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PubMed1999

Spouse-assisted coping skills training in the management of knee pain in osteoarthritis: long-term followup results.

OBJECTIVE: To evaluate the long-term effects of a spouse-assisted coping skills intervention in patients with osteoarthritis (OA) of the knees, and to evaluate how pre- to posttreatment changes in marital adjustment and self-efficacy relate to long-term improvements in pain, psychological disability, physical disability, pain coping, and pain behavior. METHODS: A followup study was conducted with 88 OA patients who had been randomly assigned to 1 of 3 treatment conditions: 1) spouse-assisted coping skills training (spouse-assisted CST), 2) a conventional CST intervention with no spouse involvement, and 3) an arthritis education-spousal support (AE-SS) control condition. To evaluate long-term outcome, comprehensive measures of self-efficacy, marital adjustment, pain, psychological disability, physical disability, pain coping, and pain behavior were collected from these individuals at 6 and 12 months posttreatment. RESULTS: Data analysis revealed that, at 6-month followup, patients in the spouse-assisted CST condition scored higher on measures of coping and self-efficacy than those in the AE-SS control group. At 6-month followup, patients who received CST without spouse involvement showed a significantly higher frequency of coping attempts and reported higher levels of marital adjustment than those in the AE-SS control group. At 12-month followup, patients in the spouse-assisted CST condition had significantly higher overall self-efficacy than those in the AE-SS control condition. In addition, patients in both the spouse-assisted CST and CST only conditions tended to show improvements in physical disability at the 12-month followup. Individual differences in outcome were noted at the 12-month followup. Patients in the spouse-assisted CST condition who reported initial (pre- to posttreatment) increases in marital adjustment had lower levels of psychological disability, physical disability, and pain behavior at 12-month followup. However, for patients in the conventional CST and AE-SS control conditions, increases in marital adjustment occurring over the initial phase of treatment were related to increases in pain and decreases in scores on the Pain Control in Rational Thinking factor of the Coping Strategies Questionnaire. Finally, patients in the spouse-assisted CST condition who showed pre- to posttreatment increases in self-efficacy were more likely to show decreases in pain, psychological disability, and physical disability at 12-month followup. CONCLUSIONS: These findings suggest that spouse-assisted CST can enhance self-efficacy and improve the coping abilities of OA patients in the long term. Individual differences in the long-term outcome of spouse-assisted CST were noted, with some patients (those showing increases in marital satisfaction and self-efficacy) showing much better outcomes than others.

Activities of Daily Living↗
PubMed2006

A longitudinal study investigating disordered eating during the transition to motherhood among Chinese women in Hong Kong.

OBJECTIVE: The current longitudinal study explored the prevalence and psychosocial factors of disordered eating among new Chinese mothers in Hong Kong. METHOD: Self-report questionnaires on bulimic symptoms and pregnancy-related factors were collected at both prenatal and postnatal periods from 131 Chinese women. RESULTS: Participants reported significantly more severe disordered eating in the postnatal than in the prenatal period, with percentages being 19.08% and 8.4%, respectively, using the Eating Disorder Inventory-2. Results revealed that prenatal disordered eating, weak maternal-fetal attachment, a low level of instrumental spousal support during pregnancy, postnatal depressive symptoms, and a poor mother-infant relationship were significantly related to disordered eating at 6 months postchildbirth. CONCLUSION: Findings suggested that the transition to motherhood is a period of stress that may either precipitate or exacerbate disordered eating.

Adaptation, Psychological↗
PubMed2005

Gender differences among spouses of surgeons.

BACKGROUND: The goal of this study was to identify whether gender differences exist regarding the degree of spousal support for, satisfaction with, and perception of surgeons' careers. METHODS: A survey was performed of spouses of academic surgeons in the United States and Canada. RESULTS: Female respondents were significantly less likely to work outside of the home and were significantly more likely to be the major decision-makers at home. They were less likely to credit their surgeon spouses with contributing to household duties and childcare. If both spouses worked outside of the home, the female spouse was still more likely to be the major decision maker. Overall, male and female respondents rated their role in and their satisfaction with their spouses' career choices similarly. CONCLUSIONS: Male and female spouses contribute equally to the career choices of their surgeon spouses. However, female spouses, both surgeon and nonsurgeon, are more likely to make the majority of the decisions at home and contributions to household care.

Adult↗
PubMedDate not supplied

Male self-disclosure of HIV-positive serostatus to sex partners: a review of the literature.

HIV-positive men face multiple challenges when deciding whether to disclose their serostatus to sex partners. The purpose of this literature review (1996-2004) is to identify valid and reliable research results that identify factors influencing serostatus disclosure to sex partners by men who are HIV-positive. Articles included in the review were identified through an electronic search using pertinent terms related to disclosure to sex partners, followed by a search of references for additional articles. A compilation of research results for 17 articles is presented under the headings of background, contextual, and psychosocial factors influencing disclosure. An analysis of the data suggests that differences in disclosure rates vary based on sex partner factors including serostatus, relationship status, and number of sex partners. Rates of disclosure to primary sex partners ranged from 67% to 88%, suggesting that nearly one third of main sex partners were not disclosed to and were at risk of contracting HIV, whereas a pattern of lower disclosure among casual partners was evident. As the number of sex partners increased, the likelihood of disclosure to all sex partners decreased, ranging from one quarter (25%) to slightly over half (58%). In addition, perceived efficaciousness and positive outcome expectations were the most frequent theoretical constructs embedded in the research associated with disclosure, suggesting that these factors play an important role in the process of disclosure to sex partners. Interpersonal factors that positively influenced self-disclosure included spousal support, emotional investment, and communication about safe sex, including asking about a partner's serostatus. Self-disclosure was not consistently associated with safer sex. Recommendations for future research are presented, based on the results included in this review.

Age Factors↗
PubMed2006

Chronic pain in a couples context: a review and integration of theoretical models and empirical evidence.

UNLABELLED: Researchers have become increasingly interested in the social context of chronic pain conditions. The purpose of this article is to provide an integrated review of the evidence linking marital functioning with chronic pain outcomes including pain severity, physical disability, pain behaviors, and psychological distress. We first present an overview of existing models that identify an association between marital functioning and pain variables. We then review the empirical evidence for a relationship between pain variables and several marital functioning variables including marital satisfaction, spousal support, spouse responses to pain, and marital interaction. On the basis of the evidence, we present a working model of marital and pain variables, identify gaps in the literature, and offer recommendations for research and clinical work. PERSPECTIVE: The authors provide a comprehensive review of the relationships between marital functioning and chronic pain variables to advance future research and help treatment providers understand marital processes in chronic pain.

Caregivers↗
PubMed2006

A family consultation intervention for health-compromised smokers.

Although spousal support predicts the success of a smoker's cessation efforts, "social-support" interventions based on teaching partners better support skills have had consistently disappointing results. We examined the potential utility of a family consultation (FAMCON) intervention based on family-systems principles in a treatment-development project involving 20 couples in which one partner (the primary smoker) continued to smoke despite having or being at significant risk for heart or lung disease. The 50% rate of stable abstinence achieved by primary smokers over at least 6 months exceeds benchmark success rates reported in the literature for other comparably intensive interventions, suggesting that a couple-focused intervention different in concept and format from social-support interventions tested in the past may hold promise for health-compromised smokers. The FAMCON approach appeared particularly well suited to female smokers and smokers whose partner also smoked--two subgroups at high risk for relapse.

Adaptation, Psychological↗
PubMed2002

Interleukin-10 levels in seminal plasma: implications for chronic prostatitis-chronic pelvic pain syndrome.

PURPOSE: Chronic prostatitis-chronic pelvic pain syndrome is a disease of unknown pathogenesis. We investigated whether the chronic inflammation and pain experienced by patients may be caused by an imbalance of proinflammatory versus anti-inflammatory cytokines within the prostate, namely interleukin (IL)-8, interferon-gamma and IL-2 versus IL-10. We measured these inflammatory cytokines in seminal plasma as a reflection of the prostate environment. MATERIALS AND METHODS: We measured levels of IL-8, interferon-gamma, IL-2 and IL-10 in the seminal plasma of 31 patients with chronic prostatitis-chronic pelvic pain syndrome and 14 controls using enzyme-linked immunosorbent assay. Results were correlated with health related quality of life, as measured by the Multidimensional Pain Inventory, McGill pain questionnaire and International Prostate Symptom Score. RESULTS: The cytokines analyzed were detectable in the seminal plasma of patients with chronic prostatitis-chronic pelvic pain syndrome and controls. Interferon-gamma, IL-2 and IL-10 levels were statistically greater in patients. Furthermore, IL-10 levels correlated directly with measures of life interference (r = 0.52, p <0.01) and pain severity (r = 0.53, p <0 0.01), and inversely with spousal support (r = -0.39, p <0.04). CONCLUSIONS: Our study suggests that IL-10 may have a role in the pain symptoms experienced by patients with chronic prostatitis-chronic pelvic pain syndrome.

Adult↗
PubMed1990

Long-term effects of testicular cancer on marital relationships.

Thirty-four long-term survivors of testicular cancer and their wives were interviewed individually almost four years past the end of treatment to measure psychological and relationship functioning. Factors identified as important for couple adjustment to cancer--good communication, spousal support, and marital satisfaction--all acted positively to facilitate functioning in this sample. Good psychological adjustment was reflected in scores on the POMS, CES-D, Sense of Coherence, and Relationship Dimension of the Family Environment Scales. Several couples demonstrated lasting impairment, but, overall, the great majority of relationships were strengthened and couples emerged more tightly bonded.

Adolescent↗
PubMed2002

Coping by redefinition: cognitive appraisals in mothers of children with autism and children without autism.

To test a model of how mothers cope with the stresses of raising a child with autism (Tunali & Power, 1993), mothers of children with and without autism were interviewed. As predicted, mothers of autistic children: (1) placed less emphasis on career success and were more likely to believe that mothers of young children should not work outside of the home; (2) spent more leisure time with their extended family; (3) placed less emphasis on others' opinions of their child's behavior; (4) placed more emphasis on spousal support and parental roles in their discussions of marriage; (5) had more difficulty understanding their child's behavior; and (6) showed a marginally significant difference in their tolerance of ambiguity. Moreover, mothers of children with autism who showed these characteristics had the greatest life satisfaction overall.

Adaptation, Psychological↗
PubMed2001

Adult attachment and the transition to parenthood.

This study examined how a major life stressor--the transition to parenthood--affects marital satisfaction and functioning among persons with different attachment orientations. As hypothesized, the interaction between women's degree of attachment ambivalence and their perceptions of spousal support (assessed 6 weeks prior to childbirth) predicted systematic changes in men's and women's marital satisfaction and related factors over time (6 months postpartum). Specifically, if highly ambivalent (preoccupied) women entered parenthood perceiving lower levels of support from their husbands, they experienced declines in marital satisfaction. Women's ambivalence also predicted their own as well as their husbands' marital satisfaction and functioning concurrently. The degree of attachment avoidance did not significantly predict marital changes, although women's avoidance did correlate with some of the concurrent marital measures. These findings are discussed in terms of attachment theory.

Adaptation, Psychological↗
PubMed1997

Child-care satisfaction: linkages to work attitudes, interrole conflict, and maternal separation anxiety.

Analysis of a 20-item measure of child-care satisfaction (CCS) revealed 3 interpretable factors: Caregiver Communication, Dependability, and Attentiveness. These CCS factors were used, along with employer sensitivity to child-care needs and spousal support, in hierarchical multiple regressions to predict various measures of work attitudes and role strain. Replicated across 2 samples of employed women, the CCS factors demonstrated differential patterns of relationships in which Caregiver Attentiveness was associated with lower professional-self role conflict and higher levels of affective organizational commitment and job satisfaction, whereas Caregiver Communication was associated with lower levels of both professional-parent conflict and maternal separation anxiety. These findings support the position that CCS is central to the functioning of employed mothers in both work and family domains.

Adult↗
PubMedDate not supplied

The role of spouses of substance abusers in treatment: gender differences.

Studies exploring gender differences among substance abusers in treatment have been fairly consistent in finding that females who enter treatment express more severe psychological and psychosocial disturbances than males, despite presenting with shorter and less intense substance abuse histories. However, strands of evidence suggest that the presence of a spouse, generally perceived as an asset in the treatment of the substance abuser, may have different implications for females than for males. In order to clarify this issue, 67 male and 18 female married substance abusers in treatment and their spouses were questioned on their substance use and psychological and social functioning. Similar to other studies, the female substance abusers reported greater disturbance on dimensions of employment and psychological functioning, but less severity of alcohol abuse. Comparison of male and female spouses, however, revealed that male spouses were likely to present with the following characteristics: (1) more symptoms of substance abuse and depression, (2) less overall physical well-being, and (3) to be less inclined to help others or be involved with their children than the female spouses. These findings are consistent with the view that the process of substance abuse is telescoped in females and is associated with more disturbed functioning in women on admission to treatment than in men. However, contextual differences--specifically in terms of availability of spousal support--may contribute significantly both to the understanding of differences in female versus male substance abusers in treatment as well as to the development of guidelines for adapting treatment based on gender.

Adult↗
PubMedDate not supplied

Contraceptive practices before conception and after the birth of a child with a chronic health problem.

Sexual and marital relations as well as family functioning may be altered by the birth of a child with a chronic health problem. After the birth of a child with a health problem, mothers have varied responses from an urgent desire to have another baby to a firm desire to avoid pregnancy. Mothers of healthy infants and mothers of infants who had been placed on apnea monitors for at least 5 months were surveyed on their contraceptive practices, family functioning, their marital satisfaction and sexual satisfaction, as well as their desire to have or not have another child. Surveys were conducted at 6 months and 12 months after delivery. The type of contraception used varied significantly between the two groups of mothers. There was an increase in the use of oral contraception after birth for the women whose infants were on apnea monitors. Frequency in the use of contraception varied between the two groups, with the mothers of healthy infants reporting more consistent use prior to the pregnancy, which was also more frequently planned than in the apnea group. Correlation matrices demonstrated a significant relationship between type of contraception and marital satisfaction, employment, and spousal support. The findings reinforce the need for health professionals to assist families in identifying how the birth of a child with chronic health problems has affected the family. Contraception counseling as well as marital counseling may be needed for some families.

Apnea↗
PubMed2005

Associations of psychosocial factors with the stress of infertility treatment.

This study investigated psychosocial factors thought to be associated with perceived stress over the course of infertility treatment. The research was based on secondary analysis of data from the Study of Marriage, Family, and Life Quality with a sample of 128 people who completed an infertility-related stress instrument at all three measurement intervals (1988, 1999, and 1990). Self-esteem and perceived health were associated with stress at the study baseline, importance of a biological family and extent of spousal support associated with stress at the 12-month follow-up, and factors pertaining to infertility treatment (number of treatments, relationship with physicians) associated with stress at the 24-month follow-up. Self-esteem was the only psychosocial factor associated with change in stress over the course of treatment. Social workers and health care professionals should be sensitive to the emotional experiences of couples during infertility treatment. Identifying factors explaining stress, or that may be targets for intervention, has significance for social workers in health care and other settings.

Adult↗
PubMed2003

Married women's satisfaction with their choice of contraception.

Fertility reduction has been promoted in Taiwan for almost 40 years. However, little research has been done into women's satisfaction with the methods of contraception they use. The purpose of this study is to explore their level of satisfaction, along with the related factors of demographic data, giving birth and types of contraceptives used. Employing a cross-sectional design, self-administered questionnaires were distributed to women in the northern area of Taiwan. Purposive sampling was used to collect data from 97 women. The results reveal a mean age of 37.21 years. The mean length of marriage was 13.53 years. The majority (43.29 %) of the subjects were graduates of high school or vocational school. Of the subjects, 92.78 % had given birth, while 35.05 % had experienced abortion. IUDs (Intrauterine Devices) were the most commonly used form of contraceptive, while 63.92 % used other types. Satisfaction was divided into four categories: satisfaction with contraceptive services, satisfaction with contraceptive knowledge source, satisfaction with contraceptive experience and satisfaction with spousal support. Overall, subjects were happy with the contraceptive methods they used. There was no statistical difference in satisfaction between demographic variances, fertility or contraceptive methods applied. Though subjects showed satisfaction with contraception, we feel women's subjective experiences should be investigated in order to promote even better satisfaction. Possible future studies could include random sampling and an examination of the related factors of contraceptive satisfaction.

Adult↗
PubMed2004

A comparative study of expectant parents ' childbirth expectations.

The purpose of this study was to understand childbirth expectations and differences in childbirth expectations among expectant parents. For convenience sampling, 200 couples willing to participate in this study were chosen from two hospitals in central Taiwan. Inclusion criteria were at least 36 weeks of gestation, aged 18 and above, no prenatal complications, and willing to consent to participate in this study. Instruments used to collect data included basic demographic data and the Childbirth Expectations Questionnaire. Findings of the study revealed that (1) five factors were identified by expectant parents regarding childbirth expectations including the caregiving environment, expectation of labor pain, spousal support, control and participation, and medical and nursing support; (2) no general differences were identified in the childbirth expectations between expectant fathers and expectant mothers; and (3) expectant fathers with a higher socioeconomic status and who had received prenatal (childbirth) education had higher childbirth expectations, whereas mothers displayed no differences in demographic characteristics. The study results may help clinical healthcare providers better understand differences in expectations during labor and birth and childbirth expectations by expectant parents in order to improve the medical and nursing system and promote positive childbirth experiences and satisfaction for expectant parents.

Adult↗
PubMed1993

What triggers the resolution of alcohol problems without treatment.

This study investigated natural recoveries (self-change) from alcohol problems, and overcame several methodological problems that affected the few previous studies of this phenomenon. Three groups of individuals who had resolved an alcohol problem without treatment were interviewed about their drinking history, life events that occurred during the year prior to their resolution, and factors that helped maintain their resolution. As a control for prevalence of life events, a control group of nonresolved, nontreated alcohol abusers were interviewed about events in a randomly selected year. Collaterals were interviewed for all subjects. No life event or constellation of events was differentially associated with the resolutions across the three resolved groups or differentiated the resolved and nonresolved groups. Interviews with resolved subjects were qualitatively analyzed-the majority (57%) of recoveries were characterized as involving a "cognitive evaluation" or appraisal of the pros and cons of drinking. Spousal support was reported by the greatest number of resolved subjects as having helped them maintain their resolution. Findings from this study may provide direction for developing new treatment strategies and for accelerating self-change among problem drinkers in the community. The study also demonstrates the importance of using a control group, without which very different conclusions might have been drawn.

Adult↗
PubMed1995

Admission health status differences of black and white indigent nursing home residents.

OBJECTIVE: To compare the health status of newly admitted lower socioeconomic status (SES) southern black (n = 81) and white (n = 53) nursing home residents. DESIGN: The study data were part of a larger prospective study on the health of newly admitted nursing home residents. SETTING: A 575-bed, government-funded nursing home providing care for indigent residents in a large southern city. PARTICIPANTS: Newly admitted black and white nursing home residents aged 60 and older. MEASUREMENTS: Mental status was measured using the Short Portable Mental Status Questionnaire, activities of daily living by Scaled Outcome Criteria, and medical status by medical diagnoses and medications. MAIN RESULTS: Blacks entering the nursing home were more cognitively and functionally impaired and had 3.7 years less education than white residents, but average age was not significantly different for black and white residents. CONCLUSIONS: Many common health status measures showed no significant black-white differences for institutionalized older adults when region and SES were constants. However, mental status, self-care activities, and marital status were significantly different. These findings indicate a possible impact of lifelong poverty or low educational attainment on the increased disability of indigent black older adults. Black residents in our study had less spousal support to remain in the community.

Activities of Daily Living↗