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PubMedDate not supplied

The spouse's positive effect on the stroke patient's recovery.

To determine the effect of the presence of a spouse on the stroke patient's adaptation, a retrospective chart review of stroke patients who had completed rehabilitation was conducted. The convenience sample comprised 67 stroke patients of a family practice service who received rehabilitation at Pitt County Memorial Hospital Rehabilitation Center in Greenville, NC, over a 45-month period. Roy's Adaptation Model was the theoretical framework for the inquiry. The Barthel Index measured the functioning level, or adaptation, of the patients on discharge from rehabilitation. It was hypothesized that patients who had a stroke and completed a rehabilitation program would achieve a higher level of adaptation if they had a spouse than would comparable patients without a spouse. This hypothesis was supported by the findings; the average Barthel Index score on discharge was 7.5 points higher in patients who had a spouse (Wilcoxon chi-square = 4.17, p < .05). The implications for nurses are presented.

Activities of Daily Living↗
PubMed1989

Female to male transmission of hepatitis B virus between Chinese spouses.

Three hundred thirty-seven community-based spouses were tested for the presence of hepatitis B virus (HBV) markers to assess the direction of HBV transmission between couples. The prevalence rate of HBV infection among husbands whose wives were hepatitis B surface antigen (HBsAg)-positive was higher compared with those whose wives were HBsAg-negative. Moreover, the frequency of HBV seropositivity among husbands was 100% if their wives carried HBeAg and showed a trend correlation (P = .009). The prevalence difference was 13.8%, and the 95% confidence interval (95% Cl) was 7.9-19.7% after adjusting for spouses' age. In contrast, HBV infection rate of wives did not show an association with the husbands' HBsAg or HBeAg carrier status. The prevalence difference was 7.1%, but 95% Cl was -2.5-16.8% after adjusting for spouses' age. Female to male transmission of HBV between spouses appears to be more efficient.

Adolescent↗
PubMed1988

Postdischarge distress in surgically treated cancer patients and their spouses.

Temporal patterns of distress among two groups of nonterminally ill, surgically treated cancer patients (n = 40) and their spouses (n = 40) during the immediate pre- and postdischarge period were studied. Data about problems encountered and standardized measures of distress (State Anxiety Index, Brief Symptom Index, and Vulnerability Index) were obtained before hospital discharge and at 10, 30, 60, 90, and 180 days postdischarge. The intensity of distress experienced by patients and spouses was remarkably similar, although the temporal pattern of occurrence was significantly different. Prior to discharge, spouse anxiety was significantly higher than that of the patients and above the norm for hospitalized persons. Spouses were least distressed after 10 days at home, but thereafter experienced a rise in vulnerability culminating in observable clinical depression at 90 and 180 days. Peak distress for the patients occurred 10 days after discharge as a function of physical symptoms that were unexpected or more severe than anticipated. Patients with ostomies (n = 20) were slower to return to pre-illness functional levels and had somewhat more psychological distress than nonostomy patients.

Depression↗
PubMed1982

The spouses of depressive and schizophrenic patients. A controlled study.

The personality structures and the well-being of the partners of a representative sample of 103 married depressive or schizophrenic hospitalised patients were examined. As a means of examination we used a semi-structured interview, the Giessen-test (Beckmann and Richter 1972, 1979) and the Eigenschaftswörterliste (Janke and Debus 1978). Concerning personality, the comparison of self-image of the partners with the patient's estimation of his or her spouse resulted in good mutual agreement. The spouses of schizophrenic and depressive patients differed neither as far as the average profiles were concerned nor according to the cluster-analysis findings. In addition to this, both groups differed only to a minor extent from a representative sample of the general population. Whereas personal attitude and the well-being of the marital partners were for the most part independent of the depressive or schizophrenic kind of illness, personality and well-being of the spouses correlated with the course of the illness. The more phases of illness the spouses had witnessed, the more unattractive, self-controlled and uncommunicative they proved to be and the less irritated and sensitive they were when the patient was hospitalised. These findings are discussed in the light of further research.

Adult↗
PubMed1984

Spouse-assistants' adjustment to home hemodialysis.

Spouse-assistants of patients undergoing maintenance home hemodialysis have been noted to suffer a variety of psychological problems if either the assistant or the patient is given sole responsibility for the conduct of home treatment. The current report is based on a prospective study of patients and spouses in the Iowa City Veterans Administration Hospital Home Hemodialysis Program, in which both partners are thoroughly trained in dialysis techniques (and the patient is expected to assume responsibility for his or her own home care). Data are presented from follow-up interviews with 32 patients and 29 spouses who had been in home treatment for a minimum of 6 months after the completion of home training. The data suggest that depression, anxiety, and marital problems are encountered less frequently in this group of spouse-assistants than in those described in earlier reports from programs with different training philosophies.

Adaptation, Psychological↗
PubMed1989

Cross-spouse correlates of blood pressure in hypertension-prone families in Utah.

This study used a subsample of 543 married couples from a large group of families in Utah, who were originally studied to assess the genetic and environmental determinants of hypertension. Excluding individuals on medication and controlling for the major risk factors for hypertension, evidence was obtained for cross-spouse blood pressure associations equal in magnitude to self-psychosocial and demographic measures. Observed spouse-spouse similarity for blood pressures remained significant after adjustment for shared psychological factors. It is speculated that different aspects of each spouse's nonmarital environments (e.g. work, social support) have differential impacts on the marital environment and on physiologic indicators of health.

Adult↗
PubMed1989

The family's functioning with chronic illness in the mother: the spouse's perspective.

While previous research has studied the impact of chronic illness on the patient or spouse, the impact on the marriage, the child, the parent-child relationship, and the family's functioning have been relatively ignored. To date ther is no known study of the impact of a mother's chronic illness on the family. The purpose of the current exploratory study was to test a set of interrelated hypotheses about family functioning with the mother's chronic illness from the spouse's perspective based on a family systems perspective. Data were obtained from standardized questionnaires from 48 fathers with young school-age children whose wife had either breast cancer, diabetes, or fibrocystic breast disease. Results of a path analysis revealed that the number of illness demands the father experienced was a significant predictor of his level of depression. More demands resulted in higher depression scores. Marital adjustment was significantly affected by both the father's level of depression as well as by his wife's type of disease. Spouses of women with breast cancer had significantly higher levels of marital adjustment than did partners of the other women. More depressed spouses had lower levels of marital adjustment. Both illness demands and level of marital adjustment significantly predicted the type of coping behavior the family used. More frequent illness demands and higher levels of marital adjustment were associated with familial introspection, that is, coping behavior characterized by frequent feedback, reflection, and discussion in the family. The quality of the father-child relationship was significantly affected by this type of coping behavior. Families characterized as introspective had fathers who reported more frequent interchange with their children.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1996

Anger management style, hostility and spouse responses: gender differences in predictors of adjustment among chronic pain patients.

This study examined whether relationships between anger management style (anger suppression; anger expression) and adjustment variables for patients with chronic pain depend on patient hostility, and/or depend on a patient's gender. A 'spouse response model' was also evaluated to test whether patient expression of hostile anger is linked to infrequent positive and frequent negative responses from spouses, and hence to poor adjustment. The sample of 127 married chronic pain patients was assessed prior to entry into a multidisciplinary pain treatment program. Hierarchical multiple regressions revealed significant 'Anger Expression x Hostility x Gender' interactions for pain severity, activity interference and activity level: High Anger Expressor/Low Hostile women reported the lowest pain and highest activity; Low Anger Expressor/High Hostile men reported the highest pain and highest interference. Among men, support was also found for a spouse response model: pain severity and activity interference for High Anger Expressors was partly accounted for by negative spouse responses. Results suggest that discriminations among patients may be made based on anger management style in interaction with level of hostile attitude and the patient's gender, and that these distinctions may have implications for understanding mechanisms of pain and disability, and for designing appropriate treatment.

Adaptation, Psychological↗
PubMed1988

Alcoholic and spouse concordance on attributions about relapse to drinking.

The purpose of this paper is to report a descriptive study of the degree of concordance between male alcoholics' and their wives' perceptions of the alcoholics' relapse to drinking within two years of their participation in an outcome study of behavioral marital therapy for alcoholism. At the end of a two-year follow-up period, the 23 alcoholics who had relapsed and their wives were independently interviewed. The results showed that both the alcoholics and their spouses reported both intrapsychic and situational determinants of the relapses. Among types of determinants, the situational spouse was reported disproportunately more often by patients and disproportunately less often by spouses. Furthermore, the concordance between patient and spouse reports was low. Use of these findings for marital therapy in the treatment of alcohol abuse is discussed.

Alcoholism↗
PubMed1992

Nagging and other drinking control efforts of spouses of uncooperative alcohol abusers: assessment and modification.

This article presents a conception of spouse drinking control and an approach to assessment and modification to reduce the customary drinking control efforts of spouses of alcohol abusers unmotivated to enter treatment. Modification of the nonalcoholic spouse's customary drinking control is offered as an important early step in helping to prepare him or her to become a positive rehabilitative influence. Based on its use in unilateral family therapy with 68 spouses of uncooperative alcohol abusers, procedural guidelines, criteria for use, and two case examples from a crossover experimental dyad are described. Also presented are clinical results illustrating the success of the program, benefits and conditions relating to its use, and areas of possible application.

Alcohol Drinking↗
PubMed1993

Spouses' perceptions of readiness for discharge after cardiac surgery.

The purpose of this study was to describe spouses' perceptions of readiness for discharge after a partner's coronary artery bypass graft (CABG) surgery. An exploratory design was used to address the research questions. Six weeks after discharge, a nonrandom sample of 67 female spouses responded to open-ended questions about discharge readiness. The data were examined using content analysis. One hundred eighty-six statements were coded from the 67 questionnaires. Forty-two women (62%) reported they felt prepared for discharge. Four key people were identified as very helpful to spouses at discharge: nurse, physician, immediate family member, and friends who have had the same experience. Availability of social support, use of coping strategies, personal resources, and knowing what to expect were the major factors that influenced spouses perceptions of readiness for discharge.

Adaptation, Psychological↗
PubMed1988

The assessment of type A behaviour pattern: results from a spouse-report approach.

Evidence is summarized suggesting that existing self-report questionnaires for the assessment of Type A behaviour pattern suffer from major methodological shortcomings. Type A individuals may be unwilling or unable to accurately self-report. The female spouse of the male patient can potentially provide a more objective, accurate 'trait' description less contaminated by 'state' variables such as diagnosis of illness or medication. The development of a spouse-report questionnaire is described and pilot data from 41 couples are presented, including comparison of the self-report and spouse-report responses on 46 questionnaire items and five scales. Unexpectedly high levels of agreement were found between self and spouse reports. Possible explanations of such agreement are critically examined.

Adult↗
PubMed1993

Implications of agency and communion for patient and spouse adjustment to a first coronary event.

The present study examined the effects of agency and communion on psychological adjustment to a 1st coronary event. Patients were interviewed about agency and communion and psychological adjustment in the hospital shortly before discharge (Time 1) and then reinterviewed along with spouses in their homes 3 months after discharge (Time 2). It was hypothesized that the extreme agentic orientation (unmitigated agency) and the extreme communal orientation (unmitigated communion) would be associated with poor adjustment for patients and spouses but that agency would promote self adjustment and communion would promote partner adjustment. In general, results confirmed predictions. It was suggested that the most distressed couples consist of a patient high in unmitigated agency and a spouse high in unmitigated communion. Although patients in such couples did not evidence the most distress, spouses did.

Adaptation, Psychological↗
PubMed2000

Perceived control, coping efficacy, and avoidance coping as mediators between spouses' unsupportive behaviors and cancer patients' psychological distress.

This study examined whether avoidance, coping efficacy, and perceived control mediate the effects of spouses' unsupportive behaviors on patient psychological distress among 191 married individuals enrolled in cancer treatment. Results of the structural equation analyses suggested that avoidance and coping efficacy mediated the relationship between spouses' unsupportive behaviors and patient psychological distress. Perceived control of emotional aspects of the illness, including emotional responses and relationships with family and friends, and perceived control of the medical course of the cancer did not mediate the relationship between spouses' unsupportive behaviors and patient psychological distress. These findings suggest 2 mechanisms to explain why unsupportive responses from spouses may be associated with psychological distress among cancer patients.

Adaptation, Psychological↗
PubMed2004

Alcohol-focused spouse involvement and behavioral couples therapy: evaluation of enhancements to drinking reduction treatment for male problem drinkers.

This study evaluated the effects of alcohol-focused spouse involvement and behavioral couples therapy (BCT) in group drinking reduction treatment for male problem drinkers. Sixty-four male clients and their female partners were randomly assigned to 1 of 3 conditions: treatment for problem drinkers only (PDO), couples alcohol-focused treatment, or the latter combined with BCT. Clients whose partners were included in treatment evidenced fewer heavy drinking days and more abstinent/light drinking days in the year following treatment, relative to PDO clients. The combination of alcohol-focused spouse involvement and BCT yielded no better outcomes than alcohol-focused spouse involvement alone. Drinking consequences, spouse behavioral support for drinking reduction, and relationship satisfaction showed no effects of treatment condition.

Adult↗
PubMed2001

Perceived spouse responsiveness to chronic pain: three empirical subgroups.

The spouse plays a fundamental role in day-to-day functioning and long-term well-being of the patient with chronic pain. Although spouses may respond differently to pain demonstrations, no study has examined patterns of perceived spouse responsiveness to chronic pain behavior. Yet perceived patterns of response to chronic pain may explain variability in pain behavior in the literature because studied samples may be drawn from any one subgroup. The purposes of this study were to run an exploratory cluster analysis to identify naturally occurring spouse response subgroups by using section 2 of the Multidimensional Pain Inventory and to examine pain-relevant variables between subgroups. It was hypothesized that subgroups would be identified and that they would differ on pain-relevant variables. Participants were 774 married pain patients from 2 University of Florida-affiliated pain clinics, 69% of whom experienced chronic low back pain. A hierarchical cluster analysis identified 3 subgroups that were labeled positively attentive, negatively attentive, and inattentive. A discriminant analysis yielded 2 significant discriminant functions that correctly classified 71.1% of subgroup membership. The support variable best differentiated between the positively and negatively attentive subgroups, whereas interference best distinguished between the negatively attentive and inattentive subgroups. Results suggest the profiles have conceptual and clinical validity, with the negatively and positively attentive subgroups exhibiting the poorest adjustment to pain. A controlled study is needed to determine the direction of causality.

Journal Article↗
PubMed1990

The work of patients and spouses in managing advanced cancer at home.

The purpose of this paper is to report the findings of a descriptive study which identified the resources used by patients with advanced cancer and their spouses to manage at home. Data were collected through semi-structured interviews with a sample of seven couples identified through two ambulatory clinics at a regional cancer institute. Participants were patients with advanced cancer, between the ages of 45 and 66, and their spouses. Interviews, conducted with each individual and with each couple, were audiotaped, transcribed, and subjected to qualitative analysis. Content analysis showed that patients and spouses utilized internal and external resources, and that external resources were either physical or interpersonal in nature. Conceptual analysis indicated that both patients and spouses dealt with facing either inevitable or uncertain death by engaging in various types of "work." Understanding the dimensions of such work has implications for health care professionals caring for patients and families in palliative care.

Activities of Daily Living↗
PubMed2004

Psychological well-being and the dyadic relationship of Chinese menopausal women (and their spouses) attending hormone replacement clinics.

This survey examined the general health and the marital relationship of 122 Chinese menopausal women and their spouses attending hormone replacement clinics. Climacteric symptoms of the participants were assessed by the modified Greene Climacteric Scale (GCS). The psychological well-being of the participants and their spouses was assessed by the 12-item Chinese General Health Questionnaire (GHQ), and their marital quality was assessed by the Chinese Dyadic Adjustment Scale (DAS). The GCS scores of our cohort were significantly higher than that of a community-based sample of menopausal Chinese women. About one-third of the participants and one-fifth of their spouses suffered from reduced psychological well-being. Although the DAS total scores of the participants and their spouses were comparable to those of the adjusted couples in a younger population, the affectional DAS subscores were significantly lower. The GCS scores of the menopausal women were significantly positively correlated with their GHQ scores but negatively correlated with their DAS scores. In summary, the menopausal women attending the hormonal replacement clinics, especially those with more dimacteric symptoms, suffered from significant psychiatric morbidity and marital maladjustment. The psychological dimension of the menopause should never be neglected.

Asian People↗