗
PubMed1999

Spouse support, coping, and mood among individuals with cancer.

A model of the relations between spouse support, coping, and positive and negative mood was examined with 221 individuals with cancer using LISREL analyses. A moderating effect for patient life expectancy was predicted for disease prognosis. Results indicated that spouse criticism was associated with negative mood indirectly through avoidant coping strategies, and spouse support was associated with positive mood indirectly through positively-focused coping. Results did not support a moderating influence for life expectancy upon the association between spouse behaviors and patient coping. The results of this study are discussed in terms of their implications for psychosocial interventions to reduce psychological distress among individuals with cancer.

Adaptation, Psychological↗