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PubMed1998

Who supports whom? How age and gender affect the perceived quality of support from family and friends.

This study investigates age and gender differences in the relative perception of social support across adulthood. Findings indicate that age and gender do affect both the perception of positive support and the perception of demandingness across different support relationships. In all age groups, men appear to perceive spousal support as the most positive, while women seem to perceive the support received from children as being the most positive. However, it is apparent that all three relationships studied--those with spouse, children, and friends/other relatives--are important sources of support for both men and women.

Adult↗

PubMed2004

Rehabilitation after coronary heart disease: spouses' views of support.

BACKGROUND: Family presence decreases mortality and improves psychosocial recovery after a coronary heart disease event. In this situation, spousal support seems important for the recovering partner's self-esteem and mastery. There is inadequate knowledge of how spouses view their supportive roles. AIM: The aim of this paper is to report a study investigating spouses' experiences of the rehabilitation phase of their partners' coronary heart disease and to gain their views about supporting them in lifestyle changes. METHOD: Eight male (mean age 61) and 17 female spouses (mean age 53), were interviewed 1 year after their partner's cardiac event. Of the partners, 18 had experienced myocardial infarction and 19 were revascularized. Interview transcripts were analysed qualitatively using a phenomenographic framework. FINDINGS: The analysis yielded five different views of the spouse's role. The participative role involved taking a practical part in lifestyle changes, communicating empathetically, and being positive about changes. The regulative role was characterized by being either positive or negative about changes, giving practical or cognitive support in order to control the partner's behaviour, and communicating authoritatively. In the observational role the spouse was passive, complied with suggestions, and communicated empathetically. The incapacitated role involved a positive attitude to changes, communicating without making demands, but being unable to provide support because of personal problems. Assuming a dissociative role entailed being negative about changes and authoritatively declaring a reluctance to be involved in the partner's change of lifestyle. Spouses adopted different roles depending on the support situation. CONCLUSION: Spouses' views of their roles in support varied considerably in terms of awareness of the benefits of behavioural changes, style of communication, pattern of co-operation and support situation. The findings favour the view that a family perspective is important in planning rehabilitation of patients following coronary heart disease.

Adult↗

PubMed1997

Reciprocal support in the context of cancer: perspectives of the patient and spouse.

PURPOSE/OBJECTIVES: To examine the relationship between mutual spousal support and psychological health status of patients and their spouses. DESIGN: Cross-sectional, descriptive. SETTING: Outpatient oncology clinics (physician, hospital, state cancer center) in the southwestern United States. SAMPLE: A convenience sample of 73 predominantly Caucasian couples with one dyad member receiving treatment for cancer. The mean age of the husbands and wives was 60.7 years and 57.1 years, respectively. METHODS: Questionnaires (Interpersonal Relationships Inventory; Disease Course Graphic Scale; Rosenberg Self-Esteem Scale; Centre for Epidemiological Studies-Depression Instrument; demographic form) completed by patients and spouses. MAIN RESEARCH VARIABLES: Marital reciprocal support, interpersonal support, severity of illness, interpersonal conflict, self-esteem, and depression as perceived by the patients and spouses; performance status as assessed by the patients. FINDINGS: The patients perceived more interpersonal support than the spouses. Both experienced more self-esteem when marital reciprocal support was balanced and high rather than unbalanced or balanced but low. A similar pattern was found for the spouses for self-esteem and depression regarding interpersonal support. Marital and interpersonal support decreased and depression increased as interpersonal conflict increased. CONCLUSIONS: Mutual spouse support is significantly related to patient and spouse self-esteem and depression. Marital reciprocal support is negatively related to interpersonal conflict. More attention must be given to family-oriented oncology nursing care. IMPLICATIONS FOR NURSING PRACTICE: Include the patients' and spouses perceptions of balance in the exchange of marital support in family assessments. Intervene directly or through referral to enable couples to understand the benefit and obligation to support each other when faced with a life-threatening illness.

Adaptation, Psychological↗

PubMed1998

How the negative and positive aspects of partner relationships affect the mental health of young married people.

The relationship between marriage and positive mental health is one of the most established findings in the stress literature. Few studies, however, examine the problematic as well as the supportive impacts of marriage on mental health. This paper uses a cohort of young adults who were sampled at 18, 21, or 24 years of age and resampled seven years later when they were married at 25, 28, or 31. It examines what factors are associated with the quality of marital relationships, the relative impact of and balance between negative and positive partner relationships on mental health, and sex differences in the determinants and outcomes of marital quality. The results indicate that the structural strains of parenthood and financial need and their interaction predict problematic and supportive spousal relationships and the difference in the levels of these two relationships. Problematic relationships with spouses have considerably stronger impacts than supportive relationships on depression. However, the difference between the amounts of supportive and problematic relationships with spouses has a greater impact on mental health than levels of either considered separately. Finally, relational quality has a greater impact on the mental health of wives than husbands. These findings indicate the importance of considering how marriage affects mental health in complex, rather than in straightforward, ways.

Adolescent↗

PubMedDate not supplied

Food selection and eating patterns: themes found among people with type 2 diabetes mellitus.

OBJECTIVE: The objective of this study was to examine the beliefs and perspectives among people with type 2 diabetes mellitus about dietary requirements, food selection and eating patterns, and attitudes about self-management practices. DESIGN: Semistructured, in-depth interviews explored participants' experiences with diabetes prior to their diagnosis, participants' understanding of the guidelines for the nutritional management of diabetes, how participants applied their understanding of dietary guidelines to daily food selection and eating patterns, and the social and personal themes influencing participants' food selection and eating patterns. SUBJECTS: Interviews were conducted with members of a convenience sample of 45 men and women diagnosed with type 2 diabetes for at least 1 year. ANALYSES PERFORMED: Interviews were coded using a conceptual matrix derived from participants' statements. Common characteristics were grouped, and broad themes were identified. RESULTS: Eating patterns were influenced by participants' knowledge of diabetes management. Challenges that participants encountered when applying nutrition recommendations were linked to their prior eating practices. Dietary self-efficacy, social support, and time management were identified as mediating variables that can influence dietary behaviors. IMPLICATIONS: Diabetes nutrition education programs should increase awareness of eating history, spousal support, and time management practices. Future research should include the refinement and validation of a nutritional management model of diabetes.

Adult↗

PubMed1990

Social support and quitting smoking for good. Is there an association? Results from the population study, "Men born in 1914," Malmö, Sweden.

The objective in this study was to analyse whether there is independent association between social network, social support, social influence and quitting smoking for good. The study sample (n = 621) comprised a random half of all male Malmö residents born in 1914, of which 500 (80.5%) participated. A new instrument based on a model with carefully defined and well differentiated concepts was used to measure different aspects of social network, social support and social influence. In logistic regression analysis, emotional support (an important aspect of social support) had an association to quitting smoking for good (odds ratio 3.1, 95% confidence interval 1.9-5.4), when adjustments were made for social class, marital status (spousal support), alcohol consumption, physical activity, smoking of spouse and different medical conditions. Emotional support reflects the individuals' opportunity for care, encouragement of personal value and feelings of confidence and trust. This may contribute to a deeper understanding of mechanisms behind smoking cessation and could be of importance in the field of health promotion, but also for improvement of the long-term results of smoking cessation programs and in our clinical work with patients who smoke.

Aged↗

PubMed2000

Individual and crossover effects of stress on adjustment in medical student marriages.

High-stress individuals may benefit from social support, although their support providers may be adversely affected via stress crossover effects. Individual and crossover effects of perceived stress within medical student marriages (n = 30) were investigated. Perceived spousal support was positively associated with individuals' own marital and emotional adjustment, attenuating stress effects. With regard to crossover effects, medical students' perceived stress was significantly associated with their spouses' emotional adjustment. Further, medical students' own emotional adjustment fully mediated this crossover effect. Results suggest that the contagion of negative affect may serve as a key mechanism through which stress crossover effects operate in marriage.

Adaptation, Psychological↗

PubMedDate not supplied

Comparison of the social support networks of Filipino and Mexican-American primigravidas.

In this descriptive-exploratory study, we sought to describe and compare the similarities and differences between Filipino and Mexican-American primigravidas in social support networks, type of support received, and expectations regarding care from health care providers. Convenience sampling was used, and face-to-face interviews using the Norbeck Social Support Questionnaire (Norbeck, Lindsey, & Carrieri, 1983) were conducted in Filipino and Spanish by trained data collectors. The profiles obtained for both groups were similar in sociodemographic characteristics; possession of an adequate social support network, predominantly composed of the spouse and family members; and expectations of more personalized care and decreased waiting time than transpired. The groups differed slightly with regard to ability to discuss pregnancy with persons reported in the network. Overall findings reflect the central role of the family as a source of support during pregnancy. Recommendations are made to conduct research addressing populations of varied ethnic groups and with different educational backgrounds, populations of single and teenage pregnant women, and spousal support.

Adult↗

PubMed1998

Health-related behaviors, social support, and community morale.

The relation among health behaviors, social support, and community morale--attitudes toward one's community, such as attachment and social participation--was examined in 597 adults living in a Japanese community. Logistic models revealed that strong spousal support was related to reduced alcohol drinking and enhanced family support was related to a reduction in smoking. The support of friends was positively associated with the frequency of alcohol drinking by men. Among women, family support was positively related to the frequency of consuming Japanese-style food. Community morale was positively associated with consuming Japanese-style side dishes and negatively associated with alcohol consumption. The results indicate that there are varied associations between social relationships and health-related behavior and that these associations are gender-related. Knowing the specific associations between an individual's social relationships and his or her health-related behavior will he helpful for community-based intervention.

Journal Article↗

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

Effects of spousal control and support on older adults' recovery from knee surgery.

The authors investigated associations between spousal control (influence) and support on the recovery outcomes for 70 men and women (mean age = 70) undergoing an increasingly common surgical treatment for osteoarthritis (OA) of the knee. Spouses' positive (motivating) and negative (pressuring) control and spouses' emotional (understanding) and problematic (dismissing) support were examined as predictors of patients' adherence and improvement in well-being. Positive control was associated with better adherence, but only among patients whose spouses provided little problematic support. In contrast, negative control strategies tended to elicit increases in negative affect. Overall, our findings revealed that the effectiveness of spousal control depended largely on the quality of support provided by the spouse.

Affect↗

PubMed2004

Pain catastrophizing and social support in married individuals with chronic pain: the moderating role of pain duration.

In the current study, 96 married chronic pain patients were recruited from the community to test hypotheses about the roles of catastrophizing and psychological distress in relation to perceived support from close others. It was expected that pain duration would moderate the relationship between catastrophizing and perceived support and between catastrophizing and psychological distress. In addition, distress was hypothesized to mediate the relationship between the pain duration-catastrophizing interaction and support. Hierarchical regression analyses showed that pain duration interacted with catastrophizing such that at shorter pain durations, pain catastrophizing was related to more perceived solicitous spouse responses; however no such relationship existed for patients with longer pain durations. In contrast, catastrophizing was significantly related to less perceived spousal support (i.e. support not specific to pain) in patients with longer durations of pain whereas no significant relationship existed for patients with shorter pain durations. Pain duration did not interact with catastrophizing in relating to psychological distress, which precluded the examination of distress as a mediator between the pain duration-catastrophizing interaction and support. Moreover, psychological distress did not significantly mediate the relationships between pain catastrophizing and perceived support. These findings are discussed in the context of cognitive-behavioral and interpersonal perspectives of pain.

Adult↗

PubMed1994

Aid to Families with Dependent Children; extension of Medicaid when support collection results in termination of eligibility--HHS. Final rule.

These final rules interpret section 20 of the Child Support Enforcement Amendments of 1984, as amended by section 303(e) of the Family Support Act of 1988, and section 8003 of the Omnibus Budget Reconciliation Act of 1989. The 1984 law extended Medicaid coverage for a period of four months to certain dependent children and adult relatives who become ineligible for Aid to Families with Dependent Children (AFDC) as a result, wholly or partly, of the collection or increased collection of child or spousal support under title IV-D of the Social Security Act (the Act). The regulations are applicable to the AFDC and Medicaid programs in all jurisdictions.

Aid to Families with Dependent Children↗

PubMedDate not supplied

Identification of factors predictive of hospital readmissions for patients with heart failure.

OBJECTIVE: The objective was to evaluate whether severity of cardiac illness, cognitive functioning, and functional health of older adults with heart failure (HF) and psychosocial factors related to caregiving are predictive of hospital readmissions for those with HF. DESIGN: A prospective, descriptive, predictive design was used. SETTING: The study took place in 2 community hospitals in northeastern Ohio. SAMPLE: Originally 156 patient-caregiver dyads were interviewed within 7 to 10 days of hospital discharge, but only 128 dyads completed the study. Subjects had HF and their mean age was 77.3 years. Their caregivers were mostly women with a mean age of 64.8 years. RESULTS: Fourty-four percent of the patients were readmitted to the hospital within 3 months. Among patients, severity of illness was moderate, blood pressure was within normal limits, functional and cognitive status were high. For patients, the interaction of severity of cardiac illness and functional status predicted risk of hospital readmission. Among caregivers, depressive symptoms and perceived stress were low; informal social support and caregiving appraisal were high. The interaction of caregiver stress and depression were significant predictors of risk of hospital readmission. CONCLUSION: Nurses should consistently assess changes in patients' cardiac symptoms in addition to their ability to provide self-care. Since patients with HF are at high risk for readmission, further study is needed to determine whether interventions designed to increase spousal support would decrease hospital readmissions.

Activities of Daily Living↗

PubMed2003

Improvement in medical risk factors and quality of life in women and men with coronary artery disease in the Multicenter Lifestyle Demonstration Project.

This study examined medical and psychosocial characteristics of 440 patients (mean age 58 years, 21% women) with coronary artery disease at baseline and at 3-month and 12-month follow-ups. All patients were participants in the Multicenter Lifestyle Demonstration Project, aimed at improving diet (low fat, whole foods, plant-based), exercise, stress management, and social support. Spousal participation was encouraged. Both genders evidenced significant improvements in their diet, exercise, and stress management practices, which they maintained over the course of the study. Both women and men also showed significant medical (e.g., plasma lipids, blood pressure, body weight, exercise capacity) and psychosocial (e.g., quality of life) improvement. Despite their worse medical, psychosocial, and sociodemographic status at baseline, women's improvement was similar to that of men's. These results demonstrate that a multi-component lifestyle change program focusing on diet, exercise, stress management, and social support can be successfully implemented at hospitals in diverse regions of the United States. Furthermore, this program may be particularly beneficial for women with coronary artery disease who generally have higher mortality and morbidity than men after a heart attack, angioplasty, or bypass surgery.

Body Mass Index↗

PubMed1995

[Social support and social stress in tumor patients and their partners].

Social support is widely believed to be an important buffer against stress in patients coping with cancer. Support efforts can, however, in turn prove to become a source of distress in themselves, both in patients and support providers. The present study was designed to explore the connections between support and emotional distress. N = 120 lung cancer patients and their relatives (n = 57) are interviewed at three intervals. Social support is assessed by multiple methods: Content analysis, a questionnaire and a confidant rating performed by experts. Cross-sectional and longitudinal analyses are combined. Content-analytical and self-report data show a correlation of support efforts and emotional distress. In the confidant rating, however, the expected differences between supportive and non-supportive spousal relationships emerge. The results are discussed from an interactional point of view.

Adaptation, Psychological↗

PubMed1998

Sexual ethics. Disclosure of HIV-positive status to partners.

OBJECTIVE: To determine factors associated with disclosure of human immunodeficiency virus (HIV)-positive status to sexual partners. METHODS: We interviewed 203 consecutive patients presenting for primary care for HIV at 2 urban hospitals. One hundred twenty-nine reported having sexual partners during the previous 6 months. The primary outcome of interest was whether patients had told all the sexual partners they had been with over the past 6 months that they were HIV positive. We analyzed the relationships between sociodemographic, alcohol and drug use, social support, sexual practice, and clinical variables; and whether patients had told their partners that they were HIV positive was analyzed by using multiple logistic regression. RESULTS: Study patients were black (46%), Latino (23%), white (27%), and the majority were men (69%). Regarding risk of transmission, 41% were injection drug users, 20% were homosexual or bisexual men, and 39% were heterosexually infected. Sixty percent had disclosed their HIV status to all sexual partners. Of the 40% who had not disclosed, half had not disclosed to their one and only partner. Among patients who did not disclose, 57% used condoms less than all the time. In multiple logistic regression analysis, the odds that an individual with 1 sexual partner disclosed was 3.2 times the odds that a person with multiple sexual partners disclosed. The odds that an individual with high spousal support disclosed was 2.8 times the odds of individuals without high support, and the odds that whites or Latinos disclosed was 3.1 times the odds that blacks disclosed. CONCLUSIONS: Many HIV-infected individuals do not disclose their status to sexual partners. Nondisclosers are not more likely to regularly use condoms than disclosers. Sexual partners of HIV-infected persons continue to be at risk for HIV transmission.

Disclosure↗

PubMed1996

Spouse-assisted coping skills training in the management of osteoarthritic knee pain.

OBJECTIVE: To evaluate the effects of a spouse-assisted pain-coping skills training intervention on pain, psychological disability, physical disability, pain-coping, and pain behavior in patients with osteoarthritis (OA) of the knees. METHODS: Eighty-eight OA patients with persistent knee pain were randomly assigned to 1 of 3 conditions: 1) spouse-assisted pain-coping skills training, (spouse-assisted CST), 2) a conventional CST intervention with no spouse involvement (CST), or 3) an arthritis education-spousal support (AE-SS) control condition. All treatment was carried out in 10 weekly, 2-hour group sessions. RESULTS: Data analysis revealed that at the completion of treatment, patients in the spouse-assisted CST condition had significantly lower levels of pain, psychological disability, and pain behavior, and higher scores on measures of coping attempts, marital adjustment, and self-efficacy than patients in the AE-SS control condition. Compared to patients in the AE-SS control condition, patients who received CST without spouse involvement had significantly higher post-treatment levels of self-efficacy and marital adjustment and showed a tendency toward lower levels of pain and psychological disability and higher scores on measures of coping attempts and ratings of the perceived effectiveness of pain-coping strategies. CONCLUSION: These findings suggest that spouse-assisted CST has potential as a method for reducing pain and disability in OA patients.

Adaptation, Psychological↗