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PubMed2002

Reproductive outcomes in the women of the Red River Valley of the north. I. The spouses of pesticide applicators: pregnancy loss, age at menarche, and exposures to pesticides.

In the current study, there was a modest but significant increase in risk (1.6- to 2-fold) for miscarriages and/or fetal loss occurring throughout the year in the spouses of applicators who use fungicides. There is a surprisingly significant deficit in the number of male children born to the spouses of fungicide applicators. First-trimester miscarriages occur most frequently in the spring, during the time when herbicides are applied. Use of sulfonylurea (odds ratio OR = 2.1), imidizolinone (OR = 2.6) containing herbicides, and the herbicide combination Cheyenne (OR = 2.9) by male applicators was statistically associated with increased miscarriage risk in the spring. Limited survey data from women who are the spouses of applicators did not show major alterations of long-term endocrinologic status (menarche, menopause, endometriosis). With regard to personal pesticide exposures, only women who engaged in pesticide application where there is direct exposure to these products are at demonstrable risk (OR = 1.8) for miscarriage. It was hypothesized that the overall reproductive toxicity observed in this population is, for the greater part, a male-mediated event. Clarification of exposure events leading to reproductive toxicity through direct measurements of exposure in both men and women is needed to resolve this issue.

Abortion, Spontaneous↗
PubMed2002

Problems associated with prostate cancer: differences of opinion among health care providers, patients, and spouses.

BACKGROUND: Problems accompany any experience with cancer. METHODS: Patients, spouses, and providers were asked to identify their perceptions of the problems associated with recently diagnosed prostate cancer. Their answers were compared across respondent categories (physician, nurse, patient, and spouse) and cross-informant variance was analyzed. RESULTS: Significant variation in responses was noted by respondent categories in spite of the relatively small sample. CONCLUSION: The response variance may contribute to communication problems among patients, spouses, and providers, as well as missed opportunities for medically appropriate referrals to psychological treatment and community support resources.

Adaptation, Psychological↗
PubMed2002

Genetic evidence of transmission of human T cell lymphotropic virus type 1 between spouses.

Sexual transmission of human T cell lymphotropic virus type 1 (HTLV-1) is considered to be an important route of infection in adults. However, no direct evidence has been reported that supports this observation. To address this issue, sequence variations of the gp46 (envelope)-coding region of HTLV-1 were determined in 13 patients infected with HTLV-1 who experienced seroconversion and in their spouses. Twenty-two nucleotide changes that were different from the reference sequence of lambdaATK-1 were identified. However, the gp46 sequences found were identical within each married couple. HTLV-1 proviral DNA loads measured in 11 of these couples varied from 10 to 3430 copies per 10(5) PBMC, and the proviral DNA loads of spouses often differed. This study provides the first genetic confirmation of the transmission of HTLV-1 from a carrier spouse to his/her partner. The findings also suggest that host-related factors play a more important role than do virus-specific factors in determining HTLV-1 proviral DNA load.

Base Sequence↗
PubMedDate not supplied

Two-year outcome of coping skills training, group support and information for spouses of alcoholics: a randomized controlled trial.

AIM: To evaluate three different intervention programmes for spouses of alcoholics. METHODS: 39 spouses of alcoholics (36 women and 3 men) with an average age of 47 years (ranging from 23 to 60 years) were randomly assigned to one of the three interventions: Coping Skills Training, Group Support, and Information. Follow-up interviews were conducted 12 and 24 months after completing the programme. Coping Behaviour Scale, Symptom Checklist 90 (SCL-90), Hardship Scale and AUDIT at admission and at follow-up were compared. 38 of the 39 spouses completed the 24-month follow-up examination. RESULTS: Improvements of coping behaviour, psychiatric symptoms and hardship noted at the 12-month follow-up examination were still evident in all groups at the 24-month follow-up examination. The three groups scored similarly at 24 months on the four scales. CONCLUSIONS: A post hoc examination of subjects with SCL-90 scores above general population means, showed less improvement in the Information group than the two therapy groups combined (P < 0.05).

Adaptation, Psychological↗
PubMed1995

The marital perceptions of elderly persons living or having a spouse living in a long-term care institution in Canada.

The focus of this study is on the way that older married persons living, or having a spouse living, in a long-term care institution perceive their marriages following relocation. A qualitative analysis of 161 interviews was conducted. For noninstitutionalized spouses (n = 74), four themes emerged from the data--"marriage as a memory," the "illusory marriage," the "changed marriage," and the "continuing marriage." For institutionalized spouses (n = 87), three themes emerged, including the "happy marriage," the "detached marriage," and the "altered marriage." Relocation did not appear to have a direct impact on the way respondents perceived their marriages. Continuity theory was helpful in understanding these marital perceptions.

Aged↗
PubMed1997

New burdens or more of the same? Comparing grandparent, spouse, and adult-child caregivers.

This study compares the health of 42 grandparent, 44 spouse, and 130 adult-child caregivers with 1,669 noncaregivers in 1994 and 1974. In 1994, all three caregiver groups had poorer mental health than the noncaregivers; grandparent caregivers also had poorer physical health and greater activity limitations. Spouse and adult-child caregivers had not differed from the noncaregivers 20 years prior, but grandparent caregivers had experienced poorer health than the noncaregivers and more stressful life events than the other caregivers. Caregiving appears to add new burdens to otherwise normal lives for spouse and adult-child caregivers, while being yet another aspect of a difficult life course for grandparent caregivers.

Aged↗
PubMed1999

Gender roles, marital intimacy, and nomination of spouse as primary caregiver.

Using data from a sample of married men and women undergoing treatment for cancer, we tested two potential hypotheses for the unequal representation of husbands and wives as spousal caregivers, including societal gender role norms and emotional closeness in the marital relationship. Multivariate analyses support both hypotheses; wives are only one third as likely as husbands to select their spouses as caregivers, and spouses who name their mates as confidants are three times more likely than those who do not to also name them as caregivers. We conclude that although gender role norms are key to caregiver selection, the intimacy inherent in the caregiving role renders an emotionally close marriage an important criterion to the selection of spouse as caregiver.

Adult↗
PubMed1995

Educational level of spouses and risk of mortality: the WHO Kaunas-Rotterdam Intervention Study (KRIS).

BACKGROUND: A 9.5-year follow-up of the Kaunas-Rotterdam Intervention Study (KRIS) provided the opportunity of investigating whether the educational level of wives was associated with their husbands' risk of mortality and coronary heart disease (CHD), independently of the educational level of the husbands themselves. METHODS: The data represent populations consisting of 2452 Lithuanian men and 3365 Dutch men. These men were extensively screened for cardiovascular risk factors in the period 1972-1974. During the follow-up 303 Kaunasians and 350 Rotterdammers died. We used the Cox proportional hazards and the logistic regression models to analyse the data. RESULTS: We found that men whose spouses had little education apparently had an increased risk of all-cause mortality, even when their own educational level was taken into account. The relative risks (RR) were 1.57 in Kaunas and 2.15 in Rotterdam. The results for fatal and non-fatal myocardial infarctions were compatible with this finding, especially in Rotterdam. The prevalence of smoking was higher among men whose wives had primary schooling only. Nonetheless, adjusting the effect of the wife's educational level on her husband's mortality risk for all coronary risk factors in the husband only partially explained the association. CONCLUSIONS: The spouse's educational level appears to have independent effects on a man's risk of mortality in both eastern and western European communities. The results strongly suggest that including characteristics of the socioeconomic status of an individual's spouse would improve studies of socioeconomic differences in health.

Cardiovascular Diseases↗
PubMed2005

Does one's own and one's spouse's education affect overall and cause-specific mortality in the elderly?

OBJECTIVES: To examine educational gradients in overall and cause-specific mortality among elderly married men and women and their spouses. METHODS: Using the census-based Israel Longitudinal Mortality Study (1983-92), 13 573 married men and 6563 married women were identified who were aged 70-89 years at baseline. Cox proportional hazard models were used to assess the strength of the association between education and overall and cause-specific mortality. RESULTS: Educational gradients for own and spouse's mortality varied by gender and cause of death. In particular, in relation to cardiovascular disease, men married to uneducated wives experienced elevated mortality risks [hazard ratio (HR) = 1.30; 95% confidence interval (95% CI) 1.11-1.52]. Women were generally unaffected by their husband's education, except for those who died from non-breast cancer, for whom husband's low education had a harmful effect (HR = 1.98; 95% CI 1.26-3.11). CONCLUSIONS: Mortality among elderly married persons is associated with one's own and one's spouse's educational achievement. Research using partner's education as a proxy for one's own attainment may be omitting valuable information regarding these and other health risks.

Aged↗
PubMed1995

Spouse support and long-term adherence to lipid-lowering diets.

Social support is inversely associated with heart disease risk. Support may influence heart disease by encouraging health behavior change in high-risk individuals. This study examined the association between spouse support and maintenance of low-fat diets in men with hypercholesterolemia. Participants were 254 men enrolled in a 24-month randomized trial of lipid-lowering diets initiated in 1985 in Seattle, Washington. The Evaluation of Spouse Support, which assesses the extent to which spouses supported maintenance of lipid-lowering diets, was administered after the last of eight dietary classes and at 3, 12, and 24 months postinstruction. Attainment of dietary goals was determined from food records completed at the end of the class and at 3, 12, and 24 months. Compared with those in the lowest quartile, those in the highest quartile of support were more likely to attain dietary goals at 3 months (odds ratio (OR) = 4.5, 95% confidence interval (CI) 1.9-10.4), 12 months (OR = 5.5, 95% CI 2.4-12.5), and 24 months (OR = 3.9, 95% CI 1.7-9.3). Support was not associated with end-of-class dietary goal achievement. Social support may be an important factor in the maintenance of low-fat diets.

Adult↗
PubMed2000

The prevalence of antibodies to anionic phospholipids in patients with the primary antiphospholipid syndrome, systemic lupus erythematosus and their relatives and spouses.

OBJECTIVES: Antiphospholipid antibodies (aPL) have been associated with syndromes involving thrombosis, fetal loss and thrombocytopenia. Genetic and environmental conditions are among the factors attributed to the cause of autoimmune diseases such as the antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE). The aim of this study was to determine whether these factors determine the prevalence of aPL. METHODS: Three groups of patients were tested for the presence of IgG, IgM and IgA anticardiolipin (aCL), antiphosphatidylinositol (aPI), antiphosphatidylglycerol (aPG) and antiphosphatidylserine (aPS) antibodies: (i) patients with primary APS (PAPS); (ii) patients with SLE and secondary APS; and (iii) patients with SLE without APS. First-degree relatives and spouses of patients with SLE/APS were also tested for circulating aPL. RESULTS: IgG aPL were particularly prevalent in patients with PAPS. IgG aPI and aCL were more prevalent in patients with PAPS than the IgM equivalents (P < 0.0001). Notably, none of the patients with PAPS had IgA aPL. A significantly higher number of relatives of patients with SLE/APS possessed IgG aPL than the normal controls. Except for aPG (P < 0.03), the prevalence of these antibodies in the relatives was not significantly different from patients with SLE/APS. The relatives also had significantly higher prevalence of IgG aPI, aPS and aCL antibodies than IgM aPL antibodies. In contrast, the prevalence of IgG aPL in the spouses was no different than in the healthy controls. CONCLUSIONS: Genetic factors, shared by patients and their relatives, seem to have some effect on the prevalence of aPL in the subjects studied, while environmental factors shared by spouses appear to have no influence.

Adult↗
PubMedDate not supplied

Spouses' perceptions of and reactions to living with a partner who has undergone surgery for rectal cancer resulting in a stoma.

The aim of this study was to illuminate spouses' perceptions of living with a partner who had been diagnosed with rectal cancer followed by surgery resulting in a stoma. The focus group interview was chosen as method of data collection. Two focus group interviews consisting of 2 meetings each were conducted. A qualitative content analysis was used. Five themes emerged: difficulties of being involved; living with uncertainty; learning to live in a new way; the altered body; and the search for explanations. There were feelings of anxiety about the partner's serious condition and the possible spread of the cancer. After the rehabilitation period, the stoma influenced the spouses' lives in many ways but they coped with the problems together with their partners and helped them adapt to their changed circumstances. This study indicates that the spouses were very much involved in caring for the patient suffering from rectal cancer by protecting them and showing empathy. However, the dependence on the stoma affected and restricted their family and social life.

Adaptation, Psychological↗
PubMed2000

Patient and spouse perceptions of stroke and its rehabilitation.

The object of the study was to determine, in stroke patients and their spouses, changes in their perceptions of stroke, information received about it, its management, and its rehabilitation. There were assessments on acute admission, on admission to and discharge from rehabilitation, and six and twelve months after discharge. Participants were 60 twelve month stroke survivors who had undergone an inpatient rehabilitation programme, and 46 spouses. Their perceptions of stroke, of medical information received, of the management of stroke, and of rehabilitation were assessed in a structured interview. Stroke was predominantly perceived by participants in terms of physiological causes and disabling consequences. Its causes were poorly understood, as was the role of doctors and hospitals for people with strokes. The role of rehabilitation was better understood. Many participants felt they were told little about the illness during care. Stroke patients and their spouses adapt with varying success to their changed circumstances. This adaptation will benefit from better communication between medical staff and families in the acute and rehabilitation settings.

Aged↗
PubMed2005

Efficacy of support groups for spouses of patients with spinal cord injury and its impact on their quality of life.

The need for a sound social support system, and its positive impact on physical, mental and behavioural health in the ever-increasing spinal cord injury (SCI) clientele, is undeniable. It is evident from recent research that spousal support should be weighed as an important contributing factor to the ongoing health and well-being of their SCI partners. Stress (severe depressive symptoms) to the care-giving spouses, and implications on their health and thereby the SCI partner, is often underestimated. Thus the present study is an attempt to treat this highly susceptible population through the provision of support groups. This study was a two-group experimental design. The study results bring to light the definite impact of SCI on the spouse's well-being. Thus it is essential to direct research towards life domains designed to improve the quality of life of these individuals. This research demonstrates the unquestionable positive effect of group therapy on the impact of well-being of spouses of SCI survivors. This finding may only be the tip of the iceberg and further research with a larger sample size must be conducted for the adequate generalization of this study.

Adaptation, Psychological↗
PubMed2006

Work hours affect spouse's cortisol secretion--for better and for worse.

OBJECTIVE: In a sample of 52 German dual-earner couples with at least one child under age 5, we examined the bodily costs and benefits of the amount of time each spouse spent on productive activities. METHODS: Diary reports of time allocated to formal and informal work activities were analyzed according to the Actor-Partner Interdependence model. RESULTS: Hierarchical linear models showed that each hour an individual allocated to market, as well as household work, increased his or her total cortisol concentration (by 192 and 134 nmol/l, respectively). Unexpectedly, the time the spouse allocated to paid work also raised an individual's total cortisol concentration (by 64 nmol/l). In line with our expectations, there was a tendency for the time the spouse allocated to household work to decrease the individual's cortisol concentration (by 81 nmol/l). CONCLUSIONS: This study contributes to the body of evidence on the complex nature of social relationships and complements the literature on specific working conditions and couples' well-being.

Adult↗
PubMed2005

Depression as a mediator between spousal bereavement and mortality from cardiovascular disease: appreciating and managing the adverse health consequences of depression in an elderly surviving spouse.

Bereavement in the elderly is becoming a more frequent phenomenon as a result of the aging of the population. The death of an elderly spouse increases psychologic morbidity, particularly depressive symptoms, as well as mortality. Depression increases the risk of death independent of age or bereavement, and can thus exacerbate the health effects of losing a spouse. This magnifier effect is especially pernicious because bereavement and depression both tend to increase cardiovascular mortality rates. Primary care physicians should be alert for signs of mood disorders in elderly persons who have recently lost a spouse. Potential therapies for depression in an elderly bereaved individual include pharmacologic agents, psychotherapy, and psychosocial support. Data also support the value of encouraging religious patients to continue with spiritual observances. Although these approaches decrease mood disorders, it is not yet clear whether they also reduce the risk of death or cardiovascular disease.

Aged↗
PubMed2003

The psychosocial functioning of children and spouses of adults with ADHD.

BACKGROUND: It is unclear what the impact of parental ADHD is on the day-to-day life of the rest of the family and how it contributes to the intergenerational transmission of this disorder. METHOD: The psychosocial functioning of 23 spouses and 63 children of 33 families with an ADHD parent and 20 spouses and 40 children of 26 comparison families was examined. Both adults and their spouses were assessed for lifetime and current Axis I and Axis II diagnoses, present general psychiatric symptoms and their marital relationships. Children were screened for ADHD and other problems, using the C-DISC, CBLC, TRF and the Social Adjustment Inventory. RESULTS: Children with an ADHD parent had higher rates of psychopathology than those from comparison families. Children with ADHD had more co-morbidities than non-ADHD children. Family and marital functions were impaired in ADHD families regardless of the gender of the affected parent. Children without ADHD from families with one psychiatrically healthy parent did well while the behaviour of children with ADHD was always poor and not associated with parental mental health. CONCLUSION: The results underscore the strong genetic contribution to ADHD and the need to carefully assess the non-ADHD parent as they seem to influence the well-being of non-ADHD children in families with an ADHD parent.

Adult↗
PubMed1999

The association between spouses' self-reports of attachment styles and representations of family dynamics.

The current research assesses the association between spouses' self-reports of attachment style and their perceptions of family dynamics. The sample included 93 Israeli married couples with young children. Both husbands and wives completed the adult attachment style scale and the perceived and ideal versions of FACES III. Findings showed that spouses whose self-reports endorsed the secure style perceived relatively high levels of family cohesion and adaptability; persons who endorsed the anxious-ambivalent style reported high levels of family cohesion but low levels of adaptability; and persons who endorsed the avoidant style reported relatively low levels of both family dimensions. In addition, significant associations were found between reports of attachment styles, on the one hand, and ideal representations of family dynamics, the marital partner's representations of family dynamics, and spouses' discrepancies in these representations, on the other. Findings are discussed in terms of attachment theory.

Adult↗