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PubMed1974

Man with sterile spouse wants vasectomy: legal implications.

QUESTION: A middle-aged man whose wife has undergone a hysterectomy wants to have a vasectomy. His obvious intent is to engage in extramarital relations without fear of causing a pregnancy. May I perform a vasectomy on this man without his wife's permission or knowledge and consider myself not vulnerable to suit by the wife? Since she is sterile, she could not claim she was deprived of having further children. What is your consultant's opinion? ANSWER: This question is one that has not been litigated thus far. Since there may be serious legal implications, a physician confronted with this problem should seek legal advice from his own attorney. It is not part of the legal obligation imposed on a physician that he police the sexual morality of his patients. On the other hand, he has no obligation to perform a procedure for which there is no medical necessity merely because the patient requests it. There is no rule of law that states that one spouse can prevent the other from receiving medical care that is desired. There also does not appear to be any legal rule that states that one spouse must always be informed of medical care received by the other. Nevertheless, spouses do have certain mutual interests in each other. Interference with these interests might provide a basis for liability. A wife might well sue a physician under these circumstances. Whether the suit would be successful cannot be conclusively determined.

Family Planning Services↗
PubMed1991

Impact of adult critical care hospitalization: perceptions of patients, spouses, children, and nurses.

This phenomenologic study describes the effects of adult hospitalization in a critical care setting on the family as perceived by patients, spouses, children in the family, and nurses. Tape-recorded interviews were completed with 12 spouses, 9 patients (2 mothers and 7 fathers), 11 children, and 12 nurses. Responses were analyzed by using systematic thematic content analysis. Themes that emerged with regard to how this event affected the family unit and individuals in the family included (1) lack of communication among family members; (2) protecting children from anxiety-provoking information; (3) overriding threat, exemplified by feelings of vulnerability, uncertainty, intense emotions, and physical illness in children; (4) disruption of normal home routines; (5) changes in relationships; and (6) role conflict. Nurses' perceptions of the impact of this event on parents, spouses, and children demonstrated some incongruences with perceptions of patients and family members. Practice implications from this study include the following nursing actions: (1) eliciting more comprehensive information about relationships among family members and the impact on the family; (2) developing mechanisms to promote communication among family members; (3) making referrals to community resources such as school nurses, counselors, and chaplains; and (4) teaching nurses and parents ways to help children cope with this event.

Adaptation, Psychological↗
PubMed1990

[Phenomenology of stress in myocardial infarction patients and their spouses: nursing perspective].

The goal of this descriptive research was to identify, using the phenomenological method, the sources of stress as they are preceived by men who have suffered a myocardial infarction, and also as perceived by their spouse. Subjects were asked to identify their perceptions of stress arising from either having suffered a myocardial infarction or having shared the life of this person as a spouse, the nursing care received and the feelings of other concerned family members. Watson's "caring" theory was explored as a useful model to address the perceived stress. Analysis of the evidence confirmed that myocardial infarction itself provoked several sources of stress for the sick person and the spouse. Lack of instruction and support are two of the elements of stress often mentioned in the subjects' comments. These findings provide a focus for nurses to use the "caring" theory of Watson to minimize the sources of stress perceived by both groups of subjects.

Adult↗
PubMed1990

Psychosocial reactions in the spouses of patients suffering polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy.

Polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (PLO-SL) is a rare hereditary disease affecting both brain and bones. Skeletal symptoms begin in early adulthood and neuropsychiatric symptoms at approximately age 30. Progressive dementia associated with an accentuated frontal lobe syndrome handicaps the patients. The author describes inadequate psychosocial reactions of the spouses of 21 Finnish PLO-SL patients. The reactions included rejection and divorce in 8 cases and rejection without divorce in 1 case. Jealousy, violence, and alcoholism were common in male spouses. The author suggests that some of the spouses' negative psychosocial reactions may be lessened if the family is informed early about the nature of the disorder.

Adult↗
PubMedDate not supplied

Using nursing research findings to meet the needs of grieving spouses.

This article describes the utilization of nursing research findings in a coronary care setting. A standardized nursing care plan, based on Hampe's eight research-identified needs of grieving spouses, was developed by staff nurses in an intensive care unit. The 13 spouses of acutely ill coronary patients who had received specific nursing interventions reported more of their needs were met by nurses than did 13 spouses on whom base-line data were collected prior to the adoption of systematic nursing interventions.

Coronary Care Units↗
PubMed1989

Effects of information on recently diagnosed cancer patients' and spouses' satisfaction with care.

The effects of an intervention consisting of information, referral, counseling, and follow-up care individualized to patient and spouse needs on satisfaction and coping were determined from data gathered from 30 recently diagnosed male cancer patients and their spouses. A control group of 30 recently diagnosed cancer patients and their spouses received routine information, referral, counseling, and follow-up care. All participants were assessed for their informational needs using the Informational Needs Assessment instrument, and all self-rated their satisfaction with information received using the Satisfaction (SAT) instrument. Couples in the experimental groups received formal individualized intervention as described earlier. Two weeks after the initial testing but before medical intervention, all participants again self-rated their satisfaction using the SAT instrument. The results of a repeated measures analysis of variance test indicated that the experimental groups gained more information and were more satisfied with that information when compared with their counterpart control groups.

Adaptation, Psychological↗
PubMed1985

Frequent transmission of HTLV-III among spouses of patients with AIDS-related complex and AIDS.

Seven cases of acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) associated with human T-cell leukemia (lymphotropic) virus (HTLV)-III infection were documented in married males whose family members consented to medical evaluation. Five spouses also had evidence of HTLV-III infection documented by isolation of virus and by detection of serum antibody directed against viral structural proteins. Three of the five HTLV-positive spouses also had clinical evidence of ARC. The remaining four spouses were clinically healthy. Eleven children (between 14 months and 13 years of age) were also evaluated for evidence of disease and exposure to HTLV-III. Only one 14-month-old child was seropositive for antibody to HTLV-III. These data support the opinion that close household contact to patients with ARC or AIDS is not an efficient mechanism for virus transmission, while demonstrating that HTLV-III can be transmitted by repeated heterosexual contact.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Spouses' physical and psychological symptoms during pregnancy and the postpartum.

This cross-sectional descriptive study investigated the type and frequency of physical and psychological symptoms experienced by pregnant and postpartal women and their spouses. The sample of 70 married couples included 23 pairs in an early pregnancy group, 24 in a late pregnancy group, and 23 in a postpartum group. Both spouses completed a symptoms checklist of 20 physical and 3 psychological symptoms and the Beck Depression Inventory. Findings indicate that both spouses experienced some physical and psychological symptoms during pregnancy and the postpartum, although the women reported many more symptoms than did the men. Women in the late pregnancy group reported the highest number of physical symptoms; those in the postpartum group, the lowest number. No differences, however, in reports of psychological symptoms were found among the three groups of women. No significant differences in reports of either physical or psychological symptoms were found among the three groups of men.

Adult↗
PubMedDate not supplied

Spouse support and myocardial infarction patient compliance.

This study investigated the relationship between spouse support and compliance of myocardial infarction patients. Data were obtained from a sample of 60 couples during home interviews with the husband at least three months following his infarction. The hypothesis tested was that there is a positive relationship between spouse support and compliance. Husband's self-reported compliance was obtained for each of 10 aspects of the regimen. A spouse support questionnaire completed by wives estimated the degree to which they engaged in behaviors theorized to be supportive. Demographic and illness variables were also obtained. The hypothesis was not supported. Moreover, compliance was not related to demographic or illness variables, although those subjects still engaged in a cardiac rehabilitation program had significantly higher compliance than those who had stopped attending.

Adult↗
PubMed1984

Job characteristics of spouses and their work shifts.

This study builds on an earlier finding from the May 1980 Current Population Survey that one-third of full-time dual-earner couples with children in the United States include at least one spouse who works other than a regular day shift. Using the same data source, the relevance of husbands' and wives' job characteristics (occupation and industry) on their shift work status are considered, and the nature of the association between husbands' and wives' work shifts is explored. Four alternative models are initially posed and tested with log-linear analysis; these models vary in the extent to which a spouse's shift work status is contingent upon the job characteristics of a husband or wife. None of these models fit the data. A modification of the simplest of the four models (using forward selection) is the best fitting model. It is not symmetrical: the wife's shift is contingent upon both her occupation and industry and that of her husband, but the husband's shift is contingent only upon his occupation and industry. There is a relationship between husband's and wife's shift, the direction of which depends upon the occupations of both spouses. This study demonstrates the importance of taking a "couple" perspective on shift work among married persons, and the need for models that include interaction effects.

Adolescent↗
PubMed1983

An immunologic study of spouses and siblings of asymptomatic hemophiliacs.

A transmissible agent may be responsible for the recent occurrence of the acquired immune deficiency syndrome (AIDS) in female heterosexual partners and infant contacts of AIDS victims or of persons at increased risk for AIDS. Therefore, we evaluated the clinical and immunologic status of 18 hemophiliac-spouse pairs and 19 hemophiliac-sibling pairs. Using surface marker assays of lymphocyte subpopulations, we found a mean T helper cell/T suppressor cell (H/S) ratio +/- SEM in 18 hemophiliac adults of 1.11 +/- 0.15 (11 less than 1.00), in their 18 spouses of 1.88 +/- 0.13 (none less than 1.00), in 19 hemophiliac children of 1.54 +/- 0.11 (3 less than 1.00), and in their 19 siblings of 1.87 +/- 0.11 (none less than 1.00). Both hemophiliac adult and hemophiliac children mean H/S ratios differed significantly (p less than 0.05) from the control mean ratio of 2.22 +/- 0.16 and from the mean of their respective nonhemophiliac spouse or sibling group (p less than 0.05). The mean ratio of hemophiliac adults differed significantly from that of hemophiliac children (p less than 0.05). These findings suggest that lymphocyte alterations in hemophiliacs are secondary to their therapy, are not influenced by genetic factors, and are not related to an infectious agent that is easily transmissible by close contact.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Goldfarb and Mathews: legal challenges to the dependency test for spouse's benefits.

Changes in the eligibility criteria for a survivor's benefit under the Social Security program resulted from a 1977 Supreme Court decision in the case of Califano v. Goldfarb. The Court ruled that legislation that required only men to prove past financial dependence on a deceased spouse in order to establish eligibility to a survivor's benefit violated equal protection guarantees in the Constitution. In a 5-4 decision, the majority of the Supreme Court Justices determined the constitutionality of the gender-based distinction by applying the heightened scrutiny test. For a statutory gender-based classification to be found constitutional under the test, the government must show that (1) use of a gender-based classification serves an important governmental purpose and (2) a direct and substantial relationship exists between the gender-based classification and the purported objective. The majority of the Court found the sex-based distinction was based on sexist assumptions about women, was not formulated to serve an important governmental objective, and, thus, was unconstitutional. Amid projections that elimination of the dependency test for men would increase annual Social Security benefit expenditures by as much as +500 million, Congress enacted a government pension offset provision to help minimize the cost increase. It required that any spouse or survivor who received or was eligible to receive a pension for his or her own work in noncovered public employment would have his or her Social Security surviving spouse's or dependent's benefit reduced dollar-for-dollar by the amount of the work-related pension. An exception clause was included in that legislation.(ABSTRACT TRUNCATED AT 250 WORDS)

Eligibility Determination↗
PubMed1984

Family-focused cardiac rehabilitation. A role supplementation program for cardiac patients and spouses.

A review of the literature yields general agreement among investigators regarding the responses of both patients and spouses to a cardiac event. Anxiety, depression, low self-esteem, marital and sexual dysfunction, and psychosomatic symptoms have been consistently documented up to 1 year following a myocardial infarction or cardiac surgery. Although the patient's physiologic status sets limits on the potential level of recovery, psychosocial variables are new recognized as playing a critical role in the rehabilitation process for both patients and their families. Our 3-year experience with patient-spouse groups supports the view that spouses must be involved throughout the rehabilitative process and that effective participation is provided within the context of a role supplementation program. Such a program facilitates direct and consistent communication as well as flexibility within and between roles. Both end points are critical to the re-establishment of family equilibrium and the ultimate recovery of the cardiac patient.

Adaptation, Psychological↗
PubMed1982

Some effects of spouse separation on fertility.

Simple probability models incorporating an approximation first demonstrated by Menken (1979) are used to study births averted by two classes of temporary spouse separation, single and cyclic, under conditions of natural fertility. For either class of spouse separation, births averted increases disproportionately with longer separation. For a given length of separation, births prevented are more sensitive to change in length of anovulation than to change in level of natural fecundability or risk of spontaneous abortion. In addition, by means of the macrosimulation model REPMOD (Bongaarts, 1977), it is shown that the fertility impact of temporary spouse separation tends to decrease as couples age.

Abortion, Spontaneous↗
PubMed1980

Attitudes towards disability expressed by spouses of stroke patients.

A report is given on attitudes to disability expressed by spouses of patients disabled by cerebrovascular accident. In a sample of 79 spouses overprotection and unrealistic attitudes were a more common response than rejection or retributive guilt feelings. Attitudes of retributive guilt, rejection, unrealistic aims and overprotection in the spouse were not significantly related to the presence or absence of aphasia.

Aged↗
PubMed1981

Sex differences in remarriage and spouse selection.

This paper explores on an international basis the incidence of remarriage among total marriages, the levels and differences in remarriage rates among widowed and divorced males and females, and differences between males and females in spouse selection according to the previous marital statuses of spouse and bride or groom. Remarriage rates by sex and previous marital status are estimated using vital registration data in combination with census information; there are 47 countries that have such data. The results of the analyses indicate that there are a number of general patterns of remarriage and spouse selection that tend to hold across countries.

Adult↗
PubMed1994

[An evaluation of multi-faceted program: intervention with violent spouses].

This article presents the results obtained from a study on the efficiency of a treatment program aimed at violent spouses. More particularly, three dimensions are evaluated, namely the program's effect on the incidence of violent behaviour (physical, verbal, psychological and sexual), on the participant's attitude toward the roles of men and women, as well as on the self-esteem of participants. Data on the violent behaviour of men was collected from them and from their spouses. The study reveals that the program tends to reduce all forms of violence and that its maximum efficiency is mostly noticed in the period following the program. On a different note, the program is less efficient when basing results on women's declarations than on men's. Finally, the program's efficiency varies according to the form of violence observed.

Adult↗
PubMed2001

Comparability of data obtained from migrant farmworkers and their spouses on occupational history.

BACKGROUND: Epidemiologic studies, particularly case-control studies, often rely on proxy respondents to provide information about subjects' occupational histories. The quality of proxy-reported information in occupational histories has never been evaluated for migrant farmworkers. METHODS: We compared occupational histories self-reported by 31 farmworkers with those reported by their wives. The work histories were obtained using an icon/calendar-based questionnaire that was designed to facilitate recall for migrant farmworkers, who typically have complex work histories. RESULTS: The work histories provided by proxy respondents contained 32% fewer jobs and accounted for 24% fewer years than the self-reported histories. Correlations for lifetime duration of employment in different types of jobs were moderate to good for general agricultural jobs in Washington (0.70) and apple-related jobs (0.65), which were held by virtually all of the farmworkers; correlations were moderate to poor for less common jobs and for specific types of tasks. Agreement was better after marriage than before, and for jobs held in the current year compared to other time frames. Overall, the ability of the spouses to provide occupational histories for farmworkers was within the range observed in studies involving other occupations and industries. CONCLUSIONS: In studies involving farmworkers, when study subjects cannot be interviewed, spouses can provide useful information on occupational histories. However, the information should be used only for more generalized exposure assessments; it is most appropriate for estimating cumulative duration of agricultural work, or recent work, by place or for common crops.

Adult↗