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PubMed1991

Nutrition information needs during cardiac rehabilitation: perceptions of the cardiac patient and spouse.

A survey instrument, which was developed from personal interviews with participants in a cardiac rehabilitation program, was administered at two hospital-based Phase II cardiac rehabilitation programs. Thirty-five patients (28 men, 7 women) and 29 spouses (5 men, 24 women) responded to survey items designed to investigate how subjects perceived themselves dealing with the cardiac diet, what questions they were asking, and how answers to those questions would help them. Subjects in the patient group (which was 80% male) most frequently asked questions dealing with compliance and the diet's benefits. Subjects in the spouse group (which was 83% female) most frequently asked questions relating to food selection. Participants indicated that having their questions answered would help them make decisions, be motivated, feel in control, and plan. Participants' overall attitude toward the diet was positive because patients were willing to make changes in their diet; however, more than half the sample thought food labels were difficult to understand and grocery shopping was difficult. We conclude that nutrition education programs that address individual needs and uses for nutrition information could enhance the learning process in group settings such as cardiac rehabilitation programs.

Adult↗
PubMed1991

Problems and coping strategies of individuals with traumatic brain injury and their spouses.

A pilot investigation is reported on the problems and coping strategies of 20 married men and 11 married women with traumatic brain injury (TBI) and their able-bodied spouses. All injured subjects experienced severe head injury at least one and a half years earlier. A structured, small-group discussion process was used to elicit a prioritized list of problems and a similar list of coping strategies. Individuals with TBI and their spouses identified problems in living as most important; loss of employment and restrictions on autonomy were reported as the most problematic. Men with TBI placed priority on controlling their anger, whereas, women with TBI were concerned with their mood disorders, particularly depression. Women with TBI and able-bodied wives of men with TBI placed high priority on the use of support groups as a coping strategy. Men placed higher priority on individualistic approaches to adjustment, such as suppression of feelings. A number of testable hypotheses resulted from the pilot study.

Activities of Daily Living↗
PubMed1989

Observations of a support group for automatic implantable cardioverter-defibrillator recipients and their spouses.

We studied the use of an 8-week group support intervention with recipients of automatic inplantable cardioverter-defibrillators (AICDs) and evaluated the effect of this treatment on both patients and spouses. Patients attending the Rhode Island Hospital Arrhythmia Clinic formed the study population. Six patients and their spouses formed the treatment group. Six patients living a distance (greater than 25 miles) from the hospital who were not able to attend the sessions formed a natural comparison group. Outcome was reported by a descriptive analysis of the group experience and assessment of changes in role functioning and psychologic adaptation after the intervention. Study results supported our hypothesis that group therapy was an effective treatment modality in promoting positive adjustment of patients to the AICD device. Furthermore, trends emerged suggesting positive shifts in both role functioning and psychologic adjustment in patients attending group sessions. These findings suggest that group therapy is a useful method of providing support and education for individuals receiving the AICD device.

Adaptation, Psychological↗
PubMed1989

Coping with cancer: the spouse's perspective.

This study explored coping difficulties experienced by wives of patients with a diagnosis of cancer. Concomitantly, the study explored the ways in which nurses intervened to help these wives. This study was designed as an exploratory study. The qualitative analysis made use of data derived from responses to open-ended questions presented to the respondents by the interview method. The study sample consisted of 40 wives who acknowledged experiencing coping difficulties in meeting the demands of everyday living as a result of their husband's diagnosis of cancer. Respondents were selected randomly from seven eligible representative settings located in the Mid-Atlantic region until the desired sample number was reached. Wives, who encountered the unexpected and uncontrollable situation of having a husband with diagnosed cancer, experienced a multitude of coping difficulties. In addition, wives underwent psychological disorganization, disequilibrium, and emotional imbalance. They attempted to cope with the resulting imbalance by using their habitual problem-solving behavior patterns and experienced difficulty when seeking situational supports. This, in turn, added to their stress. Wives also reported that their children had coping difficulties. Wives identified listening, talking, caring, availability of nurses to patients and patients' spouses, sensitivity, empathy, and honesty as essential helpful nursing behaviors. The study underscored the importance of viewing wives of cancer patients as unique systems in need of therapeutic support, and reaffirmed a view of nursing as the art of understanding the unique needs of individuals who are experiencing coping difficulties. This study also underscored the key role of psychiatric liaison nurses in providing supportive therapeutic interventions to the spouses of cancer patients as well as to the nursing staff.

Activities of Daily Living↗
PubMed1989

The relationship among background characteristics, purpose in life, and caregiving demands on perceived health of spouse caregivers.

Little is known about the impact on the family at home of managing the final course of cancer. Research to date has focused on the negative impact of physical caregiving on the caregiver's physical and emotional well-being. Limited information exists about other dimensions of the experience which may serve to buffer or prevent negative health outcomes. The purposes of this study were to examine the effect of personal meaning and the experience of caregiving on spouse caregiver health. Cross-sectional data were obtained from interviews with 65 spouse caregivers of persons with advanced cancer. Findings from the multiple regression analysis revealed that sense of purpose in life (Beta = .32, p less than or equal to .05) and the caregiver's level of uncertainty (Beta = -.46, p less than or equal to .01) were statistically significant predictors of health. The results of this study suggest that a stronger sense of purpose in life is positively associated with perceived health. Further, the finding that a higher level of caregiver uncertainty is negatively associated with health suggests the need for nursing interventions to assist caregivers to cope with their role.

Adaptation, Psychological↗
PubMed1985

HTLV-III/LAV antibody status of spouses and household contacts assisting in home infusion of hemophilia patients.

Thirty-four adult and pediatric hemophilia A and B patients and 50 nonhemophilic members belonging to 28 families were enrolled in August 1984 in a study of human T cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) antibody status and T cell subpopulation numbers. All 50 household contacts, including three spouses of LAV antibody-positive adult hemophiliacs, were immunologically normal and serologically negative with respect to HTLV-III/LAV. Based on Western blot serologic testing of blood samples collected intermittently between July 1981 and August 1984 from 33 representative St Louis hemophiliacs studied during the period from 1981 to 1984, the average time since seroconversion was estimated as 20 months. One spouse of a seropositive hemophiliac and 23 parents of 27 seropositive pediatric hemophiliacs assisted regularly with home infusions. These infusion assistants have collectively experienced 44 person-years of concentrate infusion "exposure" without seroconversion. These results suggest that the likelihood for transmission of HTLV-III/LAV from hemophiliacs to persons assisting in their therapy is extremely low.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Occupational hearing loss: an aural rehabilitation program for workers and their spouses, characteristics of the program and target group (participants and nonparticipants).

Until very recently, aural rehabilitation programs designed specifically for workers with occupational hearing loss were nonexistent in the Province of Quebec. A pilot study has been conducted to test and develop suitable services for these workers and their spouses, and to explore the factors causing them to seek (or on the other hand, avoid) professional assistance. A trial rehabilitation program was set up for this purpose. Results of a questionnaire conducted among program participants showed that the main factors leading to enrollment in the program were the acknowledgement of moderate or severe hearing handicap and the recognition of the need for help (particularly with problems such as tinnitus and stress, and in using strategies to facilitate communication). These results lend support to the idea of adopting a new approach to rehabilitation services for occupational hearing loss workers. According to the findings of the study, only a very small percentage of workers and spouses participated in the rehabilitation program, despite measures taken to adapt it to their needs. Low enrollment in the rehabilitation program suggests the need for: (1) a more well-defined target population, (2) strategies to promote greater understanding, awareness, and acceptance of hearing handicap on the part of occupational hearing loss workers and peoples surrounding them, (3) education at the work place and in society in general to increase motivation and awareness of the benefits of aural rehabilitation services, (4) integration of the program within the general health program in the work place, (5) measures to enhance the credibility of professionals in the rehabilitation services, (6) general and specific programs and follow-up services, and (7) more accessible services.

Combined Modality Therapy↗
PubMed1987

Illness of spouse and psychological well-being in older adults.

The purpose of this study is to determine whether illness of a spouse is a source of significant psychological distress for older adults. In addition, we also examine whether two intervening variables (chronic financial strain and chronic marital strain) might explain why this relationship exists. A final goal of this study was to determine whether gender differences exist in the relationships among these indicators. Findings from a random community survey of elderly people suggest that while illness of spouse exerts significant direct effects on depression for both older men and older women, the indirect effects through financial and martial strain are largely restricted to elderly women.

Aged↗
PubMed1978

Home or hospital? Terminal care as seen by surviving spouses.

Among 276 married patients with cancer under the age of 65 who died in two South London boroughs during the period 1967 to 1971, 41 were still under active treatment at the time of death. I studied the remaining 85 per cent who experienced some form of terminal care, and in particular compared reports by the surviving spouses of 65 patients whose care was home-centred and 100 hospital-centred patients.Although home-centred care was most often chosen for patients who were said to have had little severe pain before the period of terminal care, during that period there was a sharp increase in reports of pain, much of it severe and unrelieved. Hospital-centred patients were said to have had much less pain and more confusion during the final phase of care and were more likely to have been confined to bed than those at home. The amount of anxiety reported by the patient's spouse was not markedly different under the two patterns of care, nor did the pattern of care influence subsequent adjustment to bereavement.Qualitative differences between the two groups are considered and it is concluded that although home-centred care can be successful it is often associated with unnecessary suffering. Implications for the home care of the terminally ill are discussed.

Female↗
PubMed1984

Nontransmission of T-cell subset abnormalities from hemophiliacs to their spouses.

Hemophiliacs who are exposed to pooled clotting factor concentrate constitute one group at increased risk for development of acquired immune deficiency syndrome. To determine the prevalence of cellular immune aberrations in asymptomatic hemophiliacs, we studied a group of 65 adult hemophiliacs for T-cell subset abnormalities. Sixty-five percent of concentrate recipients had an abnormal T-helper to T-suppressor cell ratio, 40% had a depressed absolute T-helper cell level, and 29% had an elevated absolute T-suppressor cell count. To determine whether horizontal transmission of T-cell subset abnormalities from hemophiliacs to their female sexual partners occurred, we studied 41 spouses. We found no correlation between paired husband and wife values for T-cell ratio or any other immune parameter studied. There were no significant differences found between wives of hemophiliacs with reversed T-cell ratios and wives of hemophiliacs with T-cell ratios of 1.0 or greater, with respect to immunologic tests. We conclude that there is no evidence to date for heterosexual or household-contact transmission of T-cell subset abnormalities from hemophiliacs to their spouses in our study population.

Adolescent↗
PubMed1980

Huntington's chorea. Its impact on the spouse.

Huntington's chorea imposes a direct imprint on the life of the spouse of the affected patient. Interviews with 15 wives of patients with Huntington's chorea revealed that none of them knew prior to marriage of the presence of a heritable disease within the husband's family. When informed of the diagnosis, the wife reacted with disbelief and denial. As she became aware of the steady progression of the disease and the threat of transmission to her children, her response changed to resentment and hostility. The disease permeated the entire life of the unaffected spouse: her life style, family responsibility, goals, and marital relationship. In essence, the wife became inextricably involved in the disease and suffered continuous trauma from it.

Adjustment Disorders↗
PubMed1980

Nutritional knowledge and health goals of young spouses.

Decision-making processes relevant to food practices of young spouses were studied by means of the adoption model. Data on demographic information, nutritional knowledge, mastery orientation, and health goals of husbands and wives were analyzed for the first of a two-phase adoption process. In general, low importance was placed on goals reflecting concern with quality of diets. Nutritional knowledge of husbands was negatively related to the importance they placed on health goals, while both parameters were positively related for wives. Although nutritional knowledge of husbands was not related to that of their wives, the importance spouses placed on health goals was.

Adult↗
PubMed1994

When mom or dad has cancer: markers of psychological distress in cancer patients, spouses, and children.

This study assessed anxiety/depression and stress response symptoms in adult cancer patients (n = 117), spouses (n = 76), and their children (n = 110, ages 6 to 30 years old) near the patients' diagnoses to identify family members at risk for psychological maladjustment. Patients' and family members' distress was related to appraisals of the seriousness and stressfulness of the cancer but not related to objective characteristics of the disease. Patients and spouses did not differ in anxiety/depression or in stress-response symptoms. Both stress-response and anxiety/depression symptoms differed in children as a function of age, sex of child, and sex of patient. Adolescent girls whose mothers had cancer were the most significantly distressed. Implications for understanding the impact of cancer on the family are highlighted.

Adaptation, Psychological↗
PubMed1993

Cooperative learning as an approach for educating diabetic patients and their spouses.

The purpose of this quasi-experimental pilot study was to investigate the effectiveness of applying cooperative learning theory when educating persons with diabetes and their spouses. The target population were patient-spouse pairs who had attended a diabetic outpatient program within the past 2 years. Members of the experimental group employed cooperative learning strategies to review information about diabetes; members of the control group were provided with a lecture reviewing information about diabetes. Results suggested an increase in knowledge about diabetes in both groups. Although the experimental group reported a favorable attitude toward cooperative learning, the results did not demonstrate that the cooperative learning instructional method contributed to more improved learning than the lecture method. Limitations of the study methodology are discussed to better understand the results.

Diabetes Mellitus↗
PubMed1993

Dependent care, caregiver burden, and self-care agency of spouse caregivers.

A convenience sample of 113 spouse caregivers was used to examine the relationships between dependent care, caregiver burden, and self-care agency. Subjects were the spouses of radiation oncology or chemotherapy patients in a large metropolitan hospital. The Denyes Self-Care Agency Instrument was used to measure self-care agency. The Task Scale was used to operationalize dependent care, and the Burden Scales were used to measure caregiver burden. Demographic data were collected on the number of weeks in the caregiver role, presence of health problems in the caregiver, gender, age, income, and education. In the total sample, subjective burden was negatively and significantly related to self-care agency and objective burden, in addition, dependent care and objective burden were also negatively related. When the data were divided into subsamples based on gender, several of the relationships were in opposite directions. The most notable of these were the relationships between dependent care and self-care agency. It is evident that interventions should take these gender differences into account.

Activities of Daily Living↗
PubMed1993

Family treatment of spouses and children of patients with multiple personality disorder.

Although there is a large body of literature on the individual treatment of patients with multiple personality disorder (MPD), there are few accounts of the treatment of the spouses and children of these patients. After reviewing some of the existing literature, the authors present case examples of family work with patients, spouses, and children on two inpatient units and in the partial hospitalization program at Menninger. Techniques for the beginning, middle, and later phases of family treatment are illustrated.

Adult↗
PubMed1996

Chronic sorrow in persons with Parkinson's and their spouses.

Chronic sorrow is the grief experienced from continual loss during the trajectory of an illness or disability. The presence and nature of chronic sorrow were determined in a sample of six persons with Parkinson's disease and four of their spouse caregivers using the Burke NCRCS Questionnaire. Four of the afflicted individuals and two of the spouse caregivers reported symptoms of chronic sorrow that for half of them were more intense than at the time of diagnosis. Respondents used extensive problem-solving and emotive coping strategies to handle their sorrow. Most of the respondents described themselves within the context of the illness and the care required. Losses triggering their sorrow included loss of future plans, restricted social life, and inability to travel and participate in hobbies. Support from others was restricted mainly to physicians at the time of diagnosis and close family. Supportive nursing interventions for their grief are indicated.

Adaptation, Psychological↗
PubMed1996

Hard times and hurtful partners: how financial strain affects depression and relationship satisfaction of unemployed persons and their spouses.

The process linking unemployment and economic hardship to depression and marital or relationship satisfaction in couples was examined. Using structural equation modeling, the authors tested models in which financial strain and partners' symptoms of depression influence the behavioral exchange of the couples in terms of social support and social undermining and, in turn, the effects of support and undermining on relationship satisfaction and depressive symptoms. The analyses were based on longitudinal data from 815 recently unemployed job seekers and their spouses or partners. The results demonstrated that financial strain had significant effects on depressive symptoms of both partners, which in turn led the partner to withdraw social support and increase social undermining. Reduced supportive and increase undermining behaviors had additional adverse effects on satisfaction with the relationship and on depressive symptoms.

Depression↗