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Alcohol, tobacco and caffeine use: spouse similarity processes.

Spouse similarity research has been largely descriptive yet is of theoretical and empirical importance to understanding individual differences in substance use. The present study considers phenotypic assortment versus social homogamy processes for alcohol, tobacco, and caffeine consumption traits using an extended twin-spouse design. Whereas both assortment processes were supported for quantity of alcohol consumed, phenotypic assortment was supported for quantity of tobacco and caffeine consumed, and social homogamy for tobacco use status. Moderate heritable influences were found for all traits though no shared environmental influences were found beyond those due to social background influences, i.e. those pertaining to social homogamy. Swedish government policies in effect at the time of marriage selection may explain the presence of social homogamy for quantity of alcohol versus quantity of tobacco and caffeine consumed. Social homogamy may be more important for some substance use traits such as alcohol consumption and tobacco use status but not others.

Adult↗

Individual and marital adaptation in men with autism spectrum disorder and their spouses: the role of social support and coping strategies.

The aim of the present study was to examine the predictive value of social support and coping for individual and marital adaptation in adult men with autism spectrum disorder (ASD) and their spouses, based on the double ABCX model of adaptation. Twenty-one couples participated in the study and completed measures of stressor severity, social support, coping, individual and marital adaptation. Bivariate analyses showed that each of the model components was related to adaptation in men and women. Hierarchical regression analyses revealed that, after controlling for relevant demographics and stressor severity, informal support was a strong, and unique predictor of adaptation in both spouses (explained variance: 27-89%). Coping did not add to the prediction of adaptation. Clinical implications and limitations are discussed.

Adaptation, Psychological↗

Older spouses' cortisol responses to marital conflict: associations with demand/withdraw communication patterns.

We examined 31 older couples' wife demand/husband withdraw communication patterns and cortisol responses to marital conflict. Regression analyses indicated that wife demand/husband withdraw sequences during conflict related to cortisol responses only for wives. Based on a mixed model that accounted for the interdependence of spouses' perceptions of communication patterns and outcomes, older spouses who reported greater wife demand/husband withdraw patterns in their marriage had greater cortisol responses during a conflict discussion; actual demand-withdraw did not relate to cortisol responses in this model. Findings suggest that perceived communication patterns contribute to neuroendocrine responses to marital conflict, and implications for marriage and health research with older couples are discussed.

Aged↗

Perineal burns in males secondary to spouse abuse.

Male spouse abuse seems to be on the increase. Recognition of these injuries is often difficult as patients are reluctant to disclose the aetiology and press charges against the assailant. We identified a similar group of male patients who sustained burns to their external genitalia secondary to spouse abuse.

Adult↗

Characteristics of the grieving process: a pilot study of 10 Korean spouses of patients who passed away from cancer.

The purpose of this descriptive study was to identify the characteristics of the grieving process of Korean spouses who lost their partner to cancer. Five women and five men were recruited by convenience sampling from surviving spouses attending a follow up program at a hospice center in Seoul, Korea. In-depth interviews, observation, and instruments on grief stage and grief responses were used to collect data. Interviews were tape recorded, transcribed, and analyzed line by line to discover recurrent patterns and themes. Gender differences were noted for grief responses (physical, cognitive, emotional, social and spiritual) and factors influencing grief.

Adaptation, Psychological↗

Education for men with solvent-induced chronic toxic encephalopathy and their spouses.

In this study an education, and a series of group sessions for patients with solvent-induced chronic toxic encephalopathy (TE) and their spouses are evaluated. Thirty-eight patients and 21 family members participated in a 1-day education scheduled with short lectures on the clinical examination of chronic toxic encephalopathy and the prognosis. A specialist in occupational medicine, a psychologist and a social worker gave the lectures. Small discussion groups were also arranged. Of the participants from the educational days, 16 TE patients and 14 wives attended a 10-week counselling and coping improvement program with separate group sessions once a week, for patients and spouses. Questionnaires were used to assess symptoms, social network, mastery and family climate, and the participants' satisfaction with the education and the group sessions. The majority of the participants experienced the 1-day information as useful and relevant. The 10-week group sessions were rated as meaningful and the design, number, duration and frequency of the sessions equally good. Self-reported symptoms, social network and mastery were measured before the group sessions, and 3 and 9 months after breaking up the group sessions. In most measurements, there were no statistically significant differences between the three points in time. However, the wives improved more than did the patients but the effect was not lasting the whole follow-up period. Considering the patients' dependence on their wives, it might be most important that the wives experienced some relief from their own symptoms.

Adult↗

Pre- and post-operative counseling for laryngectomees and their spouses: an update.

This survey was developed to determine if pre-operative counseling services have improved since the 1978 Keith, Linebaugh, and Cox study. The questions were aimed to obtain information on the quality and quantity of support services available to laryngectomees and their spouses. Questions addressed the type, amount, and content of information received. In addition, questions regarding post-operative counseling services for laryngectomees and spouses of laryngectomees also were included. Results indicated that 21% of the laryngectomees were not aware that laryngectomy surgery would result in loss of voice. In addition, not all speech rehabilitation options were explained to the patients. Pre- and post-operative counseling services for laryngectomees continue to be inadequate. It appears that little change has been made to improve this situation.

Aged↗

Marriage in eating disorders comparisons between patients and spouses and changes over the course of treatment.

OBJECTIVES: This study examines one aspect of the marital satisfaction, intimacy, of couples where one member has an eating disorder (ED), before and after intensive day hospital treatment for ED. METHODS: Subjects were consecutive patients (n=22) attending a day hospital program for EDs and their spouses. The Waring Intimacy Questionnaire (WIQ) was administered to the couples at admission to and discharge from the treatment program. RESULTS: Patients showed less favorable ratings of the marriage at admission and discharge, compared to spouses, but patient's ratings improved significantly over the course of treatment. Patients generally improved in terms of their ED symptoms during the treatment. Spousal ratings showed satisfactory ratings of intimacy at the start of treatment and did not change over the course of treatment. CONCLUSION: The self-reported marital dissatisfaction of patients with an ED is at least partially alleviated after symptomatic treatment of the ED. Treatment of the ED in one member does not diminish marital satisfaction in the other member of the couple. The long-term prognosis for these couples remains unknown.

Adult↗

Correlations in perceived food use between the family food preparer and their spouses and children.

Previous research has demonstrated that family members' eating habits are similar. We hypothesized that family members' eating habits would be predicted by the eating habits of the person who prepares the majority of the family's meals and the number of meals the family shares. Participants were 282 members of religious organizations who identified themselves as family food preparers (FFPs), and provided information about their own and their family members' eating habits. Results revealed that FFP fruit and vegetable intake predicted the fruit and vegetable intake of spouses, children, and adolescents (p<0.01), and that FFP consumption of high-fat foods predicted the consumption of high-fat foods of spouses and children (p<0.01). Child fruit and vegetable consumption was also influenced by shared meals: the more meals the child shared with the FFP, the stronger the relationship of FFP fruit and vegetable intake with child fruit and vegetable intake (p<0.05). These findings indicate that dietary interventions targeting the FFP may benefit other family members.

Adult↗

Dimensions of anger and CHD in men and women: self-ratings versus spouse ratings.

One hundred one males and 95 females referred for thallium stress testing were administered Spielberger's State-Trait Anger Expression Inventory (STAXI), the Ho scale cynicism items, the Cynical Beliefs Scale, and Bendig's Manifest Anxiety Scale. A subset of 53 males and 43 females was rated by their spouses by means of STAXI. Based on the thallium findings and their medical history, patients were classified either as healthy, or as having documented CHD, or as questionable. Patients' STAXI and cynicism measures were submitted to a principal-components analysis which yielded three factors: Impulsive Anger-out. Inwardly experienced anger, and Cynicism. The relationships between factor scores and documented CHD was determined by means of logistic regression analyses. Only Impulsive Anger-out correlated (positively) with CHD, but only when based on spouses' ratings and only in males (p < .01, RR = 3.13). Covarying traditional risk factors and cynicism did not attenuate this relationship. However, a significant relationship between Ho scale cynicism and CHD did not survive adjustment for traditional risk factors. Anxiety was not a risk factor for CHD.

Adult↗

Characteristics of women physically abused by their spouses and who seek treatment regarding marital conflict.

Physically abused women seeking treatment for marital difficulties (abused women, n = 49) were compared with maritally discordant, nonabused women (discordant only, n = 23) and maritally satisfied nonabused women (community control, n = 25). Abused women reported significantly more fear of their spouses and reported that their spouses were significantly more coercive and psychologically aggressive than women in the 2 matched nonabused groups. Abused women did not report higher rates of abuse as a child, nor did they report higher rates of past psychopathology than women in the nonabused groups. However, abused women and nonabused discordant women reported higher rates of emotional abuse in childhood than maritally satisfied nonabused women. Furthermore, both clinical groups had a tendency to have higher lifetime rates of major depression before their current marriage than the maritally satisfied women. This result suggests that childhood abuse and a history of depression may be risk factors for women in abusive and nonabusive discordant relationships. As expected, abused women reported higher rates of posttraumatic stress disorder than women in the discordant-only and community control groups. Treatment implications for both standard treatments for marital problems and treatments for victims of physical abuse are discussed.

Adult↗

Work-family conflict, spouse support, and nursing staff well-being during organizational restructuring.

This study examined work and family conflict, spouse support, and nursing staff well-being during a time of hospital restructuring and downsizing. Data were collected from 686 hospital-based nurses, the vast majority (97%) women. Nurses reported significantly greater work-family conflict than family-work conflict. Personal demographic but not downsizing and restructuring variables predicted family-work conflict; downsizing and restructuring variables but not personal demographics predicted work-family conflict. Spouse support had no effect on work-family conflict but reduced family-work conflict. Both work-family conflict and family-work conflict were associated with less work satisfaction and greater psychological distress.

Adaptation, Psychological↗

A dyadic investigation of exercise support between cardiac patients and their spouses.

The authors examined married partners' similarity in reported exercise behavior as a moderator of the association between social support for exercise provided and received by extending an actor-partner dyadic effects model. Participants were married cardiac rehabilitation patients and their spouses (N=99 couples). For couples similar in their reported exercise behavior, a significant association was found between both partners' independent reports of providing exercise support to and receiving exercise support from one another (n=49 couples). However, for couples differing in their reported exercise behavior (n=50 couples), no association was found between either partner's provision and receipt of support for exercise. Findings have the potential to inform practitioners of patients who may not be receiving adequate social support for their recommended exercise. Future interventions may consider implementing dyadic educational or motivational strategies with patients and their spouses.

Cardiac Rehabilitation↗

Continuation of caregiving among partners who give total care to spouses with multiple sclerosis.

As is expressed in the term 'caregiving career', caregiving is a dynamic phenomenon. The present study addresses the total care phase in which spouses give direct and ongoing personal care to their partners with multiple sclerosis (MS). The dyadic nature of caregiving is stressed by examining the roles which both spouses play in establishing a commitment that results in the continuation of caregiving. For this purpose, 17 couples facing MS were selected in the Netherlands and Belgium. Ten females and seven males were disabled, and all were living with partners who provided a full range of care. Both partners were interviewed separately about their motivation to give care, dependency on help, the continuation of caregiving and their relationship. The analysis consisted of fragmenting and connecting the data, and involved close reading and constant comparison. The present findings support those previous studies, i.e. that continuation of caregiving is the result of an interchange between the partners. The commitment that is established can be expressed in terms of inevitability, shared misfortune, reciprocity and the desire to prevent admission to a nursing home. Three aspects appear to contribute to the creation of commitment and the ensuing continuation of caregiving: namely, marital loyalty, and the arbitrariness of the disease and its serious nature. For community care, it is important to consider the negotiations between partners and the impact of caregiving on their relationship.

Adult↗

The experience of spouses whose partners have suffered a myocardial infarction: a phenomenological study.

This phenomenological study describes the lived experience of spouses whose partners have suffered a myocardial infarction. In-depth interviews were conducted with three participants (two females and one male) about their experiences. The findings from the participants were analysed using Giorgi's method (1985). Informants' experiences were captured within five major themes: (i) crushing uncertainty, (ii) overwhelming emotional turmoil, (iii) the need for support, (iv) the lack of information heightened anxiety and (v) the acceptance of lifestyle changes. The implications from this study suggest that health care workers need to: embellish their skills in managing spouses' emotions; communicate with community health professionals regarding support systems; provide families with information concerning the emotional issues associated with MI; provide advice in terms of financial aid; and identify community support groups if these are required. The in-depth knowledge gained from the study will enable nurses to understand how family members feel when a spouse/partner has suffered an MI. It will also provide a framework with which practitioners and families can understand their reactions and assist in the overall rehabilitation of clients.

Adaptation, Psychological↗

Placing a spouse in a care home: the importance of keeping.

Despite a universal policy of community care, the number of frail older people entering care homes is likely to increase in the future. There have been relatively few studies exploring the experience of spouses who have placed a partner in care. Due to a lack of preparation, the placement process is often ad hoc, with little attention being given to spouses' emotional reactions or their efforts to maintain their relationship with their partner. The relationship between care home staff and families is often superficial and strained. There is a need for more proactive efforts to facilitate a partnership between care home staff and families.

Adaptation, Psychological↗

Presurgery experiences of prostate cancer patients and their spouses.

PURPOSE: In this article, the authors describe the experiences of men with prostate cancer and their spouses between diagnosis and surgery. DESCRIPTION: As part of a longitudinal qualitative study, semistructured interviews were held with 34 prostate cancer patients who were waiting for surgery. Separate interviews were held with their spouses. RESULTS: Six main components of experience were evident from the analysis of transcripts related to the presurgery period: 1) the news of a diagnosis of prostate cancer came initially as a shock for both partners, the impact of which lessened over time; 2) the new reality of illness necessitated readdressing the marital relationship, most often resulting in a sense of renewed connection and commitment; 3) the illness crisis precipitated a search for information to guide decisions about treatment; 4) there was a need for couples to decide who to inform about the cancer diagnosis and how much to say about it; 5) couples attempted to seek a semblance of normality in their lives, especially after treatment decisions had been made; and 6) despite attempts to minimize the potential impact of upcoming surgery, anxiety was typically experienced at least intermittently by one or both partners. CLINICAL IMPLICATIONS: Physicians, nurses, social workers, and other health professionals need to facilitate attempts by the patient to gather and synthesize information. Cancer specialists can play a positive role in reducing distress in couples, and, thus, the attention of the specialists to communication issues is critical. The strain of waiting for surgery must be considered when treatment recommendations are made; watchful waiting protocols require further study from a psychological perspective. Clinicians need to be alert to the balance between being positive and carrying on as normal, and acknowledging and dealing with the distress that arises.

Activities of Daily Living↗

Screening to predict complicated grief in spouses of cancer patients.

OBJECTIVES: Grief is the expected reaction to the death of a family member or close friend and is accompanied by substantial distress for almost everyone who experiences it. For some the grief response becomes complicated. This pilot study sought to identify individuals at high risk for complicated grief, by 1) examining the relationships that exist between family functioning before the death, psychological distress, and the grief reaction of a family after the death, and 2) presenting the use of screening with standardized measures to identify those at risk. MATERIALS AND METHODS: This pilot study examined the relationships between family functioning, psychological distress, and grief reaction. A cross-sectional design was used and the instrument included the Family Adaptability and Cohesion Evaluation Scale (FACES III), the Brief Symptom Inventory (BSI), and the Texas Revised Inventory of Grief (TRIG). Significant relationships were identified between the level of family functioning, psychological distress and grief reaction. Depression, anxiety, and general distress were significantly correlated with the two subscales of the TRIG. CONCLUSIONS: The findings clearly illustrate the merit of psychosocial screening of spouses and suggest the possible benefits of screening before the patient's death, using FACES III and the BSI to identify which spouses are at risk for complicated grief reactions.

Aged↗