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The results of 2000 standardized psychiatric diagnostic interviews of randomly selected adult household residents of Edmonton showed that having had any psychiatric diagnosis increased the risk for being involved in spouse and child abuse, particularly for those with alcohol abuse/dependence plus anti-social personality or depression. Altogether 56% of spouse abusers and 69% of child abusers had a lifetime psychiatric diagnosis.
This study investigated the reliability and validity of the Index of Spouse Abuse (ISA) when used with a sample of 504 African-American women. The initial factor validity analysis for the ISA (Hudson & McIntosh, 1981) resulted in two subscales: a physical abuse scale (ISA-P) and a nonphysical abuse scale (ISA-NP). Factor analysis with this sample of African-American women revealed three factors instead of two. Coefficient alpha estimates of reliability were over .90 for the original ISA subscales and with the African-American sample. The discussion compares and contrasts the factor structure observed with the sample of African-American with the factor structure reported in the original validation studies. The study demonstrates the need to critically evaluate the extent to which instruments developed to measure spouse or partner abuse are valid and reliable when used with diverse groups that may not have been represented in the samples used for initial instrument development and validation work.
The following is a report of the first phase of exploratory research growing out of a parent grant on breast and cervical cancer screening among Latinas in Colorado. This paper reports data gathered from 14 focus groups conducted with Latino (Mexican, Mexican-American, and other Hispanic) males to identify their supportive and nonsupportive attitudes and behaviors toward their spouse's breast and cervical cancer screening. The men represent a cross-section of Latino males, yet the findings presented here are strongly suggestive and not representative of Latinos as a whole. Latinos exhibited three distinct modes of knowledge and attitudes toward their partners' health-seeking efforts. The first mode was characterized by limited knowledge, a lack of information, and for some, disinterest or even disdain. Those in the second mode can be considered "generalists" who knew only generalities concerning their wives' health states and practices. The third mode includes Latino males who were genuinely interested in seeking "meaningful ways" to promote their partners' health and well-being. These long-time married couples seemed to have strong relationships highlighted by a genuine concern for each others' well-being, including their health problems. The younger cohorts were generally unconcerned about their spouses' breast and cervical cancer screening and lacked knowledge in the area. As age and educational level increased, so too did the general awareness and knowledge of breast and cervical cancer increase. Most Latinos, however, lacked specific knowledge about screening, the procedures, or the recommended frequency of such examinations.(ABSTRACT TRUNCATED AT 250 WORDS)
OBJECTIVE: To understand the grieving process after the loss of a spouse and to find the opinion of the person grieving about the best intervention under the circumstances. DESIGN: Qualitative, with discussion groups. SETTING: Primary care. PATIENTS AND OTHER PARTICIPANTS: Widowers/widows between 30 and 70, who suffered their loss between 3 months and 2 years before the study. MEASUREMENTS AND MAIN RESULTS. The data were obtained from recordings and transcriptions, and the main ideas analysed. Two groups were defined: 11 widows between 49 and 68 years old and 6 widowers between 36 and 70. The majority of deaths had followed a previous terminal illness. Four phases of grief were found: 1) anticipated grief, 2) early grief, 3) intermediate grief and 4) delayed grief. There were differences between widows and widowers. An intervention could involve: pre-arranged appointments, home visits, and groups and, in general, spaces to be able to "talk". CONCLUSIONS: The results, in so far as they refer to the grieving process and similarities and differences of type, coincide with other authors. The participants highlighted the importance of psychological support from health workers during the last moments of the illness and the importance of this in how grieving developed. Similarly, they evaluated their own support to the dying spouse as an additional factor which helped them.
HLA-A, -B, -DR and -DQ antigen profile was studied in pulmonary tuberculosis patients (n = 209) and their spouses (family contacts; n = 50) and healthy volunteers (n = 72). An increased frequency of HLA-A-10, B7, B15, DR2 and DQ1 was seen in the pulmonary-TB (PTB) patients when compared to the total control subjects (n = 122). However, a significant increase was seen only with HLA-DR2 (P < 0.001; Pc < 0.01; Relative Risk 2.3) and -DQ1 (P < 0.005; Pc < 0.015; Relative Risk 2.8). Among the spouses and the corresponding patients, a similar increase of HLA-DR2 was seen. A decreased frequency of HLA-A19, B8, B17, B35, DR5 and DR6 were seen in PTB as compared to control groups. The present study suggested that HLA-DR2 and DQ1 genes/gene products may be associated with the susceptibility to tuberculosis either alone or in combination with other HLA or non-HLA genes.
A study of three married couples where both spouses developed malignant melanoma was undertaken at the New York University-Bellevue Medical Center melanoma registry. An upper bound was calculated for the number of spouses expected to develop melanoma, along with the origin of the disease and its relation to nation-wide rates of incidence. The observed number was six times greater than the bound.
Two families in which successive spouses who lived in the same house developed multiple myeloma are reported. In the first instance, a man whose first wife died of multiple myeloma remarried, and his second wife also developed myeloma. In the second family, a woman's first husband died of multiple myeloma and her second husband did too. Radiation studies of the houses and yards showed no increased radioactivity. No evidence was found for excessive exposure to chemicals or other environmental agents, for contact with other patients having similar malignancies, or for exposure to viruses or other transmissible factors. The significance of the occurrence of multiple myeloma in subsequent spouses is unknown. It is hoped that this report will stimulate research for other instances and lead to careful epidemiologic, radiologic, and virologic studies.
OBJECTIVE: To determine whether physical disability, pain, depressive mood, and criticism by the spouse are differentially related to intrusiveness of rheumatoid arthritis (RA) on sexuality in male and female patients. METHODS: Physical and psychological aspects of health were assessed in 102 male and 118 female RA patients who were living with a spouse. Patients were classified into 3 levels of intrusiveness of RA on sexuality. The data were analyzed by means of analysis of covariance and multiple regression analysis. RESULTS: Greater intrusiveness of RA on sexuality was related to greater physical disability, pain, and depression in male and female RA patients. Female patients, compared with male patients, appeared to have lower levels of mobility and self-care. Male and female patients did not differ in their level of intrusiveness of RA on sexuality. CONCLUSION: Physical disability, pain, and, to a lesser extent, depression were found to contribute to intrusiveness of RA on sexuality. It is suggested that differences in sexual motivation between men and women might have been influential in the absence of gender differences in intrusiveness.
An innovative population-based case-control study was conducted in a national mortality survey to assess the hazards of tobacco use on esophageal cancer among Chinese men. Cases were 19,734 males aged 35 years or older, who died of esophageal cancer during 1986-1988. Controls were 104,846 male living spouses of the same age when their wife died (of any cause) during the same period in the same county or city. The absolute esophageal cancer death rates were higher in smokers than those in nonsmokers in all geographical groups. The relative risks for esophageal cancer were 1.88 (95% CI: 1.73-2.05) and 1.39 (95% CI: 1.28-1.50) in urban and rural men, respectively, after adjustment for other relevant covariates including age group (5 years) and locality. When the calculation was restricted to men aged 35-69, the risk ratios for current cigarette smokers increased significantly with increasing number of cigarettes smoked daily and duration of smoking. Tobacco use, in any form, is an important risk factor for esophageal cancer in Chinese men. Selecting living spouses as controls is a unique and useful approach in the design of case-control studies of cigarette smoking.
This research assessed the effect on a war-veteran outpatient group in a week-long residential lifestyle-management course. This course also included the veterans' partners, and all participants were assessed at intake, post-intervention, and at three- and six-month follow-ups. In summary, it was found that while there was a statistically significant drop in PTSD symptomatology for the veterans, the clinical utility of this improvement was minimal, with an estimated effect size of d = 0.19 by six-month follow-up. However, the veterans displayed a significant decrease in measures of depression, anxiety, and stress by six-month follow-up, all with small-to-moderate effect sizes. Likewise, ratings of anger showed statistically significant improvement with a moderate effect size. While dyadic adjustment displayed a significant improvement to six-month follow-up, the derived effect size was small for the veterans. The spouses (all females in this study) displayed larger effect sizes on all measures, with the exception of ratings of anger, where a small effect was noted. Subjective quality-of-life indices displayed a significant change in the desired direction, although with a minimal effect for the veterans and a small effect size for the females. It was not feasible to have a control group during this naturalistic investigation and, therefore, caution is advised in over-generalizing from these data. However, these results warrant further 'controlled' investigation into the inclusion of spouses in the treatment of veterans and the utility of lifestyle-management courses as a first step in the treatment of trauma related problems that have become chronic in nature within the veteran community.
This study examined concordance and discordance of self-reported alcohol consumption in 184 spouse pairs drawn from a representative sample of the Tecumseh, MI community. A significant association (tau B = .57, p less than .001) between self-reported alcohol consumption of husbands and that of wives was observed. Drinking daily and high maximum drinking were also significantly correlated between spouses, as were church attendance, smoking, impulsivity, and sociability. A significant association between the drinking of wives and that of their mothers-in-law was noted. The relationship between husbands' drinking and that of their fathers-in-law was marginally significant. However, three-quarters of daughters of heavy-drinking fathers (21 of 28) married abstemious men (never drank or drank lightly), while only 7% married heavy-drinking husbands. These findings lend support to the idea that a network of familial influences--both primary and secondary assortative mating--contributes to regulating adult drinking behavior.
A major proportion of care for patients with laryngectomies is provided by their spouses. This study assessed caregiver strain and burden using two standardized measures. Questionnaires were completed by 75 spouses of individuals with laryngectomies. The correlates of perceived strain and burden, time since the diagnosis of cancer, the caregivers gender, the caregivers present health status, and the effects of current stressors were considerations in the analyses. The strain and burden of caregiving decreased as time from the diagnosis of cancer increased. Male caregivers reported less strain and burden than female caregivers. Subjects reported strain and burden independent of other current stressors in their lives. Implications for counseling and support groups for caregivers are discussed.
The prevalence of serum anti-DNA antibodies was evaluated by ELISA using oxidatively damaged DNA as antigen in 21 patients with systemic lupus erythematosus (SLE), in 9 spouses and in 15 first-degree relatives. These were compared with 12 healthy controls. There was no significant difference in the levels of serum antibodies detected between the group of spouses and normal controls with all results within the normal range of the assay. Binding of serum antibodies to the oxidatively damaged DNA was detectable in 12 (80%) of the relatives studied, and the range of values obtained overlapped significantly with the SLE patient group. The relevance of these antibodies to the immunopathology of SLE is unclear since they appear to be present in the absence of any clinical symptoms. However, they may be useful predictively as a marker for those individuals who are more likely to develop SLE.
Post-exposure efficacy of hepatitis B vaccine was evaluated in susceptible sexual partners of acute hepatitis B patients in a randomized double-blind, placebo-controlled trial in Greece. Vaccine (20 micrograms dose) or placebo was repeated one and six months after initial administration. Nine months' follow-up was completed by 146/160 entrants. Vaccinated (16.0%) and control spouses (18.3%) showed similar attack rates for all infections. The vaccine group had fewer clinical infections (2.7% against 7.0%) and fewer infections occurring more than one month after first vaccination (8.7% against 14.7%). These differences are not statistically significant, but suggest modification of infection. Overall, the attack rate was lower (p less than 0.01) for male spouses (6.4%) than for females (22.4%). It may be necessary to complement hepatitis B vaccination with hepatitis B immunoglobulin to protect this high-risk group.
Sixty-eight patients on hospital dialysis and their spouses were studied to compare their levels of adjustment and to examine gender differences. Two measures were used: BSI for psychological distress and PAIS for psychosocial adjustment to dialysis. High scores of psychological distress and adjustment problems were found both for patients and their spouses, with high correlations between the partners. Female patients and their husbands had higher scores than male patients and their wives respectively, and in some areas the husbands of female patients reported even more problems than the male patients. Clinical and theoretical conclusions are discussed.
The present study is an investigation of differences between alcoholics and significant others in their perceptions of the functioning of their families or households. A sample of 80 pairs of alcoholic patients (PTs) and their spouses or spouse equivalents (SOs) who were living together in the same household evaluated family functioning by completing the Family Assessment Device (FAD). Agreement between PTs and SOs was moderate on the Affective Responsiveness, Communication, Problem Solving, Roles, and General Functioning scales. However, there was little or no agreement on the Behavior Control and Affective Involvement scales. These results indicate that although PTs and SOs tended to agree about how well family members work together and share thoughts and feelings, they disagreed about how well boundary issues were dealt with in their families. Implications for treating alcoholic families are discussed.
This study examined the coping methods, health perceptions, and marital adjustment of 37 middle-aged men with chronic cardiovascular disease and their spouses. Despite variation in disease types and the absence of disease among the spouses, the couples were similar in their coping responses. Both partners used more emotionally focused strategies than problem-focused strategies to cope with chronic illness. Subjective health perceptions were more useful than objective indices for predicting coping. Preillness and current marital adjustment were satisfactory for both partners. The major implications for nursing practice are in the area of assessment, and suggested interventions are discussed.
The purpose of this study was to develop an objective instrument to measure changes in quality of life of spouses of post-myocardial infarction (MI) patients, and to determine its responsiveness and validity. A 70-item list of potential areas of concern was compiled; the 25 most frequent and important concerns comprised the framework of the final questionnaire. The questions on the Quality of Life Questionnaire for Cardiac Spouses (QL-SP) were categorized into the Emotional Function Dimension (EFD), and the Physical and Social Function Dimension (PSFD). Subjects (n = 39) completed the QL-SP and a battery of established questionnaires at home, 1-2 weeks post-hospital discharge for the patient, and 8 weeks later. Scores on the QL-SP between visits were improved for both the EFD (t = 5.56, p less than 0.001), and the PSFD (t = 6.11, p less than 0.001). The agreement between predicted and observed relationships between the dimension changes and other index changes, as measured statistically by a kappa with Cicchetti weights, was significant (kappa w = 0.43, p = 0.0012). The QL-SP appears to be responsive and valid, and may be useful in evaluating clinical and research intervention strategies.