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PubMed1997

Lymphocyte reactivity to hepatitis C virus (HCV) antigens shows evidence for exposure to HCV in HCV-seronegative spouses of HCV-infected patients.

Lymphocyte reactivity against hepatitis C virus (HCV) antigens was studied in 20 couples in which 1 member had chronic hepatitis C. This was done to investigate the possibility of HCV transmission between spouses that was not followed by seroconversion. Twenty healthy subjects without any risk factors for HCV transmission served as negative controls. All the patients' spouses and the healthy controls were negative for HCV RNA and for anti-HCV antibody. Lymphocytes were cultured with recombinant HCV core and nonstructural antigens (c22, c33, c100, c200, and NS5) and with control antigens (sperm whale myoglobin, chicken lysozyme, and superoxide dismutase). Lymphocytes from 10 patients and 4 seronegative spouses proliferated in the presence of at least one HCV antigen. No proliferation was shown with nonspecific antigens or in the control group. This study gives evidence for possible in vivo priming with HCV antigens that did not lead to seroconversion in spouses of HCV-positive patients.

Adult↗
PubMed2003

Genetic association studies of adult-onset diseases using the case-spouse and case-offspring designs.

Genetic studies of complex human diseases rely heavily on the family-based association paradigm. However, recruiting parents or siblings can be a difficult task in practice. The author proposes two alternatives, the case-spouse and the case-offspring designs, that are to be analyzed by the mating disequilibrium test. Two assumptions are required: 1) the marker genotype frequencies at conception should be the same for both sexes; and 2) there is no selective attrition of marker allele(s) through gestation and over time. Within this setting, the case-spouse and the case-offspring studies are valid designs, even if only one sex can get the disease, even if cases/spouses/offspring all have different risk factor profiles, and even under assortative mating. If the population is stratified and there is intermarriage between strata, one can type additional null markers across the genome for an admixture correction. The number of families required in a case-spouse design is almost identical to that in a case-parents design. For the case-offspring study with one offspring per family, the number of families should be doubled. Because of the ease in recruiting control subjects, the case-spouse and the case-offspring designs are viable alternatives for genetic association studies of adult-onset diseases.

Adult↗
PubMed2004

Impact of self-assessed hearing loss on a spouse: a longitudinal analysis of couples.

OBJECTIVES: Hearing loss is increasingly common among older persons and is negatively associated with health and well-being. Its impact on spouses, however, is poorly researched. This study analyzed the relationship between a spouse's self-assessed hearing loss and his or her partner's physical, psychological, and social well-being 5 years later. METHODS: Subjects were 418 older married couples from the Alameda County Study. Hearing loss and adjustment variables were assessed in 1994 and outcomes in 1999. Longitudinal analyses included multivariate statistical models using generalized estimating equations to adjust for paired data and partners' hearing loss, age, gender, chronic conditions, and financial problems. RESULTS: Spouse hearing loss increased the likelihood of subsequent poorer physical, psychological, and social well-being in partners. The negative impact of husbands' hearing loss on wives' well-being appears stronger than the reverse. DISCUSSION: Findings suggest that early diagnosis and treatment of hearing loss constitute important clinical strategies to enhance the well-being of both hearing-impaired individuals and their spouses and support policy change to cover hearing devices by insurance. Further research incorporating theoretical perspectives from communication theory and qualitative methodology would enhance understanding of how hearing loss impacts older couples and support refinement of interventions to promote quality of life.

Adaptation, Psychological↗
PubMed2005

Spouse as health care proxy for dialysis patients: whose preferences matter?

PURPOSE: We examined the extent to which the substituted judgments made by spouses of patients with end-stage renal disease actually reflect patient preferences. DESIGN AND METHODS: We used data from 291 couples to compare dialysis patients' preferences for continuing hemodialysis under a variety of hypothetical situations with both substituted judgment data from spouses and information about spouses' own preferences. RESULTS: Substituted judgments were more highly related to spouses' preferences than to patients' preferences. IMPLICATIONS: Findings raise questions about the extent to which the moral principle of patient autonomy should guide decision making at the end of life.

Aged↗
PubMed1997

Non-smoker lung cancer deaths attributable to exposure to spouse's environmental tobacco smoke.

BACKGROUND: The causal relationship between environmental tobacco smoke (ETS) and lung cancer is established; however, the magnitude of the risk is not known. Therefore, it is conceivable that ETS is responsible for a number of lung cancer deaths because of the large number of smokers and the widespread presence of ETS. We estimated the number of lung cancer deaths occurring in 1990 in the European Union (EU), attributable to ETS generated by a spouse. METHODS: In each country and for each sex, we used the proportion of smokers and of married people in 1970 to estimate the number of lung cancer deaths not attributable to tobacco smoking occurring in married people, assuming a relative risk (RR) for active smoking equal to 10. We then assumed a prevalence of smoking among these deaths equal to the population at large, and estimated the number of deaths attributable to ETS based on an RR for ETS of 1.3. Additional analyses were carried out assuming different values of RR for smoking and exposure to spouse's ETS. RESULTS: Based on our best assumptions, we calculated that 1146 (839 females, 307 males) lung cancer deaths were attributable to exposure to spouse's ETS in the EU in 1990. All the hypotheses tested resulted in not less than several hundred deaths. CONCLUSION: Regardless of the limitations of this exercise, our results suggest that exposure to spouse's ETS represents a relatively important public health problem in the EU.

Adult↗
PubMed2004

Impact of spouses' sleep problems on partners.

STUDY OBJECTIVES: To analyze relationships between spouses' sleep problems and their partners' physical health, mental health, well-being, social involvement, and marital quality in a sample of older persons. DESIGN: The Alameda County Study is a population-based longitudinal study focusing on behavioral factors associated with health and mortality. SETTING: Participants completed questionnaires for the sixth wave of data collection (1999). PARTICIPANTS: 405 couples (810 husbands and wives aged 51 to 94 years). MEASUREMENTS AND RESULTS: Participants were asked how often they had experienced difficulty falling asleep, waking up in the middle of the night, and waking up very early in the morning over the past month. Response sets ranged from "never" to "often." Scores were summed. Analyses included multivariate statistical models using generalized estimating equations to adjust for paired data as well as partner age, sex, chronic conditions, financial problems, and own sleep problems. Although partners' associations with negative outcomes were stronger for their own sleep problems, spouses' sleep problems were associated with partners' poor health, depressed mood, poor mental health, unhappiness, low optimism, feeling left out, not satisfied with relationships, and unhappy marriage, even after adjusting for the partners' sleep problems. We found no sex differences in associations between spouses' sleep problems and partners' outcomes. CONCLUSIONS: Although data are cross-sectional, findings suggest that spouses' sleep problems negatively impact partners' health and well-being. Our analyses emphasize the importance of treating sleep problems to promote the health and well-being of both affected individuals and their partners.

Aged↗
PubMedDate not supplied

The effects of therapeutic back massage on psychophysiologic variables and immune function in spouses of patients with cancer.

BACKGROUND: Spouses of patients with cancer are at risk for stress-related disorders and may experience a reduction in immune function. Therapeutic back massage (TBM) has been shown to enhance relaxation and thus, may reduce stress associated with caring for an ill partner. OBJECTIVES: To determine if TBM's influences on psychosocial, physiologic, and immune function variables in spouses of patients with cancer, and explore the relationships between psychosocial variables and immune function in spouses of patients with cancer. METHODS: This group experimental design measured the effects of a 20-minute TBM at three time points (preintervention, immediately postintervention, 20 minutes postintervention) on spouses of patients with cancer (N= 42) randomly assigned to either the experimental or control group. The major dependent variables including natural killer cell activity (NKCA), heart rate, systolic and diastolic blood pressure, mood, and perceived stress were measured at the three time points to examine the effects of TBM. Data collected on measures of mood and perceived stress were correlated with NKCA to examine their relationships. Prior to hypotheses testing, data collected on measures of depressive mood, loneliness, marital disruption, and health practices were also correlated with NKCA to ascertain any possible confounding variables. RESULTS: Two-way repeated measures analysis of variance tests determined the effects of TBM over the two postintervention time points and resulted in significant group x time interactions on mood (F [2, 40]= 14.61, p=.0005) and perceived stress (F [2, 40]= 28.66, p=.001). Significant inverse relationships were found between mood and NKCA (r= -.41, p=.009, N= 42) and perceived stress and NKCA (r= -.37, p=.017, N= 42). DISCUSSION: Findings suggest that TBM may enhance mood and reduce perceived stress in this population. Insight was gained into the psycho-immunologic relationships studied.

Affect↗
PubMedDate not supplied

Concordance of risk factors in female spouses of male patients with coronary heart disease.

PURPOSE: Shared environment may put marital partners at increased risk for coronary heart disease (CHD). In this study, the authors examined the degree of concordance of risk factors between men with CHD (n = 177) and their spouses, and described the risk profiles of both patients and spouses. Risk factors examined were smoking, hypertension, obesity, cholesterol level, diet, and exercise. METHODS: Data were collected 2 months after the cardiac event using the Behavioral Risk Factor Surveillance System tool. Concordance between patient and spouse pairs was evaluated using Pearson correlation coefficients (r) for continuous data and phi coefficients (phi) for nominal data. RESULTS: Significant concordance was found between patient and spouse pairs for body mass index, history of smoking, current smoking status, frequency of exercise, miles per exercise session, and the amount of fat and fiber in the diet. There was no significant spousal concordance in relation to the diagnosis of hypertension, systolic and diastolic blood pressure (BP), cholesterol level, history of high cholesterol, current exercise program, duration of exercise, and amount of salt in the diet. Thus, although the physiological indicators of risk (e.g., BP) were not significantly related among marital partners, behavioral indicators of risk (e.g., smoking) were significantly related. CONCLUSIONS: The findings suggested that shared lifestyles of marital partners may result in greater risk of CHD for female partners of men with CHD. Furthermore, lifestyle interventions that specifically target the marital partners as a unit may be more efficacious than individual patient education strategies.

Adult↗
PubMedDate not supplied

A randomized, placebo-controlled, crossover study of tibolone (Livial) on menopause symptoms, psychological well-being, and dyadic relationship of postmenopausal Chinese women and their spouses.

OBJECTIVE: To investigate the effects of 6-month treatment of tibolone on menopause symptoms, psychological well-being, and the dyadic relationship of postmenopausal Chinese women and their spouses. DESIGN: A randomized, double-blind, crossover study was conducted in 100 postmenopausal Hong Kong Chinese women who received tibolone (2.5mg/day) and placebo. At baseline, 6-month and 13-month visits, the women filled in the Greene Climacteric Scale (GCS), 12-item General Health Questionnaire (GHQ) and Dyadic Adjustment Scale (DAS), and their spouses completed GHQ and DAS. RESULTS: Both tibolone and placebo treatment were associated with a significant reduction in the GCS total scores after the first 6-month interventional period (95% CI: -8.0 to -2.5 for tibolone, and -5.7 to -0.7 for placebo). After the correction for placebo response, tibolone treatment was associated with a significant reduction in the GCS somatic subscore (-1.1 +/- 0.4 for tibolone group versus 0.6 +/- 0.5 for placebo group, P < 0.05). There were no significant changes in the GHQ and DAS total scores of the women and their spouses after tibolone treatment, both with and without the correction for placebo response. CONCLUSIONS: Tibolone treatment had a significant beneficial effect on the somatic menopause symptoms but had no effect on the psychological well-being or marital relationship of the postmenopausal Chinese women and their spouses.

China↗
PubMed1995

Assessing the quality of the working life of nurse educators in Finland: perceptions of nurse educators and their spouses.

As part of a broader descriptive study of nurse educators' well-being at work in Finland, the quality of working life was assessed by the nurse educators themselves and by their spouses (or another adult living with them). Data were analysed from 477 (68% of 706) educators from 25 institutes throughout Finland and from 409 (58% of 706) spouses. Nurse educators evaluated their working life as being good. Background factors that improved one or several features of working life were: young age, being married, permanent employment in a small institute in the countryside, and highschool education. Lack of freedom to choose the teaching field and tasks at work reduced the quality of working life. Nurse educators estimated that they did an average of 9.6 hours overtime a week; according to their spouses the figure was 12.7 hours. More than moderate amounts of negative stress, derived mainly from work, were reported. Interactions with people at work and the support obtained for their work were generally judged to be good. Participants reported that they were not very satisfied with relationships with college directors, while they were, generally, satisfied with relationships with students. The spouses estimated nurse educators' working life more negatively than did the educators themselves, with the exception of the balance between work and leisure time, which both groups estimated similarly.

Adult↗
PubMed2005

Spouse's life situation after partner's stroke event: psychometric testing of a questionnaire.

AIM: This paper reports a study to validate and test the reliability of a questionnaire constructed to evaluate the life situation of spouses after their partners have had a stroke. BACKGROUND: Stroke is a disease with great consequences for survivors and their families. Most survivors return home after the hospitalization and rehabilitation due to the stroke event. Relatives, primarily spouses, often feel obligated to care for the survivor at home, providing emotional support or assisting the person in activities of daily living. More specific information is needed about the spouse's life situation after the stroke event in order to develop effective supportive strategies. METHODS: Psychometric testing of the Life Situation Questionnaire was undertaken with 99 spouses of stroke survivors. The 13-item questionnaire consists of four subscales: 'Worries', 'Powerlessness', 'Personal adjustment' and 'Social isolation'. RESULTS: Item analysis showed that each item correlated with its own subscale (r = 0.63-0.78). The instrument had high internal consistency, with Cronbach's alphas of 0.80-0.86 and reasonable high congruent validity when correlated with a Wellbeing instrument, with a correlation of 0.59 (P = 0.001). Exploratory factor analysis confirmed the subscales, accounting for 77% of the variance. CONCLUSION: The Life Situation Questionnaire is a valid and reliable instrument, and could serve as an assessment tool after a stroke event to identify family caregivers who have problems in their life situations and need support from healthcare services.

Adaptation, Psychological↗
PubMed1998

Evidence of transmission of hepatitis B virus to spouses from sequence analysis of the viral genome.

Heterosexual contact is one of the common routes of transmission for hepatitis B virus (HBV) among adults in Taiwan, but only a few studies have provided direct evidence at the level of the HBV genome of infected couples with acute non-fulminant hepatitis to document a common source. By cloning and sequencing polymerase chain reaction-amplified HBV-DNA, we analysed the sequences of the conserved region of the surface gene (nucleotide (n.t.) 305-513, representing 6.5% of the viral genome) of HBV in five HBV-infected index patients, their spouses and four randomly selected HBV carriers as controls. Risk factors associated with acute HBV infection in index cases were sexual contact with their spouses within 3 months before the onset of hepatitis. For all five couples, the HBV-infected index patient and the spouse shared a 100% sequence homology of HBV-DNA. In contrast, there was significantly more variation (mean heterogeneity 6.1%, range 1-13.9%) in the amplified region between the five couples and between each couple and the controls (P<0.001). This study demonstrated that sequence analyses can correlate well with epidemiological findings and confirm the value of the molecular approach for linked infections of HBV through heterosexual contact between spouses. Susceptible adults should receive vaccination.

Adult↗
PubMed1989

Gynaecological impact of sexual and physical abuse by spouse. A study of a random sample of Norwegian women.

A sample of 150 women aged between 20 and 49 was randomly selected from the census of the city of Trondheim, Norway. Of the 131 eligible for the study, 13 refused to participate; the participating 118 women were interviewed by a gynaecologist. Detailed information about their present and previous spouse(s) and about sexual problems and gynaecological symptoms was obtained. Physical abuse by spouse had occurred in 20 (18%) of the 111 women who had ever lived in a relationship, and sexual abuse in 19 (17%). Eleven (10%) had experienced both physical and sexual abuse. A history of physical abuse with or without sexual abuse by spouse was associated with sexual problems in the present or in previous relationships. Reported abuse by spouse was also associated with a higher frequency of gynaecological symptoms at the time of interview.

Adult↗
PubMed1996

Helicobacter pylori infection in spouses of patients with duodenal ulcers and comparison of ribosomal RNA gene patterns.

BACKGROUND: In recent studies, familial coinfection with the same Helicobacter pylori strains has been indicated, but more data are necessary to confirm intra-familial spread of the micro-organism. AIMS: The aim of this study was (a) to assess the frequency of H pylori infection in spouses of patients with duodenal ulcers and (b) to investigate the possibility of intraspousal typing of the respective strains. PATIENTS: Sixty four patients with duodenal ulcer and their spouses were included in the study. METHODS: The H pylori infection was confirmed after endoscopy by culture and histological examination of biopsy specimens, and CLO test. The isolates were compared on the basis of their rRNA gene patterns (ribopatterns) after digestion of chromosomal DNA by the restriction endonucleases HaeIII or HindIII. RESULTS: Of the patients, 54 were found to be H pylori positive. Of the respective spouses, 42 (78%) were also H pylori positive. In contrast, only two out of 10 (20%) partners of H pylori negative patients were infected. Ribopatterns of H pylori strains derived from 18 patients and their spouses showed that in each of eight couples a single strain had colonised both partners, while in the remaining 10 couples each partner was colonised by a distinct H pylori strain. CONCLUSIONS: These data suggest person to person transmission within couples or exposure to a common source of infection.

Adult↗
PubMed2005

Cigarette smoking among spouses: another risk factor for stroke in women.

BACKGROUND AND PURPOSE: It is well known that passive exposure to cigarette smoking increases the risk of coronary events, but the effect on the risk of stroke is not well defined. We performed this study to determine the effect of cigarette smoking among spouses on the risk of developing stroke and ischemic stroke among a nationally representative sample of women. METHODS: We examined the association between history of smoking among spouses with the incidence of stroke in a national cohort of 5379 women who participated in the First National Health and Nutrition Examination Survey Epidemiologic Follow-Up Study. RESULTS: During a mean follow-up of 8.5 years, the risk was significantly increased for all strokes (relative risk, 5.7; 95% CI, 1.4 to 24) and ischemic stroke (relative risk, 4.8; 95% CI, 1.2 to 20) among cigarette-smoking women with a cigarette-smoking spouse compared with those with a nonsmoking spouse after adjusting for other cardiovascular risk factors. CONCLUSIONS: The study provides new evidence linking spousal smoking to stroke.

Adult↗
PubMed1999

Sexual functioning among stroke patients and their spouses.

BACKGROUND AND PURPOSE: The aim of this study was to assess effects of stroke on sexual functioning of stroke patients and their spouses and to study the associations of clinical and psychosocial factors with poststroke changes in sexual functions. METHODS: One hundred ninety-two stroke patients and 94 spouses participating in stroke adjustment courses sponsored by the Finnish Stroke and Aphasia Federation completed a self-administered questionnaire concerning their prestroke and poststroke sexual functions and habits. The main outcome measures were (1) libido, (2) coital frequency, (3) sexual arousal, including erectile and orgastic ability and vaginal lubrication, and (4) sexual satisfaction. RESULTS: A majority of the stroke patients reported a marked decline in all the measured sexual functions, ie, libido, coital frequency, erectile and orgastic ability, and vaginal lubrication, as well as in their sexual satisfaction. The most important explanatory factors for these changes were the general attitude toward sexuality (odds ratio [OR] range, 7.4 to 21.9; logistic regression analysis), fear of impotence (OR, 6.1), inability to discuss sexuality (OR range, 6.8 to 18.5), unwillingness to participate in sexual activity (OR range, 3.1 to 5. 4), and the degree of functional disability (OR range, 3.2 to 5.0). The spouses also reported a significant decline in their libido, sexual activity, and sexual satisfaction as a consequence of stroke. CONCLUSIONS: Sexual dysfunction and dissatisfaction with sexual life are common in both male and female stroke patients and in their spouses. Psychological and social factors seem to exert a strong impact on sexual functioning and the quality of sexual life after stroke.

Adult↗
PubMed2006

Social and emotional characteristics of adults seeking a cochlear implant and their spouses.

OBJECTIVES: Because past research has shown that benefits of cochlear implantation may include a significant decrease in psychological and emotional difficulties, this study examined whether persons seeking cochlear implants in recent years differed psychologically from those referred in the early 1980s. A second objective was to explore mechanisms by which profound deafness could contribute to psychological and emotional difficulties for implant candidates and their spouses. METHODS: 178 cochlear implant candidates referred from 1981 to 1998 at the University of Iowa Hospitals completed a standard battery of psychological tests and questionnaires. The sample was divided into six 3-year cohorts and compared on standardized measures of psychological and emotional adjustment, and in participation in social and non-social activities. Spouses of implant candidates completed a similar assessment. RESULTS: The sample was characterized by elevations in depression, social introversion, suspiciousness, and social anxiety and loneliness. There were no significant differences among cohorts across time except for an increase in expectations for implant success. Spouses also evidenced elevated levels of psychological distress. Hearing status was associated with significant differences in social activity participation. A paradoxical interaction was found between marital status and deafness. CONCLUSIONS: There was no evidence that the psychological status of implant candidates is changing across time, suggesting continued psychological benefit for persons receiving cochlear implants. Both candidates and their spouses participated in fewer social activities than normal controls. Findings underscore the complex relation between marital status, deafness, and engagement and participation in positive activities.

Adult↗
PubMed2004

Publicly funded and family-friend care in the case of long-term illness: the role of the spouse.

In recent years, considerable attention has been devoted to the value of unpaid work in the economy. One very important aspect of unpaid work is caregiving for chronically ill or disabled people and the question of whether or not family-and-friend caregiving eases the burden on the publicly funded system. Using data from the 1996 General Social Survey, this paper investigates the extent to which the presence of a spouse of a senior aged 55 and over with a long-term illness reduces the amount of publicly funded care received. The findings from the multivariate Tobit analysis show that the presence of the spouse does significantly reduce the amount of publicly funded care used. This result is not gender-specific. The total hours of caregiving by the spouse are valued, as well as the savings generated for the publicly funded system, and the policy issue of tax relief for spouses who are engaged in long-term caregiving is explored.

Aged↗