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PubMed1996

The impact of cohesive groups in the trauma recovery context: police spouse survivors and duty-related death.

This paper examines the impact of surviving spouse social interactions on psychological distress following the death of a police officer. It was hypothesized that satisfactory interactions within the police work group would lower distress, and unsatisfactory interactions outside the police environment (justice system, media, community persons) would increase distress. Results indicated that increased quality of interaction with police groups lowered psychological distress scores. Despite increased satisfaction with groups outside of policing, spouse's distress still increased, suggesting that satisfaction with and support by police groups appears to ameliorate distress more effectively than others. These findings suggest that police agencies and personnel may be helpful to surviving spouses after the death of an officer and should formulate policy to provide long term contact and assistance.

Adult↗

PubMed1991

Achalasia and diet: assessment of the effect of achalasia on the diet of patients and their spouses.

The effect of achalasia on the diet of patients and their spouses was investigated using a validated questionnaire. The discordance between the diet of the patients and their respective spouses was compared with matched controls. There is no statistically significant difference between the discordance of case couples and control couples. Patients with achalasia, and their spouses, eat a normal diet.

Adult↗

PubMed1989

Gynecologic screening examinations: does the obstetrician-gynecologist's spouse comply?

The practicing obstetrician-gynecologist has certainly moved toward more active teaching and encouragement of preventive medical measures during the past decade. The purpose of this study was to determine how these measures espoused by the practitioner are applied in the physician's family setting. To accomplish this, 5000 questionnaires were sent to actively practicing obstetrician-gynecologists. Questions pertained to health habits as well as social and demographic issues. The results revealed that preventive medical practices, which have a high impact on morbidity and mortality, were not practiced to a significant degree by the spouses of obstetrician-gynecologists. Approximately 17% of the spouses did not have yearly Papanicolaou smears. Women older than 55 years of age were less likely to have this screening test than their younger cohorts. Only 65% perform breast self-examination, and 36% did not have screening mammography performed when recommended. In the postmenopausal group, 57% of the spouses did not receive estrogen replacement therapy, whereas 32% had both estrogen- and progesterone replacement therapy and 11% took estrogen alone. Contraceptive measures used by respondents indicated essentially equal distribution among methods available. The majority of the physicians who responded indicated they did not smoke (84%), did not use illegal drugs (99%), and used alcohol occasionally or not at all (71%).

Adult↗

PubMed1984

Communication and related problems as perceived by aphasic individuals and their spouses.

Aphasics' and spouses' perceptions of the presence and degree of bothersomeness of communication-related problems and whether enrollment in a language treatment program affected these perceptions were examined. Aphasic-spouse perceptions were more concordant in the treated group; aphasic patients in the untreated group reported their problems did not bother them. Type and severity of aphasia were not related either to the reported frequency or to the degree of bothersomeness of problems. Interview data from spouses revealed that the speech-language pathologists' role extended beyond solely providing information about language behavior.

Adult↗

PubMed1996

Spouse-pair risk factors and cardiovascular reactivity.

Epidemiological research has identified increased risk for coronary heart disease in Type A men married to well-educated women. The present study examined mechanisms that may explain the increased risk associated with this specific spouse-pair combination. Cardiovascular and self-report responses to an individual, standardized laboratory stress task and a dyadic, interactive affect provocation task were assessed in Type A or B men married to women of either low ( < or = 13 years) or high ( > 13 years) educational levels. Type A men with highly educated spouses (i.e., the highest risk group) also reported the greatest anger-out tendency, high trait anger, and low anger control scores. These men further exhibited elevated diastolic blood pressure at baseline and greater diastolic reactivity specific to the dyadic task than did the men in the lower risk groups. These findings, based on a laboratory study of spousal interactions, support the epidemiological high-risk designation of the Type A man with a highly educated spouse and confirm earlier conceptions that Type A research benefits more from a social interaction approach rather than from an individual trait perspective.

Adult↗

PubMed1985

Status of life-areas: congruence/noncongruence in ESRD patient and spouse perceptions.

Perceptions of ESRD patients' satisfaction with, and abilities in, 13 life-areas were assessed in 50 patients and their spouses by means of a series of linear rating scales. Patient and spouse views were congruent on 10 dimensions. Noncongruence existed only on perception of the patient's satisfaction with his/her medical situation, perception of the patient's ability to care for self, and perception of the patient's satisfaction with feelings about self. This noncongruence was especially pronounced in certain patient subgroups, and explanations related to the nature of ESRD and its treatment are suggested. We recommend that future studies examine not only perceptions of patients' satisfaction but also perceptions of the spouse's own satisfaction with various life-areas.

Activities of Daily Living↗

PubMed1985

Living with chronic pain: the spouse's perspective.

This report is part of a larger study mounted for purposes of investigating the effects on a family of chronic pain in one of its adult members. Data concerning the spouses' understanding of their mate's pain along with the spouses' perception of the impact of this problem on their own health are presented. The factors of uncertainty and helplessness were found to be central to the distress experienced by the spouses in this study. The finding that the experience of living with chronic pain extends beyond the individual sufferer to encompass the family as a whole would suggest that health professionals must incorporate the family into the process of learning the meaning and management of chronic pain.

Adult↗

PubMed1986

Antabuse contracts for married alcoholics and their spouses: a method to maintain antabuse ingestion and decrease conflict about drinking.

Antabuse is widely used in alcoholism treatment as a deterrent to impulsive drinking when the alcoholic encounters some temporary life crisis or other stressful situation. Unfortunately, Antabuse therapy often is not effective because the alcoholic discontinues the drug prematurely. Marital conflicts and arguments, frequently about past drinking or the likelihood of future drinking, are an important stressor that can lead the newly abstinent alcoholic to relapse. The Antabuse Contract procedure is designed to maintain Antabuse ingestion and abstinence from alcohol and to decrease alcohol-related arguments and interactions between the alcoholic and his/her spouse. In the Antabuse contract the alcoholic agrees to take Antabuse each day while the spouse observes. The spouse, in turn, agrees to record the observation of the Antabuse-taking on a calendar provided by the therapist. Finally, the couple agree to refrain from discussions about the alcoholic's past or possible future drinking. This report describes the Antabuse contract procedure in detail, discusses resistances and problems commonly encountered in using the procedure, and presents two case illustrations of successful use of the procedure.

Adaptation, Psychological↗

PubMed2004

The impact of own and spouse's urinary incontinence on depressive symptoms.

This study investigated the impact of own and spouse's urinary incontinence on depressive symptoms. Attention was paid to the possibility that gender and caregiving might be important factors in understanding significant effects. We used negative binomial regression to analyze survey data for 9974 middle-aged and older respondents to the Health and Retirement Study in the USA. Results supported the hypothesis that the respondents' own urinary incontinence was associated with depressive symptoms (unadj. IRR = 1.73, 95% CIs = 1.53, 1.95 for men; unadj. IRR = 1.50, 95% CIs = 1.38, 1.63 for women). Controlling sociodemographic and health variables reduced this relationship, but it remained statistically significant for both men and women. Having an incontinent wife put men at greater risk for depressive symptoms (unadj. IRR = 1.13, 95% CIs = 1.02, 1.25), although this relation became nonsignificant with the addition of control variables. No relation between women's depressive symptoms and husbands' (in)continence status was found. Caregiving was not a significant variable in the adjusted analyses, but spouses' depressive symptoms emerged as a significant predictor of the respondents' own depressive symptoms. Health care providers must be sensitive to the emotional impact of urinary incontinence. Our findings also suggest the importance of considering the patient's mental health within a wider context, particularly including the physical and mental health of the patient's spouse.

Aged↗

PubMed1978

Antibodies to synthetic polyribonucleotides in spouses of patients with inflammatory bowel disease.

Serum from patients with inflammatory bowel disease (I.B.D.) and their unaffected spouses bound significantly more synthetic single-stranded (poly.rA) and double-stranded (poly.rA.poly.rU) R.N.A. but not KB cell D.N.A. than did serum from age-matched controls and their spouses. Binding activity resided in Ig fractions and was predominantly of IgM class. A significant corelation was observed between the amount of double-stranded but not single-stranded R.N.A. bound by serum from patients and from their respective spouses. These findings provide indirect support for the presence of R.N.A. viruses in patients with I.B.D. and the transmission of such agents to their close personal contacts.

Antibodies, Viral↗

PubMed2003

The health impact of health care on families: a matched cohort study of hospice use by decedents and mortality outcomes in surviving, widowed spouses.

Alternative ways of caring for seriously ill patients might have implications not only for patients' own outcomes, but also, indirectly, for the health outcomes of their family members. Clinical observation suggests that patients who die "good deaths" may impose less stress on their spouses. Consequently, we sought to assess whether hospice use by a decedent is associated with decreased risk of death in surviving, bereaved spouses. We conducted a matched retrospective cohort study involving a population-based sample of 195,553 elderly couples in the USA. A total of 30,838 couples where the decedent used hospice care were matched using the propensity score method to 30,838 couples where the decedent did not use hospice care. Our principal outcome of interest was the duration of survival of bereaved widow/ers. After adjustment for other measured variables, 5.4% of bereaved wives died by 18 months after the death of their husband when their deceased husband did not use hospice and 4.9% died when their deceased husband did use hospice, yielding an odds ratio (OR) of 0.92 (95% CI: 0.84-0.99) in favor of hospice use. Similarly, whereas 13.7% of bereaved husbands died by 18 months when their deceased wife did not use hospice, 13.2% died when their deceased wife did use hospice, yielding an OR of 0.95 (95% CI: 0.84-1.06) in favor of hospice use. Our findings suggest a possible beneficial impact of hospice--as a particularly supportive type of end-of-life care--on the spouses of patients who succumb to their disease. Hospice care might attenuate the ordinarily increased mortality associated with becoming widowed. This effect is present in both men and women, but it is statistically significant and possibly larger in bereaved wives. The size of this effect is comparable to the reductions in the risk of death seen in a variety of other modifiable risk factors in women. Health care may have positive, group-level health "externalities": it may affect the health not only of patients but also of patients' family members.

Aged↗

PubMed1990

Psychologic distress of chronic pain sufferers and their spouses.

Recent research has begun to document the relationship between chronic pain and psychologic distress among pain patients, yet little attention has been given to the spouses' reaction to the chronic pain condition. The results of this research using the Symptom Checklist-90 (SCL-90) to assess the psychologic distress among both chronic pain sufferers and spouses (61 couples) reveal elevated distress scores among both groups when compared with the norms from a nonpatient sample. Patients and spouses present similar profiles according to the SCL-90 subscales, with patients' scores significantly higher on the somatization, hostility, and psychoticism subscales. No differences by sex were found.

Adult↗

PubMed1993

Social support and long-term recovery from coronary artery surgery: effects on patients and spouses.

Using a longitudinal design, the effect of social support on recovery from coronary bypass surgery was examined in 155 patients and 103 of their spouses. Perception of the availability of 5 types of social support was relatively stable from preoperation to 1 year after surgery and was significantly related to emotional and functional outcomes. Of the 5 types of support measured, only esteem support was significantly and consistently related to outcomes for patients and spouses. This relationship was strongest within-time, and across-time relationships effects were weaker. Spouse's perception of support was related to patient outcomes, controlling for patient perceptions of support. Results suggest that perception of esteem support may be the most salient type of support related to feelings of well-being during and after an acute health-care event. In addition, perception of social support may be characterized by stable individual differences.

Activities of Daily Living↗

PubMed1989

Spouse and parent-offspring similarities in cardiovascular response to mental arithmetic and isometric hand-grip.

Thirty spouse pairs were recruited for a stress protocol consisting of alternating stress and relaxation periods. Repeated measurements of blood pressure, heart rate, and blood volume pulse were obtained. Spouse pairs were parents of young adult sibling pairs who had previously participated in a slightly different version of the protocol. Although spouses exhibited some behavioral similarities, there were no significant similarities in cardiovascular response to stress. However, despite the fact that parents and their offspring were tested on different occasions using somewhat different procedures, some similarities in cardiovascular reactivity were observed. Significant parent-offspring similarities in heart-rate response to mental arithmetic and diastolic blood pressure response to isometric hand-grip were observed, as well as several behavioral similarities. Assortative mating and the nature of one's current home environment seem to be less important in the familial aggregation of cardiovascular reactivity to stress than early environmental and/or genetic factors.

Adolescent↗

PubMed2005

Do you remember? How caregivers question their spouses who have Alzheimer's disease and the impact on communication.

This study examined the types of questions caregivers use and their outcomes when conversing with their spouse with Alzheimer's disease (AD). Of particular interest was caregivers' use of yes-no and open-ended questions and the demands they make on the memory of the person with AD. It was hypothesized that communication between caregivers and their spouses would be more successful when caregivers used yes-no rather than open-ended questions; however, it was also predicted that a more positive communication outcome would occur when caregivers used open-ended questions that requested information from semantic rather than episodic memory. Eighteen caregivers and their spouses diagnosed with AD were audiotaped while they conversed for approximately 10 min on a topic of their choosing. The conversations were transcribed and coded according to the occurrence of questions, the type of question (yes-no, choice, or open-ended), the type of memory required to respond to a question (semantic or episodic), and the outcome of a response to a question (communication breakdown). The results indicated that caregivers used yes-no and open-ended questions to a similar extent, whereas episodic questions were used almost twice as frequently as semantic questions. Communication was more successful when caregivers used yes-no compared with open-ended questions and when questions placed demands on semantic rather than episodic memory. The findings from this study suggest that caregivers can reduce communication problems by avoiding the use of questions that depend on episodic memory. In addition, while yes-no questions were associated with more favorable outcomes than open-ended questions, the latter do not need to be avoided if they refer to information that draws only on semantic memory.

Aged↗

PubMed1997

Recovering from the death of a spouse.

Within the context of an international comparative grief project, the goal of this study has been to compare the grief reactions to grieving Finnish women and men who had lost their spouse within a period of either less than or more than 2 years prior the study. The sample consisted of women (n = 242) and men (n = 76) who had lost a spouse between the ages of 25 and 65 years at the time of their death. Two instruments were used in data collection: a sociodemographic instrument and the Hogan Grief Reactions Checklist, developed in the USA. In comparing the different dimensions of grief in the subgroups divided by the bereavement time, there were significant differences in the grief reactions. Despair and disorganization diminished over time. Panic behaviour and detachment dimensions also showed differences although they were not statistically significant. The widowers who lost their spouse more than 2 years prior to the study displayed their feelings of blame and anger more than the widows. Results showed that if the death had occurred less than 2 years prior to the study there were no differences between the groups.

Adaptation, Psychological↗

PubMed1975

Hepatitis B immune globulin as a prophylactic measure for spouses exposed to acute type B hepatitis.

Because the value of usual immune globulin preparations in preventing Type B hepatitis is doubtful, we carried out a double-blind comparison of a control human immune globulin preparation with one--identified as HBIG--that had a high concentration (442 mug per milliliter) of antibodies to surface components of hepatitis B virus. Effectiveness was tested in spouses of patients with acute Type B hepatitis. Within 150 days after injection, nine of 33 spouses in the control group had symptomatic Type B hepatitis, compared with one of 25 spouses receiving HBIG. One non-B case also occurred in the HBIG group. Five control globulin recipients had evidence of subclinical hepatitis B infection, compared with one HBIG recipient. Thus, HBIG appeared effective in suppressing not only disease, but also infection itself. Prophylactic value has been demonstrated in persons who should now be recognized as being at exceptionally high risk.

Acute Disease↗

PubMedDate not supplied

Locomotive engineers and their spouses: coffee consumption, mood, and sleep reports.

Locomotive engineers (train drivers) on irregular work schedules reported a general coffee consumption rate higher than that reported by a comparison sample of permanent shift factory workers. The present study examines the impact of this consumption on workday and non-workday sleep behaviour and mood ratings. Twenty-seven engineers and their spouses each completed daily logs for 30 consecutive days. Daily logs were then sorted into workday and non-workday categories. Workday sleep length was significantly shorter than non-workday sleep length for both engineers and spouses. For the engineers only, coffee consumption on workdays was higher than on non-workdays. This increased coffee consumption was correlated with longer sleep latency, increased negative mood, and decreased positive mood on both work and non-workdays. This was not true for spouses. These results may be related to a days-off carry-over effect of caffeine or a general consumption behaviour characteristic.

Adult↗